OF PROFESSIONAL INTEREST

A new food guide for North American vegetarians

VIRGINIA MESSINA, MPH, RD; VESANTO MELINA, MS, RD; ANN REED MANGELS, PhD, RD, FADA

he first North American food guide was published by the To establish a guide that would meet the needs of people

T
■
US Department of Agriculture (USDA) in 1916. It was not following different types of vegetarian diets;
until the 1940s, however, when wartime shortages, indica- ■ To help vegetarians choose diets that would meet the most
tions of malnutrition among citizens, and the release of the first recent recommendations established by the Institute of Medi-
recommended dietary allowances focused greater attention on cine;
nutrient requirements, that food guides became a familiar ■ To include guidelines that focus on specific nutrients of par-
meal-planning tool in the United States (1). The Canadian gov- ticular interest in vegetarian diets, as discussed in the Ameri-
ernment released its first food guide at this time, in 1942 (2). can Dietetic Association (ADA) and Dietitians of Canada’s joint
Until 1992, when the USDA’s Food Guide Pyramid (3) and position on vegetarian diets in this issue of the Journal of the
Canada’s Food Guide to Healthy Eating (CFGHE) (2) with its American Dietetic Association (7,8);
rainbow design were introduced, the emphasis of food guides ■ To include a wide variety of foods that are consumed by
was largely placed on meeting nutrient needs. vegetarians; and
The 1992 guides were the first to consider the harmful ■ To increase awareness about the availability of calcium from
effects of overnutrition. They were also the first guides to nondairy foods.
visually emphasize the importance of plant foods in the diet. In addition, we strived to meet the challenge spelled out in
However, they did not include sufficient guidelines for plan- the 1981 issue of the Journal of Nutrition Education by
ning vegetarian diets. USDA publications noted that vege- then US Food and Drug Administration (FDA) nutritionist
tarians needed special guidance in planning healthful diets, Jean Pennington for an “instrument which converts the pro-
implying that the USDA’s food guide was not appropriate for fessional’s scientific knowledge of food composition and nu-
vegetarians (4). trient requirements for health into a practical plan for food
Over the past several decades, a number of meal-planning selection by those without training in nutrition” (9).
tools have been developed specifically for vegetarians (5,6). Challenges in designing such a guide exist regardless of
The majority of these have used the pyramid format or the dietary pattern. Individual food preferences, habits, and
rainbow design, and many have been revised versions of the choices within food groups will all impact diet quality. Al-
USDA’s Food Guide Pyramid and CFGHE. However, because though no food guide is completely reliable, a food guide can
vegetarian diets differ in many ways from nonvegetarian diets, maximize the chances that consumers will choose healthful
the USDA Food Guide Pyramid and CFGHE are not necessarily diets. The inclusion of “Eight Tips for Meal Planning” (Fig-
the most useful starting point when considering guidelines for ure 1) provides additional help to vegetarians in planning
vegetarians. It is particularly difficult to manipulate these tools healthful diets.
when attempting to provide adequate and practical guidelines
for vegans (vegans are vegetarians who exclude all animal FOOD GROUPS
products). The food guide principle that has been in use in North America
In designing a new food guide for vegetarians, we aimed to since 1916 is based on an approach that classifies foods into
achieve the following goals: groups based on similar nutrient content. We have adhered to
this principle, with some modification. In the vegetarian food
guide, calcium needs are met through choices from several
V. Messina is a nutrition consultant with Nutrition food groups.
Matters, Inc., Port Townsend, WA. V. Melina is a nutrition In keeping with familiar and widely used approaches to food
consultant with Nutrispeak.com, Langley, BC, Canada. guide presentation in North America, we have designed our
A. R. Mangels is a nutrition advisor to The Vegetarian guide in the forms of both a pyramid and a rainbow; the latter is
Resource Group, Baltimore, MD. the graphic used in Canada. Both guides use the same food
Address correspondence to: Virginia Messina, MPH, groupings, specify the same number of servings, and can be
RD, 439 Calhoun St, Port Townsend, WA 98368. E-mail: used interchangeably (Figures 2 and 3).
[email protected] Foods are grouped as follows:
Copyright © 2003 by the American Dietetic Association.
0002-8223/03/10306-0012$35.00/0 Grains: At the base of the pyramid and in the widest arc of
doi: 10.1053/jada.2003.50141 the rainbow, these foods form the foundation of the diet.

Journal of THE AMERICAN DIETETIC ASSOCIATION / 771

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Grains provide energy, complex carbohydrates, fiber, iron,

and B-vitamins. Whole grains are an important source of zinc
and other minerals. Vegetarians should choose whole grains
often, but enriched refined grains can play a role in vegetar-
ian diets and may be especially valuable for children.

Vegetables and fruits: Vegetables have been grouped sep-

arately from fruits to encourage vegetarians to choose a va-
riety of both types of food rather than to focus on one or the
other for most choices. A higher number of servings of veg-
etables is specified because of the greater nutrient density
and phytochemical content of vegetables compared with
fruits.

Legumes, nuts, and other protein-rich foods: This group

includes foods that are good sources of protein, B-vitamins,
and many trace minerals. It includes all legumes, including
soy products such as soy milk and tofu, as well as nuts, seeds,
nut and seed butters, eggs, and meat analogs. In a departure
from most existing food guides, we have placed dairy foods
in this group as well. This groups dairy products with other
foods that offer similar amounts of protein per serving. It
makes dairy an available but optional choice for vegetarians,
while ensuring that protein needs will be met whether or not
dairy foods are included in the diet. Categorizing dairy foods
with other protein sources also meets the goal of emphasiz-
ing the availability of calcium from all of the food groups.
Most of the foods in this group provide iron, which is well
absorbed when a source of vitamin C is consumed with the
meal (10). Dairy foods are the exception here, and those
vegetarians who consume frequent servings of dairy foods
should be advised to ensure that they are including adequate
sources of iron in their meals.

Fats: Vegetarians and others who do not eat fish require

small amounts of plant sources of n-3 fats. In addition, re-
search suggests that moderate intake of certain healthful
plant fats may reduce risk for cardiovascular disease (11),
may improve nutrient intake (12), and may even aid in
weight control (12). Ideally, most of the fat in vegetarian
FIG 1. Tips for meal planning. diets should come from fat-rich whole plant foods such as
nuts, seeds, and avocado. To ensure an optimal fat intake
and to support a practical approach to meal planning, we
have specified a minimum of two servings of fats per day.
Figure 1 indicates that nuts or seeds may be used in place of
these fats and also directs vegetarians toward choosing the
most healthful fats.

Calcium-rich foods: Adults should choose a minimum of

eight servings of calcium-rich foods daily. Each serving also
counts toward choices from one of the other food groups in
the guide. For example, 1 cup of certain cooked leafy green
vegetables counts as a serving from the calcium-rich foods
group and as 2 servings from the vegetable group. Placement
of the calcium food group adjacent to each of the other food
groups allows this concept to be presented in a clear visual
way. It also emphasizes the fact that calcium needs are met
by choosing a variety of foods from across the food groups.
Diets based on the minimum specified servings from each of
the food groups provide approximately 1,400 to 1,500 calories
per day, which may be an inadequate energy intake for many
vegetarians. Because the numbers of servings in the food guide
are minimum recommendations, consumers can meet higher

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FIG 2. Vegetarian food guide pyramid.

energy needs by choosing more servings from any of the food However, not all vegans choose to consume soy milk daily.
groups. Regardless of energy needs, most food choices should Those who do may not wish to consume the two to three
come from these groups, with only moderate servings of sweets recommended servings. For many families, the expense of
and alcohol at most. soy milk compared with cow’s milk makes it an unrealistic
choice as the primary source of calcium in the diet.
EXPANDED CHOICES FOR MEETING CALCIUM This food guide illustrates acceptable choices in addition
NEEDS to dairy foods and fortified soy milk for meeting calcium
Survey data suggest that vegans account for as much as 40% needs. It incorporates the principles of variety and modera-
of the actual vegetarian population (13). Actual vegetarians tion and encourages consumers to consider more plant foods
are those who never eat meat, in contrast to self-described as sources of nutrients. This is in keeping with government
vegetarians, many of whom actually eat some type of animal
recommendations. Although this food guide does not em-
flesh regularly. Therefore, any guide aimed at vegetarians
phasize the value of one calcium source over another, there
must consider the needs of vegans. Studies also indicate that
may be an advantage to including more plant sources of
a substantial percentage of vegan women as well as some
lacto-ovo-vegetarian women (lacto-ovo-vegetarians are calcium in diets because research suggests that other com-
those vegetarians who use dairy products and eggs) have pounds in plant foods, such as isoflavones in soy foods (15)
calcium intakes that are too low, which suggests that cal- and potassium (16) and vitamin K (17) in fruits and vegeta-
cium deserves special attention in vegetarian food guides bles, may favorably impact bone health.
(14). With few exceptions, vegetarian food guides have not By including foods that provide approximately 10% to 15%
provided appropriate guidelines for vegans. A number of (100 to 150 mg) per serving of the adult adequate intake for
guides have included an optional dairy group, which pre- calcium, we have allowed consumers to meet calcium needs
sents the risk that consumers will choose diets that are de- using a variety of foods in realistic serving sizes. Although the
ficient in both calcium and protein. Other guides have in- serving size of one-half cup for milk differs from many other
cluded a dairy group that also includes fortified soy milk. food guides, it is consistent with common serving sizes on many

Journal of THE AMERICAN DIETETIC ASSOCIATION / 773

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FIG 3. Vegetarian food guide rainbow.

Table
Modifications to the vegetarian food guide (Figures 2 and 3) for
children, adolescents, and pregnant and lactating women

Life cycle Food groupa

B-12-rich Beans/nuts/ Calcium-
foods seeds/egg rich foods
(servings) (servings) (servings)

Childb 2 5 6
Adolescentc 2 6 10
Adolescentd 3 6 10
Pregnancy 4 7 8
Lactation 4 8 8
a
The number of servings in each group is the minimum amount needed. The
minimum number of servings from other groups is not different from the
vegetarian food guide (Figures 2 and 3). Additional foods can be chosen from
any of the groups in the vegetarian food guide to meet energy needs.
b
4 to 8 years.
c
9 to 13 years.
d
14 to 18 years.

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food labels, such as on puddings or for use with breakfast ce- other guides for both vegetarians and nonvegetarians direct
reals. consumers only to dairy foods to meet calcium needs, whereas
It should be noted that this approach of emphasizing the this guide emphasizes the wide variety of foods that can meet
variety of calcium-rich foods in different food groups is not calcium requirements.
specific to the needs of vegetarians but could be adopted for ■ It focuses on foods that are commonly consumed by vegetar-
those who consume nonvegetarian diets as well. The advan- ians.
tages of this approach are relevant for all consumers regardless
of diet choices.
References
SPECIAL CONSIDERATIONS FOR VEGETARIANS 1. Hertzler AA, Anderson HL. Food guides in the United States. J Am Diet
Assoc. 1974;64:19-28.
Unsupplemented vegan diets do not provide vitamin B-12. 2. Health Canada, Office of Nutrition Policy and Promotion. Canada’s Food
Dairy products and eggs supply vitamin B-12; however, de- Guides From 1942 to 1992. Available at: http://www.hc-sc.gc.ca/hpfb-dgpsa/
pending on food choices, some lacto-ovo-vegetarians may have onpp-bppn/food_guide_history_int_e.html. Accessed April 3, 2003.
inadequate intakes as well. The Institute of Medicine has rec- 3. Food Guide Pyramid: A Guide to Daily Food Choices. Washington, DC: US
Dept of Agriculture, Human Nutrition Information Service; 1992. Home and
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Vegetarian Diets. J Am Diet Assoc. 2003;103:748-765.
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Figure 1 provides specific guidelines for meeting needs for Committee. Circulation. 1999;100:1253-1258.
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