Dietary Quality in Vegetarian and Omnivorous Female Students in Germany: A Retrospective Study

Abstract

Vegetarian diets have gained in popularity, especially among highly educated women, and are considered beneficial to health. Comparative studies assessing the diet of vegetarians against omnivores are rather limited and often provide ambivalent results. Therefore, this study examined the nutrient intake and nutritional quality of vegetarian and omnivorous diets in a group of 61 female students in Germany. Habitual dietary intake was evaluated using a validated graphical online food frequency questionnaire (FFQ). Differences in nutrient intakes were analyzed by Mann–Whitney-U-Tests. Odds Ratios (OR) were calculated for vegetarians exceeding dietary reference values (DRV) compared to omnivores. The overall nutritional quality was assessed using the Healthy-Eating-Index-2015 (HEI-2015). In omnivores, intakes of total energy from saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), long-chain omega-3 polyunsaturated fatty acids (LC-n3-PUFA), cholesterol, sucrose, lactose, retinol, and cobalamin were significantly higher than in vegetarians. Significantly lower intakes were observed for fiber, magnesium, and beta-carotene. Significant OR were detected for total fat (OR = 0.29), SFA (OR = 0.04), beta-carotene (OR = 4.55), and cobalamin (OR = 0.32). HEI-2015 scores were higher for vegetarians than for omnivores (79 points versus 74 points) and significant differences were recorded for the HEI-2015 components dairy, seafood & plant proteins, fatty acids, added sugars, and saturated fatty acids.

Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians, Vegans and Omnivores in Germany

“…Several studies have determined the diet quality for different target groups (e.g., national consumer surveys, children or seniors), based on an HEI [ 27 , 37 , 38 , 61 , 62 , 63 , 64 ]. However, calculations of plant-based diets using an HEI are rare.…”

“…Semi-vegetarians and V were considered in a Belgium study based on HEI-2010 only once [ 53 ]. Nutritional quality has already been determined in Germany several times based on an HEI [ 35 , 36 , 37 , 38 ], but so far, neither FX nor V have been explicitly studied regarding their diet quality. Furthermore, specific recommendations that apply to V have not yet been addressed in current HEI evaluations [ 35 , 37 , 38 , 50 ].…”

“…Nutritional quality has already been determined in Germany several times based on an HEI [ 35 , 36 , 37 , 38 ], but so far, neither FX nor V have been explicitly studied regarding their diet quality. Furthermore, specific recommendations that apply to V have not yet been addressed in current HEI evaluations [ 35 , 37 , 38 , 50 ]. Therefore, the HEI-flex has integrated some important extensions and amendments, which are discussed below.…”

“…Thereby, the increasing consumption of these plant-based alternatives and their health quality were reflected. However, these foods have not been explicitly recorded yet [ 28 , 36 , 37 , 38 , 52 , 53 , 64 ] or have only been added to protein sources without considering the degree of processing [ 53 ].…”

“…The HEI has also been used in Germany in modified form, based on official dietary recommendations, for example, as HEI-Epic (relationship between dietary intake and cancer, n = 5465) or HEI-NVSII (dietary intake of organic buyers and non-organic buyers, n = 13,154) [ 34 , 35 , 36 ]. However, neither the great variety nor the nutritional quality of plant-based alternatives has been integrated into a diet quality evaluation based on a HEI yet [ 35 , 36 , 37 , 38 ].…”