Health, Celebration and Inclusion
PEN
® eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.
June shines a spotlight on several important health and community awareness initiatives, including Men's Health Month, Fresh Fruit and Vegetable Month, Dysphagia Awareness Month, and Pride Month.
- Men's Health Month encourages boys and men to prioritize their physical and mental well-being through preventive care, healthy eating, regular physical activity, and routine health screenings.
- Fresh Fruit and Vegetable Month celebrates the important role that fruits and vegetables play in a healthy diet. Rich in vitamins, minerals, fibre, and antioxidants, they support overall health and help reduce the risk of chronic disease.
- Dysphagia Awareness Month raises awareness of swallowing disorders that can affect individuals of all ages. Early identification and appropriate nutrition care can help improve safety, quality of life, and nutritional status for those living with dysphagia.
- Pride Month recognizes and celebrates the diversity, resilience, and contributions of 2SLGBTQIA+ communities. It is also an opportunity to promote inclusive, respectful, and equitable healthcare environments where everyone feels welcome and supported. Happy Pride Month, one and all!
PEN subscribers can log in now to explore curated resource collections for each of these topics — practice-ready tools you can use this month.
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Plant-based and omega-3 smart
The Question
How should omega-3 (ALA, EPA, DHA) requirements be met for adults following a vegetarian or vegan diet, including individuals who are pregnant and breastfeeding?The Recommendation
Omega-3 polyunsaturated fatty acid (PUFA) status may be lower among vegetarians and vegans, including those who are pregnant or breastfeeding/lactating, compared to non-vegetarians, due to lower intakes of food sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and limited conversion of alpha linolenic acid (ALA) to these fatty acids. The following suggestions may aid in ensuring omega-3 fatty acid intakes are adequate to support good health for those following a vegetarian or vegan dietary pattern:
Limiting intake of omega-6 fatty acid rich oils and margarines (e.g. sunflower, safflower, corn, sesame, grapeseed) may help maintain an optimal (i.e. 2:1 or 3:1) omega-6 to omega-3 ratio and favour the conversion of ALA to EPA and DHA.
It is suggested that vegetarians and vegans who are not pregnant aim for an intake of ALA (e.g. from the seeds of flax, chia, camelina, canola, and hemp; walnuts and their oils) above the Dietary Reference Intakes of 1.6 g/day and 1.1 g/day for men and women, respectively, although an exact recommendation is not currently available and evidence for this is inconsistent. For pregnancy, see Additional Content: Is flaxseed (ground flax, flaxseed oil, flaxseed oil capsules) safe to consume during pregnancy?
The regular consumption of supplemental EPA and DHA, such as a daily intake of low dose (100 to 200 mg) microalgae-derived DHA supplement may also help maintain plasma/erythrocyte concentrations of these fatty acids, especially for those who are pregnant or breastfeeding/lactating.
Further studies are needed to establish the impact of consuming ALA-rich foods, as well as optimum EPA and DHA ratios and dosages in vegetarian and vegan populations.
Limited evidence from two systematic reviews suggests that health interventions delivered through social media likely have either no effect or a small positive effect on dietary behaviours of adolescents and adults. More research is needed before a recommendation can be made.
Grade of Evidence: B & C
*Grade B - The conclusion is supported by fair evidence.
*Grade C - The conclusion is supported by limited evidence or expert opinion
Remarks
For country-specific recommendations for ALA, see the International Dietary Reference Values Collection. There is currently no consensus on the recommended intake and status of EPA and DHA.
See Additional Content:
What is the effect of increasing omega-3 fatty acid intake during pregnancy?
What are the omega-3 fatty acid needs of a lactating individual?
Are omega-3-6-9 supplements more beneficial in preventing cardiovascular disease (CVD) disease than just omega-3 supplements?
Should omega-3 fatty acids (fish or plant-based food or supplements) be recommended for the primary or secondary prevention of cardiovascular disease (CVD) in adults?
Do vegetarians have a lower incidence of cardiovascular disease risk factors than non-vegetarians?
Omega-3 Fatty Acids and Vegetarian Diets
Increasing Your Omega-3 Intake
Unlock the full evidence — read the complete practice question now.
Can soy affect testosterone or fertility in men?
The Question
Do males who consume soy (foods or supplements) have more fertility/reproductive problems than males who do not consume soy?The Recommendation
Soy or isoflavone-rich foods or supplements do not affect testosterone or estrogen levels and do not appear to affect semen parameters or breast tissue in men.
If soy is consumed, a suggested reasonable adult recommendation is 15-25 g/day of soy protein and 50-100 mg/day of isoflavones.
Grade of Evidence: A and C
*Grade A - The conclusion is supported by good evidence.
*Grade C - The conclusion is supported by limited evidence or expert opinion
Remarks
The estrogen-like effects of isoflavones have raised concerns about the impact of soy food consumption in males as highlighted in case reports and animal research.
There was a high variance in the forms and amounts of soy in the included studies of the 2022 review. However, based on studies in all populations, a suggested reasonable adult recommendation provided was 15-25 g/day of soy protein and 50-100 mg/day of isoflavones. Intakes greater than this level do not appear to be associated with adverse effects, but there is little research for consuming more than these amounts.
Unlock the full evidence — read the complete practice question now.
Thriving on a Vegan Diet
Discover how a well-planned vegan eating pattern can provide needed nutrients while supporting heart health and overall well-being.
✔ This client handout includes food choices to include these key nutrients: protein, iron, iodine, zinc, omega-3 fatty acids, calcium, vitamins D and B12.
✔ The handout also provides a few practical tips for building a balanced vegan eating pattern at every stage of life, including during pregnancy and lactation and for children, teenagers and older adults.
To read more about healthy food options and other considerations, view our handout here.
PEN eNews
June 2026 Volume
16 (6)
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