Choline[edit]

This section is using very weak sourcing, for example [1] this article by Physicians Committee for Responsible Medicine and another piece from Sky News should be removed. Psychologist Guy (talk) 03:28, 5 January 2023 (UTC)Reply[reply]

I did find mentioning the media buzz around choline quite helpful and would not want so see it completely removed. I have added the Euronews article (Euronews being public broadcast and a good source) a while ago to make sure it sticks. Sky and PCRM can be removed. CarlFromVienna (talk) 08:33, 5 January 2023 (UTC)Reply[reply]
I had a look around there is not a lot of research on choline in relation to vegan diets, I could only find two primary papers that mention the topic but we can't use these on Wikipedia, example [2]. There is a review here [3] but it only mentions vegetarian diets but it might be worth citing because it notes the limited evidence we have on the topic. There is no RDI but it has been suggested that 550 mg is an adequate daily intake for men [4]. I doubt most people are meeting 550mg unless they are loading up on beef liver, cod, salmon or chicken breasts on a daily basis. Psychologist Guy (talk) 19:04, 5 January 2023 (UTC)Reply[reply]
The AI given by the ODS has been derived as follows:
For adults, the AI for choline was set at 550 mg/day for men and 425 mg/day for women. These values were based on the amount (7 mg/kg/day) that prevented hepatic alteration in men, defined as elevated alanine aminotransferase concentration in serum [7], and reference body weights of 76 kg and 59 kg for men and women, respectively [8]. It should be noted that the small depletion-repletion study used to derive these values was conducted only in men and did not provide information on whether less choline would be effective, as researchers only studied one dose [7]. From this, the AIs for children and adolescents were extrapolated
The researchers of the original study used a study design with only two amounts of choline: zero or 500mg per day. And yeah, zero wasn't enough and the participants got liver damage. 500mg was enough. That's how the AI was born. Thus, it seems very likely that the RDI (if ever established) lies well below 500mg.
Do you think this little science history would be a good addition to the Choline article? I think the sources would allow for that (even though one paper above is from Nutrients, I think for the statement it makes, the source can be used.) CarlFromVienna (talk) 08:10, 6 January 2023 (UTC)Reply[reply]
The best paper I have seen to date on vegan diets and nutrition is this systematic review, it should be added to the article [5], it gives a very balanced review. It does not mention anything about choline. There is hardly anything in the medical literature about choline deficiency or inadequacy in relation to vegan diets. I agree 500mg is too high, looks like a weak study. It is probably worth expanding the choline article with any history. Psychologist Guy (talk) 17:05, 6 January 2023 (UTC)Reply[reply]
In regard to reviews on vegan nutrients and children, this is the best review to date [6]. We can use this to expand the article section "Pregnancy, infants and children". Psychologist Guy (talk) 02:13, 7 January 2023 (UTC)Reply[reply]

I have deleted the weak sources. I added some history of how the AI has been derived to Choline. I deleted the discussion of RDI/AI from this article as it's redundant and probably best to read the article Choline to get the whole picture. CarlFromVienna (talk) 07:25, 7 January 2023 (UTC)Reply[reply]

Position of paediatric associations[edit]

I have expanded this section with position papers from France, Germany and Italy. The Argentine Society of Pediatrics have issued a position paper [7] and there are recommendations from Chile [8]. If one goes looking some other countries can probably be found but they are probably not relevant to this English speaking Wikipedia. We already cover Canada. But as the section already contains a lot of information it's probably not worth making it too big. Psychologist Guy (talk) 22:55, 5 January 2023 (UTC)Reply[reply]

When reading the European statements (and using translation tools) one has to take care to get an exact understanding of what they are saying.
For example, the German Society for Nutrition does not claim that there are any nutrients that cannot be obtained from supplements and a plant-based diet. Rather, what they are saying is that people are generally not well disciplined to take supplements, eat whole grains and veggies and that for this lack of discipline they do not recommend to leave out nutrient-dense foods like meat and cheese. So their arguments are not based on nutritional science but also blend in some sociological arguments.
In a way, this is in line with the general difference between the anglosphere and continental Europe, where in the first places more trust in the individual while the second does not trust the individual to be able to deal with "too much freedom".
If I read the Italian position correctly they are making a similar argument. I have rephrased the paragraph to make this two-step argument more clear. CarlFromVienna (talk) 07:41, 7 January 2023 (UTC)Reply[reply]
My understanding is that the consensus from paediatric associations is that if a vegan diet is to be taken up by pregnant women and infants then it needs to be done either under strict medical supervision or dietetic supervision, now what does that mean? It means hiring a professional paediatrician or dietitian and seeking regular dietary advice. Only very wealthy people will be able to afford this. Psychologist Guy (talk) 11:57, 10 January 2023 (UTC)Reply[reply]

Iron[edit]

This systematic review [9] looked at vegetarians and iron and appears to be the only systematic review on iron intake and vegetarians. I do not have full access but the review is cited in another review [10] as "individuals adhering to a vegetarian or vegan diet are more prone to lower iron stores which may increase the risk of iron deficiency anaemia", so it must include studies on vegans. If anyone has full access we can add the source if there is confirmation about iron intake and vegans. Psychologist Guy (talk) 11:50, 10 January 2023 (UTC)Reply[reply]

I added the paper. It also discusses the potential benefits of lower iron stores. CarlFromVienna (talk) 08:13, 11 January 2023 (UTC)Reply[reply]
I just tried to verify the 14mg/33mg. The source given in the article is not the primary source. I don't have the book, and could not look up footnote #18, but I think it's this. If its the 2001 Dietary Reference Intakes, the paragraph there reads as follows:
As previously discussed, iron is more bioavailable from meat than from plant-derived foods. Meat and fish also enhance the absorption of nonheme iron. Therefore, nonheme iron absorption is lower for those consuming vegetarian diets than for those eating non-vegetarian diets (Hunt and Roughead, 1999). Serum ferritin concentrations have been observed to be markedly lower in vegetarian men, women, and children than in those consuming a nonvegetarian diet (Alexander et al., 1994; Dwyer et al., 1982; Shaw et al., 1995). For these reasons, individuals who typically consume vegetarian diets may have difficulty consuming adequate intakes of bioavailable iron to meet the EAR. Cook and coworkers (1991) compared iron bioavailability from single meals with that of a diet consumed over a 2-week period. There was a 4.4-fold difference between maximally enhancing and maximally inhibiting single meals, but the difference was only two-fold when measured over the 2-week period. It is therefore estimated that the bioavailability of iron from a vegetarian diet is approximately 10 percent, rather than the 18 percent from a mixed Western diet. Hence the requirement for iron is 1.8 times higher for vegetarians. It is important to emphasize that lower bioavailability diets (approaching 5 percent overall absorption) may be encountered with very strict vegetarianism and in some developing countries where access to a variety of foods is limited.
Meaning the 33mg and 14mg given would be based on a single study over 2 weeks. If this is indeed the only source for the 33mg/14mg claim, I would not include it in the article as it has not been picked up by any nutritional society as a recommendation for vegan/vegetarian diets and would be WP:UNDUE. I you look at how the 2001 document is structured it is even not an official recommendation (these are bold text in separate paragraphs. The 14mg/33mg are not even given as values. It seems to me that the factor of 1.8 is simply an estimate and that Mangels blew it totally out of proportion in their book. After that it has never been heard of again -- except here. CarlFromVienna (talk) 11:55, 11 January 2023 (UTC)Reply[reply]
I just noticed that the first footnote citing Mangels confirms that the primary source is the 2001 Dietary Reference Intakes. As explained above this is neither an official RDA nor was it adopted by other nutritional organizations. I will therefor delete these values from the article. There are probably a lot more of moderate recommendations to eat a little more iron than on an omnivorous diet, and we should cite these instead. CarlFromVienna (talk) 06:52, 12 January 2023 (UTC)Reply[reply]
Yeah the 2001 Dietary Reference Intakes are clearly outdated and there is cherry picking on this topic, many of the studies are only a few weeks, I don't have access to the Mangels book either. I see you added the systematic review, you have done a good job there I would just leave it at that. They need to do more studies on iron and vegan diets, in about 5-10 years we will have more results. Psychologist Guy (talk) 13:06, 14 January 2023 (UTC)Reply[reply]

Zinc[edit]

While I am sceptical about the iron (see talk above) I noticed that zinc is missing. I have added a section on zinc based on the reference values of the German Nutrition Society. I think it should be padded with some context by societies form the English-speaking world. CarlFromVienna (talk) 07:09, 12 January 2023 (UTC)Reply[reply]

There's mention of zinc [11] in the 2021 systematic review. In the section on zinc, the conclusion was "In general, vegan diets are more likely to contain inadequate amounts of serum zinc [5]. Similarly, vegans have shown the lowest zinc intake when compared to groups with different dietary habits". The only other review that has been published on zinc was this review from 2013 [12] which looked mostly at vegetarians. Zinc stays in the body for about 25 hours, it doesn't have a long storage like some of other nutrients. In 2012 it was estimated that 17.3% of the world’s population is at risk of inadequate zinc intake [13]. That figure is probably closer to 20% now. Psychologist Guy (talk) 13:14, 14 January 2023 (UTC)Reply[reply]
Thanks, I added the 2021 review. CarlFromVienna (talk) 07:16, 18 January 2023 (UTC)Reply[reply]

Protein[edit]

According to the Netherlands Nutrition Centre, the recommended amount of protein required on a vegan diet is 1.3 times higher [14]. Is there any other sources on this? The reference they give was in Dutch and I have not been able to locate it. Psychologist Guy (talk) 17:26, 14 March 2023 (UTC)Reply[reply]

Removing original research[edit]

I have expanded the positions of dietetic and government associations section and added the position of paediatric associations. I have made sure all the sourcing is accurate to my own edits. Unfortunately some content that was added on 3 April 2021 contains original research [15] which was never checked. Unfortunately this information has remained on the article for 2 years. The content I am talking about is a list of organizations listed that recognize "a well-planned vegan diet as viable for any age". Yes some of these do indeed support this, but some organizations were added that have not stated that. So it is original research that has to be removed.

Let me go through some of these links.

National Health and Medical Research Council, Mayo Clinic [23], Heart and Stroke Foundation of Canada [24], Canadian Pediatric Society [25] all support a well-planned vegan diet for any age so those were accurate however 5 references I cited above all failed to support the statement. This is a bad case of original research and not fact checking sources. This page needs to be accurate so I am making the corrections. Psychologist Guy (talk) 21:15, 27 June 2023 (UTC)Reply[reply]

Nordic Council of Ministers[edit]

The Nordic Council of Ministers (NHMRC) who published the Nordic Nutrition Recommendations 2012 have stated that "Vegan, lacto-vegetarian and lacto-ovo-vegetarian diets should be able to satisfy the nutrient needs of infants, children, and adolescents and promote normal growth if they are appropriately planned, but vegan diets always need to be supplemented with vitamin B12 and vitamin D." [26]. However, the Nordic Nutrition Recommendations 2023 which has just been published does not mention age groups in relation to vegan diets [27]. Because the new recommendations have been published there is no need to cite the 2012 recommendations. Psychologist Guy (talk) 22:02, 27 June 2023 (UTC)Reply[reply]

Slovenian Paediatric Society[edit]

The Slovenian Paediatric Society do not support vegan diets for pregnant women and infants, this is clarified in this paper "In line with the proven effects of vegetarian and vegan diets on health and development, the Slovenian Paediatric Society advises against the use of such diets in pregnant and lactating women, newborns, infants, children, and adolescents [28]. The paper itself also links to another paper which says "Slovenian guidelines do not recommend strictly vegetarian or vegan-nutrition for children." [29] Psychologist Guy (talk) 14:41, 7 August 2023 (UTC)Reply[reply]

State of Israel Ministry of Defence[edit]

The article by the State of Israel Ministry of Defence [30] does not claim that "vegan diets can provide all dietary requirements in infancy", anyone can read the article and see no wording like that appears on the article therefore this edit is WP:OR [31] and should be removed.

The source says "In vegan families which avoid all animal-derived foods, it is advisable to consult with a nutritional expert or dietitian in order to assess the mother’s food consumption and consider referral for blood tests." Psychologist Guy (talk) 15:21, 22 October 2023 (UTC)Reply[reply]

Categories