Assessing Dairy-Free Vegetarian and Vegan Modeled USDA Food Patterns for Lactation Among Adult Females

OBJECTIVES: Among its recommended dietary patterns for Americans, including lactating mothers, the 2020 Dietary Guidelines for Americans (DGA) includes a Healthy Vegetarian Dietary Pattern (HVDP). However, the DGA does not provide guidance for adapting the HVDP for vegetarians who avoid dairy (ovo-vegetarian) or all animal foods (vegan). A recent study from our lab created ovo-vegetarian and vegan models of the HVDP and found that there were minimal impacts on nutrient levels for non-pregnant, non-lactating healthy adults. The objective of this study was to determine whether our modeled ovo-vegetarian and vegan HVDPs could provide sufficient nutrition during lactation, a life stage with unique nutrient needs. METHODS: For this study, we evaluated the HVDP alongside the ovo-vegetarian and the vegan HVDP models at the 2,200 and 2,400 kcal levels, comparing these patterns to Dietary Reference Intakes for women ages 19–30 and ages 31–50 during lactation months 1–12. In the ovo-vegetarian and vegan models, dairy foods were replaced with equivalent servings of a dairyALT group, comprised of soy milk and soy yogurt. In the vegan model, eggs were replaced with equal proportions of other protein group foods (beans, peas, lentils; soy products; nuts, seeds). RESULTS: Like the 2,200 and 2,400 kcal HVDP, the ovo-vegetarian and vegan adaptations provided too little vitamin A, vitamin E, vitamin D, and choline to meet nutrient needs during lactation. At both 2,200 and 2,400 kcal, these models provided 73–76% of vitamin A, 62–66% of vitamin E, 59–63% of vitamin D, and 62–75% of choline recommendations. While these modeled patterns provided sufficient amounts of most other vitamins and minerals, the ovo-vegetarian and vegan models at 2,400 kcal also provided only 95% of zinc recommendations and, at 2,200 kcal, provided only 87% of zinc and 98% of vitamin B6 recommendations. CONCLUSIONS: The ovo-vegetarian and vegan adaptations of the HVDP provided insufficient vitamin A, vitamin E, vitamin D, zinc, choline, and vitamin B6 to support lactation. Following ovo-vegetarian and vegan diets during lactation requires careful planning and attention to sources of these nutrients to protect maternal and child health. FUNDING SOURCES: United States Department of Agriculture- Agricultural Research Service.