Dietary patterns among children and adolescents in Germany consuming vegetarian, vegan or omnivore diets: results of the VeChi Youth Study.

Adolescents Children Dietary patterns Nutrient intake Vegan diet Vegetarian diet

Journal

European journal of nutrition
ISSN: 1436-6215
Titre abrégé: Eur J Nutr
Pays: Germany
ID NLM: 100888704

Informations de publication

Date de publication:
23 Sep 2024
Historique:
received: 14 03 2024
accepted: 31 08 2024
medline: 23 9 2024
pubmed: 23 9 2024
entrez: 23 9 2024
Statut: aheadofprint

Résumé

To identify dietary patterns of vegetarian, vegan and omnivore children and adolescents in Germany and to examine associations with nutrient intake. First, three principal component analyses based on 17-22 food groups were used to identify dietary patterns among vegetarians (n = 145, 3-day weighed dietary records), vegans (n = 110) and omnivores (n = 135) from the cross-sectional Vegetarian and Vegan Children and Youth (VeChi Youth) Study (2017-2019, 6-18 years, 57% girls). Secondly, these patterns were correlated (Spearman correlations) with energy and nutrient intakes. Among vegetarians, 3 dietary patterns were identified ("Animal foods", "Vegetables and fruits", "Meat alternatives and potatoes") accounting for 32.7% of the variance in food group intake. In the vegan group, 4 patterns were identified ("Vegetables and legumes", "Refined carbohydrates", "Meat alternatives and juices", "Fruits and convenience foods") accounting for 43.2% of the variance. Among omnivores, 5 ("Flexitarian", "Vegetables and fruits", "Dairy Products", "meat and convenience foods", "Refined grains and juices") patterns accounting for 43.0% of the variance could be identified. Regardless of diet group, both more favorable dietary patterns ("Vegetables and fruits", "Meat alternatives and potatoes", "Vegetables and legumes", "Fruits and convenience food", "Flexitarian") correlated with higher micronutrient density and less favorable dietary patterns ("Animal foods", "Refined carbohydrates", "Meat alternatives and juices", "Dairy products", "Meat and convenience food", "Refined grains and juices") with unfavorable nutrient profiles were found. Various dietary patterns exist within omnivore, vegetarian, and vegan diets of children and adolescents, which differ in their contribution to nutrient intake. It is therefore necessary to distinguish between different dietary patterns, also within the vegetarian and vegan diet.

Identifiants

pubmed: 39311899
doi: 10.1007/s00394-024-03497-6
pii: 10.1007/s00394-024-03497-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Robert Koch-Institut (2016) Verbreitung der vegetarischen Ernährungsweise in Deutschland. RKI-Bib1 (Robert Koch-Institut)
Bundesministeriums für Ernährung und Landwirtschaft (2022) Deutschland, wie es isst: Der BMEL-Ernährungsreport 2022. https://www.bmel.de/SharedDocs/Downloads/DE/Broschueren/ernaehrungsreport-2022.pdf?__blob=publicationFile&v=6 . Accessed 11 Nov 2022
Patelaki E, Lage Barbosa C, Haftenberger M et al (2019) Prevalence of vegetarian diet among children and adolescents in Germany. Results from EsKiMo II. Ernahrungs Umschau 85–91. https://doi.org/10.4455/eu.2019.018
Hemler EC, Hu FB (2019) Plant-based diets for Cardiovascular Disease Prevention: all Plant Foods are not created equal. Curr Atheroscler Rep 21:18. https://doi.org/10.1007/s11883-019-0779-5
doi: 10.1007/s11883-019-0779-5 pubmed: 30895476
Appleby PN, Key TJ (2016) The long-term health of vegetarians and vegans. Proc Nutr Soc 75:287–293. https://doi.org/10.1017/S0029665115004334
doi: 10.1017/S0029665115004334 pubmed: 26707634
Benatar JR, Stewart RAH (2018) Cardiometabolic risk factors in vegans; a meta-analysis of observational studies. PLoS ONE 13:e0209086. https://doi.org/10.1371/journal.pone.0209086
doi: 10.1371/journal.pone.0209086 pubmed: 30571724 pmcid: 6301673
Dinu M, Abbate R, Gensini GF et al (2017) Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr 57:3640–3649. https://doi.org/10.1080/10408398.2016.1138447
doi: 10.1080/10408398.2016.1138447 pubmed: 26853923
Wang F, Zheng J, Yang B et al (2015) Effects of vegetarian diets on blood lipids: a systematic review and Meta-analysis of Randomized controlled trials. J Am Heart Assoc 4:e002408. https://doi.org/10.1161/JAHA.115.002408
doi: 10.1161/JAHA.115.002408 pubmed: 26508743 pmcid: 4845138
Yokoyama Y, Levin SM, Barnard ND (2017) Association between plant-based diets and plasma lipids: a systematic review and meta-analysis. Nutr Rev 75:683–698. https://doi.org/10.1093/nutrit/nux030
doi: 10.1093/nutrit/nux030 pubmed: 28938794 pmcid: 5914369
Ocagli H, Berti G, Rango D et al (2023) Association of Vegetarian and Vegan Diets with Cardiovascular Health: an Umbrella Review of Meta-Analysis of Observational studies and Randomized trials. Nutrients 15. https://doi.org/10.3390/nu15194103
Koller A, Rohrmann S, Wakolbinger M et al (2023) Health aspects of vegan diets among children and adolescents: a systematic review and meta-analyses. Crit Rev Food Sci Nutr 1–12. https://doi.org/10.1080/10408398.2023.2263574
Neufingerl N, Eilander A (2021) Nutrient intake and status in adults consuming plant-based diets compared to Meat-Eaters: a systematic review. Nutrients 14. https://doi.org/10.3390/nu14010029
Rudloff S, Bührer C, Jochum F et al (2019) Vegetarian diets in childhood and adolescence: position paper of the nutrition committee, German Society for Paediatric and Adolescent Medicine (DGKJ). Mol Cell Pediatr 6:4. https://doi.org/10.1186/s40348-019-0091-z
doi: 10.1186/s40348-019-0091-z pubmed: 31722049 pmcid: 6854160
Richter M, Boeing H, Grünewald-Funk D, Heseker H, Kroke A, Leschik-Bonnet E (2016) Vegane Ernährung Position Der Deutschen Gesellschaft für Ernährung e. V. (DGE). Ernährungs Umschau 63:M220–M230
Rivera JA, Hotz C, González-Cossío T et al (2003) The effect of micronutrient deficiencies on child growth: a review of results from community-based supplementation trials. J Nutr 133. https://doi.org/10.1093/jn/133.11.4010S . 4010S-4020S
Bryan J, Osendarp S, Hughes D et al (2004) Nutrients for cognitive development in school-aged children. Nutr Rev 62:295–306. https://doi.org/10.1111/j.1753-4887.2004.tb00055.x
doi: 10.1111/j.1753-4887.2004.tb00055.x pubmed: 15478684
Georgieff MK (2007) Nutrition and the developing brain: nutrient priorities and measurement. Am J Clin Nutr 85. https://doi.org/10.1093/ajcn/85.2.614S . 614S-620S
Alexy U, Keller M, Straub S (2019) Vegetarische oder vegane Ernährung in Der Kindheit – was ist zu Beachten? Kinder- und Jugendarzt 50:240–245
Marczykowski F, Breidenassel C (2017) Vegan diet: reaching the reference values for nutrient intake of critical nutrients: assortment and necessity of fortified foods. Ernährungs Umschau 64. https://doi.org/10.4455/eu.2017.002
Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9. https://doi.org/10.1097/00041433-200202000-00002
doi: 10.1097/00041433-200202000-00002 pubmed: 11790957
Newby PK, Tucker KL (2004) Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 62:177–203. https://doi.org/10.1301/nr.2004.may.177-203
doi: 10.1301/nr.2004.may.177-203 pubmed: 15212319
Ambrosini GL, O’Sullivan TA, de Klerk NH et al (2011) Relative validity of adolescent dietary patterns: a comparison of a FFQ and 3 d food record. Br J Nutr 105:625–633. https://doi.org/10.1017/S0007114510004137
doi: 10.1017/S0007114510004137 pubmed: 21269548 pmcid: 3308192
Flynn AC, Thompson JMD, Dalrymple KV et al (2020) Childhood dietary patterns and body composition at age 6 years: the children of SCOPE study. Br J Nutr 1–21. https://doi.org/10.1017/S0007114520000628
Northstone K, Smith ADAC, Newby PK et al (2013) Longitudinal comparisons of dietary patterns derived by cluster analysis in 7- to 13-year-old children. Br J Nutr 109:2050–2058. https://doi.org/10.1017/S0007114512004072
doi: 10.1017/S0007114512004072 pubmed: 23068994
Richter A, Heidemann C, Schulze MB et al (2012) Dietary patterns of adolescents in Germany–associations with nutrient intake and other health related lifestyle characteristics. BMC Pediatr 12:35. https://doi.org/10.1186/1471-2431-12-35
doi: 10.1186/1471-2431-12-35 pubmed: 22439777 pmcid: 3386018
Richter A, Rabenberg M, Truthmann J et al (2017) Associations between dietary patterns and biomarkers of nutrient status and cardiovascular risk factors among adolescents in Germany: results of the German health interview and examination survey for children and adolescents in Germany (KiGGS). BMC Nutr 3. https://doi.org/10.1186/s40795-016-0123-1
Wolters M, Joslowski G, Plachta-Danielzik S et al (2018) Dietary patterns in Primary School are of prospective relevance for the development of body composition in two German Pediatric populations. https://doi.org/10.3390/nu10101442 . Nutrients 10
Diethelm K, Günther ALB, Schulze MB et al (2014) Prospective relevance of dietary patterns at the beginning and during the course of primary school to the development of body composition. Br J Nutr 111:1488–1498. https://doi.org/10.1017/S0007114513004017
doi: 10.1017/S0007114513004017 pubmed: 24382029
Araújo J, Teixeira J, Gaio AR et al (2015) Dietary patterns among 13-y-old Portuguese adolescents. Nutrition 31:148–154. https://doi.org/10.1016/j.nut.2014.06.007
doi: 10.1016/j.nut.2014.06.007 pubmed: 25466659
Cribb V, Emmett P, Northstone K (2013) Dietary patterns throughout childhood and associations with nutrient intakes. Public Health Nutr 16:1801–1809. https://doi.org/10.1017/S1368980012004132
doi: 10.1017/S1368980012004132 pubmed: 22974523
Smith ADAC, Emmett PM, Newby PK et al (2013) Dietary patterns obtained through principal components analysis: the effect of input variable quantification. Br J Nutr 109:1881–1891. https://doi.org/10.1017/S0007114512003868
doi: 10.1017/S0007114512003868 pubmed: 22950853
Kanellopoulou A, Kosti RI, Notara V et al (2021) Dietary patterns, weight perception and obesity status, among 10-12-year-old children; an epidemiological study in Greece. Child (Basel) 8. https://doi.org/10.3390/children8080626
Barchitta M, Maugeri A, Agrifoglio O et al (2019) Dietary patterns and school performance: evidence from a sample of adolescents in Sicily, Italy. Ann Ig 31:72–80. https://doi.org/10.7416/ai.2019.2279
doi: 10.7416/ai.2019.2279 pubmed: 30994166
Wadolowska L, Kowalkowska J, Lonnie M et al (2016) Associations between physical activity patterns and dietary patterns in a representative sample of Polish girls aged 13–21 years: a cross-sectional study (GEBaHealth Project). BMC Public Health 16:698. https://doi.org/10.1186/s12889-016-3367-4
doi: 10.1186/s12889-016-3367-4 pubmed: 27485607 pmcid: 4971681
Plaza-Díaz J, Molina-Montes E, Soto-Méndez MJ et al (2020) Clustering of Dietary Patterns and Lifestyles Among Spanish Children in the EsNuPI Study †. Nutrients 12. https://doi.org/10.3390/nu12092536
Kafyra M, Kalafati IP, Kumar S et al (2021) Dietary patterns, blood pressure and the Glycemic and Lipidemic Profile of two teenage, European populations. Nutrients 13 https://doi.org/10.3390/nu13010198
Northstone K, Smith ADAC, Cribb VL et al (2014) Dietary patterns in UK adolescents obtained from a dual-source FFQ and their associations with socio-economic position, nutrient intake and modes of eating. Public Health Nutr 17:1476–1485. https://doi.org/10.1017/S1368980013001547
doi: 10.1017/S1368980013001547 pubmed: 23782861
Haider S, Sima A, Kühn T et al (2023) The Association between vegan dietary patterns and physical Activity-A cross-sectional online survey. Nutrients 15 https://doi.org/10.3390/nu15081847
Gallagher CT, Hanley P, Lane KE (2021) Pattern analysis of vegan eating reveals healthy and unhealthy patterns within the vegan diet. Public Health Nutr 1–11. https://doi.org/10.1017/S136898002100197X
Alexy U, Fischer M, Weder S, Längler A, Michalsen A (2020) Vegetarische und vegane Ernährung Bei Kindern Und Jugendlichen in Deutschland – VeChi-Youth-Studie. DGE-Ernährungsbericht, Bonn, pp 289–354, p 14. Deutsche Gesellschaft für Ernährung
Alexy U, Fischer M, Weder S et al (2021) Nutrient intake and status of German children and adolescents consuming vegetarian, vegan or Omnivore diets: results of the VeChi Youth Study. Nutrients 13. https://doi.org/10.3390/nu13051707
Alexy U, Fischer M, Weder S et al (2021) Food group intake of children and adolescents (6–18 years) on a vegetarian, vegan, or omnivore diet: results of the VeChi Youth Study. Br J Nutr 1–26. https://doi.org/10.1017/S0007114521003603
Koebnick C, Garcia AL, Dagnelie PC et al (2005) Long-term consumption of a raw food diet is associated with favorable serum LDL cholesterol and triglycerides but also with elevated plasma homocysteine and low serum HDL cholesterol in humans. J Nutr 135:2372–2378. https://doi.org/10.1093/jn/135.10.2372
doi: 10.1093/jn/135.10.2372 pubmed: 16177198
Winkler J, Stolzenberg H (2009) Adjustierung Des Sozialen-Schicht-Index für die Anwendung Im Kinder- Und Jugendgesundheitssurvey (KiGGS) 2003/2006. Wismarer Diskussionspapiere, 2009, H. 7. Hochsch. Fakultät für Wirtschaftswiss, HWS-Hochsch.-Wismar-Service, Wismar
Booth ML, Okely AD, Chey TN et al (2002) The reliability and validity of the adolescent physical activity recall Questionnaire. Med Sci Sports Exerc 34:1986–1995. https://doi.org/10.1097/00005768-200212000-00019
doi: 10.1097/00005768-200212000-00019 pubmed: 12471306
Ainsworth BE, Haskell WL, Herrmann SD et al (2011) 2011 Compendium of Physical activities: a second update of codes and MET values. Med Sci Sports Exerc 43:1575–1581. https://doi.org/10.1249/MSS.0b013e31821ece12
doi: 10.1249/MSS.0b013e31821ece12 pubmed: 21681120
Butte NF, Watson KB, Ridley K et al (2018) A Youth Compendium of Physical activities: Activity codes and metabolic intensities. Med Sci Sports Exerc 50:246–256. https://doi.org/10.1249/MSS.0000000000001430
doi: 10.1249/MSS.0000000000001430 pubmed: 28938248
Kromeyer-Hauschild K, Moss A, Wabitsch M (2015) Referenzwerte für den body-Mass-Index für Kinder, Jugendliche Und Erwachsene in Deutschland. Adipositas - Ursachen. Folgeerkrankungen Ther 09:123–127. https://doi.org/10.1055/s-0037-1618928
doi: 10.1055/s-0037-1618928
Sichert-Hellert W, Kersting M, Chahda C et al (2007) German food composition database for dietary evaluations in children and adolescents. J Food Compos Anal 20:63–70. https://doi.org/10.1016/j.jfca.2006.05.004
doi: 10.1016/j.jfca.2006.05.004
O’Rourke N, Hatcher L (2014) A Step-by-Step Approach to Using SAS for Factor Analysis and Structural Equation Modeling, Second Edition, Cary, North Carolina
Hatcher L (2007) A Step-by-Step Approach to Using the SAS System for Factor Analysis and Structural Equation Modeling. 9 edition, Cary, North Carolina
Schulze MB, Hoffmann K, Kroke A et al (2001) Dietary patterns and their association with food and nutrient intake in the European prospective investigation into Cancer and Nutrition (EPIC)-Potsdam study. Br J Nutr 85:363–373. https://doi.org/10.1079/bjn2000254
doi: 10.1079/bjn2000254 pubmed: 11299082
Willett WC, Howe GR, Kushi LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65. https://doi.org/10.1093/ajcn/65.4.1220S . 1220S-1228S; discussion 1229S-1231S
Hernes S, Cabo RN, Mansoor MA et al (2012) Eating patterns are associated with biomarkers in a selected population of university students and employees. J Nutr Sci 1:e8. https://doi.org/10.1017/jns.2012.8
doi: 10.1017/jns.2012.8 pubmed: 25191555 pmcid: 4153286
Cohen J (2013) Statistical Power Analysis for the behavioral sciences, 2nd edn. Taylor and Francis, Hoboken
doi: 10.4324/9780203771587
Veganz Group AG (2021) veganz Ernährungsreport: Zahlen 2021. https://veganz.de/wp-content/uploads/2021/11/20211101-veganz-ernaehrungsreport-2021.pdf . Accessed 11 Nov 2022
Deliens T, Mullie P, Clarys P (2022) Plant-based dietary patterns in flemish adults: a 10-year trend analysis. Eur J Nutr 61:561–565. https://doi.org/10.1007/s00394-021-02630-z
doi: 10.1007/s00394-021-02630-z pubmed: 34213604
Dawczynski C, Weidauer T, Richert C et al (2022) Nutrient intake and Nutrition Status in vegetarians and vegans in comparison to omnivores - the nutritional evaluation (NuEva) study. Front Nutr 9:819106. https://doi.org/10.3389/fnut.2022.819106
doi: 10.3389/fnut.2022.819106 pubmed: 35651513 pmcid: 9149309
Craig WJ, Messina V, Rowland I et al (2023) Plant-based dairy Alternatives Contribute to a healthy and sustainable Diet. https://doi.org/10.3390/nu15153393 . Nutrients 15
Gehring J, Touvier M, Baudry J et al (2021) Consumption of Ultra-processed Foods by Pesco-Vegetarians, vegetarians, and vegans: associations with Duration and Age at Diet initiation. J Nutr 151:120–131. https://doi.org/10.1093/jn/nxaa196
doi: 10.1093/jn/nxaa196 pubmed: 32692345
Sridhar K, Bouhallab S, Croguennec T et al (2023) Recent trends in design of healthier plant-based alternatives: nutritional profile, gastrointestinal digestion, and consumer perception. Crit Rev Food Sci Nutr 63:10483–10498. https://doi.org/10.1080/10408398.2022.2081666
doi: 10.1080/10408398.2022.2081666 pubmed: 35647889
Flint M, Bowles S, Lynn A et al (2023) Novel plant-based meat alternatives: future opportunities and health considerations. Proc Nutr Soc 82:370–385. https://doi.org/10.1017/S0029665123000034
doi: 10.1017/S0029665123000034 pubmed: 36603854
Streiner DL (1994) Figuring out factors: the use and misuse of factor analysis. Can J Psychiatry 39:135–140. https://doi.org/10.1177/070674379403900303
doi: 10.1177/070674379403900303 pubmed: 8033017
Mikkilä V, Räsänen L, Raitakari OT et al (2005) Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young finns Study. Br J Nutr 93:923–931. https://doi.org/10.1079/bjn20051418
doi: 10.1079/bjn20051418 pubmed: 16022763
González-Gil EM, Martínez-Olivan B, Widhalm K et al (2019) Healthy eating determinants and dietary patterns in European adolescents: the HELENA study. Child Adolesc Obes 2:18–39. https://doi.org/10.1080/2574254X.2019.1615361
doi: 10.1080/2574254X.2019.1615361
Bailey RL (2021) Overview of dietary assessment methods for measuring intakes of foods, beverages, and dietary supplements in research studies. Curr Opin Biotechnol 70:91–96. https://doi.org/10.1016/j.copbio.2021.02.007
doi: 10.1016/j.copbio.2021.02.007 pubmed: 33714006 pmcid: 8338737
Martínez ME, Marshall JR, Sechrest L (1998) Invited commentary: factor analysis and the search for objectivity. Am J Epidemiol 148:17–19. https://doi.org/10.1093/oxfordjournals.aje.a009552
doi: 10.1093/oxfordjournals.aje.a009552 pubmed: 9663398
Michels KB, Schulze MB (2005) Can dietary patterns help us detect diet-disease associations? Nutr Res Rev 18:241–248. https://doi.org/10.1079/NRR2005107
doi: 10.1079/NRR2005107 pubmed: 19079908

Auteurs

Lea Hansch (L)

Department of Nutritional Epidemiology, Institute of Nutritional and Food Science (IEL), University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany.

Morwenna Fischer (M)

Faculty of Human Resources, Health and Social Work, University of Applied Sciences (FHM), 33602, Bielefeld, Germany.

Alfred Längler (A)

Department of Pediatrics, Gemeinschaftskrankenhaus, Herdecke, Germany.
Faculty of Health, Professorship for Integrativ Pediatrics, Witten Herdecke University, Witten, Germany.

Andreas Michalsen (A)

Institute of Social Medicine, Epidemiology and Health Economics, Charité- Universitätsmedizin Berlin, 10117, Berlin, Germany.

Stine Weder (S)

Research Institute of Plant-Based Nutrition, 35444, Gießen/Biebertal, Germany.

Markus Keller (M)

Research Institute of Plant-Based Nutrition, 35444, Gießen/Biebertal, Germany.

Ute Alexy (U)

Department of Nutritional Epidemiology, Institute of Nutritional and Food Science (IEL), University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany. alexy@uni-bonn.de.

Ines Perrar (I)

Department of Nutritional Epidemiology, Institute of Nutritional and Food Science (IEL), University of Bonn, DONALD Study, Heinstück 11, 44225, Dortmund, Germany.

Classifications MeSH