Dietitians Critique Academy of Nutrition and Dietetics' Position on Vegetarian and Vegan Diets

Dietitians from the Physicians Committee for Responsible Medicine have raised concerns regarding the Academy of Nutrition and Dietetics' recent Position Paper on Vegetarian Dietary Patterns for Adults. The position paper suggests that dietitians should only provide information about vegetarian and vegan diets to patients who express interest, which the dietitians contest. They argue that similar to smoking cessation, dietitians should be encouraged to recommend plant-based diets to all patients.

The letter, authored by Anna Herby, DHSc, RD, CDCES, and Noah Praamsma, MS, RDN, highlights errors in the paper, particularly regarding claims that vegans are prone to vitamin D deficiency. Published in June 2025 in the Journal of the Academy of Nutrition and Dietetics, the position paper erroneously states that research indicates a high incidence of vitamin D deficiency among vegetarians and vegans, according to Herby and Praamsma. They clarify that the cited research actually found no significant difference in vitamin D levels based on vegetarian status.

Additionally, the dietitians criticized the position paper for misrepresenting a 2021 systematic review, which concluded that individuals on vegan diets have serum vitamin D concentrations that are not below healthy levels. They emphasized that vitamin D primarily comes from sun exposure, and that all diets, whether vegetarian or not, can require planning to ensure adequate intake.

The letter also noted that the position paper authors have issued an erratum acknowledging some lack of clarity, but changes did not fully rectify the implications regarding vitamin D levels in vegans. The authors maintained that dietary changes should be tailored to individual patient preferences and readiness.

Praamsma and Herby argue for a stronger stance in promoting plant-based diets, stating that many patients require significant dietary interventions. They believe dietitians have a responsibility to use their expertise to encourage life-saving dietary changes through evidence-based counseling. The Physicians Committee has formally requested the Academy to retract the position paper and revise other sections.