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The 2020 Dietary Guidelines for Americans (DGA) recommends a Healthy Vegetarian Dietary Pattern (HVDP) but does not provide guidance for dairy-free vegetarian (ovo-vegetarian) or vegan diets. A recent study from our lab modeled ovo-vegetarian and vegan HVDPs for healthy adults and found minimal impacts on nutrient content. However, since these models provide only recommendations for food group amounts, the objective of this study was to determine the feasibility of implementing the 2000 kcal ovo-vegetarian and vegan models by developing sample menus and evaluating them for nutrient adequacy and diet quality. We implemented a search strategy for ovo-vegetarian and vegan recipes on the MyPlate.gov website, using the most frequently consumed foods from each food group as a guide. We then developed 5-day sample menus for each model and analyzed these menus for diet quality using the Healthy Eating Index Score-2015 (HEI-2015) and nutrient content. The HEI-2015 scores were 99.4 and 98.4 for the vegan and ovo-vegetarian menus, respectively. These sample menus did not achieve a perfect score of 100 due to sodium and refined grains (both menus), added sugars (ovo-vegetarian menu only), and fatty acid profiles (vegan menu only). Mean total energy was 1860 kcal (vegan) and 1880 kcal (ovo-vegetarian). Amounts of all macronutrients were within the Acceptable Macronutrient Distribution Ranges, but amounts of some micronutrients were below 90% of recommended levels. Healthy adults may be able to follow ovo-vegetarian and vegan diets with careful planning, but this study reveals challenges in meeting micronutrient needs with these eating patterns.

IntroductionThe 2020–2025 Dietary Guidelines for Americans (DGA) includes a Healthy Vegetarian Dietary Pattern (HVDP) with dairy foods and eggs as one of its three recommended dietary patterns for non-pregnant, non-lactating healthy adults. This study evaluates whether pescatarian, lacto-vegetarian, and “pescavegan” adaptations of the HVDP can be nutritionally adequate if modeled with foods recommended by the DGA.MethodsThe nutrient composition of these three alternative models of the HVDP were assessed at 1, 800-, 2, 000-, 2, 200-, and 2,400- kcal/day using similar food pattern modeling procedures as the 2020 DGA. For the pescatarian and pescavegan models, 0.5 ounce-equivalent of refined grains per day was replaced with seafood. For the lacto-vegetarian and pescavegan models, eggs were replaced with equal proportions of the other vegetarian protein foods. In the pescavegan model, dairy foods were replaced by a dairy alternative group comprised of fortified soy milk and soy yogurt.ResultsAll models at all energy levels were within Acceptable Macronutrient Distribution Ranges (AMDRs) for all macronutrients, contained ≤5% of total kcal from saturated fat, and met recommendations for most micronutrients. Nutrients provided below the Dietary Reference Intakes (DRIs) in these models included iron, sodium, vitamin D, vitamin E, and choline. Micronutrients provided at less than 50% of their respective DRIs included vitamin D and choline.DiscussionAdapting the HVDP for lactovegetarian, pescatarian, and pescavegan dietary patterns provided adequate amounts of macronutrients and most micronutrients.