Consumption of Key Food Groups by Individuals Consuming Popular Diet Patterns: Mixed Effects of Replacing Foods High in Added Sugar, Sodium, Saturated Fat, and Refined Grains

Adults in the United States are increasingly following 'popular' diet patterns that restrict food groups, macronutrients, or eating time. However, the intake of food groups associated with these diet patterns has not been well characterized. The objectives of this study were to (1) characterize the mean intake of food groups among consumers of popular diet patterns in the US, and (2) model the effect of targeted food substitutions on the intake of food groups. Data were acquired from the National Health and Nutrition Examination Survey, 2005-2018 (n = 34,411). A diet model was developed to assess the effects of replacing one serving each of foods highest in added sugar, sodium, saturated fat, and refined grains with healthy alternatives on the intake of key food groups for each diet pattern. Modeled replacement resulted in increased intake of fruit and whole grains and decreased intake of dairy for most diet patterns, while the effects on the intake of vegetables, protein foods, and oils were variable across diet patterns. The complexity of the natural eating environment, in which many people consume mixed dishes that include both healthy and less healthy ingredients, produces a challenge for health professionals when providing dietary counseling. Nevertheless, this substitution approach may help improve adherence to dietary guidelines, especially if used as a steppingstone for further dietary improvement.

Do urban tourists prefer vegetarianism? An urban-rural comparison of vegetarian consumption in China

The adoption of a vegetarian diet might have public health and environmental benefits. However, little is known about urban and rural Generation Z tourists' attitudes toward vegetarianism or vegetarian consumption within the Chinese urban and rural settings. Hence, to address this gap, the present study adopted a sequential and mixed research approach based on a survey (n = 212) and laddering interviews (n = 20) to validate post-millennial tourists' motives for adopting a vegetarian diet. The results identified the top four motives as environmental protection and resource conservation, ethical consideration, personal taste and choice, and personal healthcare issues. The top four barriers to vegetarianism were unavailability and limited choice, peer pressure, traditional prejudice/habit, and the inability to change. The results also demonstrated that both rural and urban tourists adopt vegetarianism mainly for environmental protection and ethical consideration, a subtle difference between them is that urban vegetarians emphasized ethical considerations more but rural ones emphasized food and variety. Urban consumers considered unavailability and limited choice as the topmost barriers to being vegetarian, while rural vegetarians found traditional prejudice to be restricting. Due to traditional dietary habits and peer influence, rural tourists face many more challenges when adopting a vegetarian diet. Understanding the perceived benefits and barriers to being vegetarian in different regions will not only enrich the theory of food nutrition but also expand Generation Z tourists' consumption behavior and practices.

Inadequate Choline Intake in Pregnant Women in Germany

Choline is an essential nutrient that is involved in various developmental processes during pregnancy. While the general adequate choline intake (AI) for adults has been set at 400 mg/day by the European Food Safety Authority (EFSA), an AI of 480 mg/day has been derived for pregnant women. To date, the choline intake of pregnant women in Germany has not been investigated yet. Therefore, in this survey, the total choline intake from dietary and supplementary sources in pregnant women was estimated using an online questionnaire. A total of 516 pregnant women participated in the survey, of which 283 met the inclusion criteria (13 to 41 weeks of gestational age, 19−45 years). 224 (79%) of the participants followed an omnivorous diet, 59 (21%) were vegetarian or vegan. Median choline intake was 260.4 (±141.4) mg/day, and only 19 women (7%) achieved the adequate choline intake. The median choline intake of omnivores was significantly higher than that of vegetarians/vegans (269.5 ± 141.5 mg/day vs. 205.2 ± 101.2 mg/day; p < 0.0001). 5% (13/283) of pregnant women took choline-containing dietary supplements. In these women, dietary supplements provided 19% of the total choline intake. Due to the importance of choline for the developmental processes during pregnancy, the study results prove the urgent need for an improved choline supply for pregnant women.

A Global Analysis of National Dietary Guidelines on Plant-Based Diets and Substitutions for Animal-Based Foods

Discussing plant-based diets and substitutions for animal-based foods in food-based dietary guidelines (FBDGs) can be a key step in making dietary recommendations more sustainable and healthy as well as more inclusive. The existing large-scale evaluations of FBDGs do not assess whether and to what extent countries cover the broad spectrum of plant-based diets and have policy positions on vegetarian diets, including vegan diets, and whether they mention specific plant-based alternatives to milk, dairy products, and meat. The main aim of this state-of-the-art review was to determine whether and how FBDGs provide such information. An overall 95 guidelines and 100 corresponding countries were assessed via an exploratory sequential mixed method. This involved qualitative explorative content analysis of the guidelines, followed by hierarchical cluster analysis. Furthermore, the Balanced Food Choice Index (BFCI) was constructed, which measures the extent to which FBDGs provide recommendations that cover the broad spectrum of plant-based diets, with some or no animal-based products. To explore the correlations between FBDGs' recommendations and ecological and economic country characteristics, ordinary least squares regression was used. It was found that most countries do not provide information to their citizens that cover the broad spectrum of plant-based diets, as indicated by the mean score of the BFCI (33.58 of 100 points). A total of 38 guidelines (40%) contain a position on vegetarian diets. Nearly half (45%) of all FBDGs already mention plant-based alternatives to meat or animal milk. The regressions showed that the BFCI correlates positively with countries' ecological efforts and negatively with the importance of animal-based products in their economies. This study demonstrates considerable information insufficiency in current FBDGs worldwide. FBDGs should provide recommendations for the broad spectrum of plant-based diets and balance the ethical, ecological, religious, and economic aspects that play a role in people's food choice.

Does a Plant-Based Diet Stand Out for Its Favorable Composition for Heart Health? Dietary Intake Data from a Randomized Controlled Trial

A plant-based diet (PBD) can provide numerous health benefits for patients with cardiovascular risk factors. However, an inadequately planned PBD also bear the potential for deficiencies in certain macro- and micronutrients. The present study analyzed nutrient profiles of individuals who adopted a PBD as part of the CardioVeg study. Participants with cardiovascular risk factors were randomly assigned to either a whole-food PBD intervention (n = 36; eight 90 min group meetings including two 120 min cooking sessions) or a control group asked to maintain an omnivorous diet (n = 34) for eight weeks. Food intake data were collected using three-day weighed food records and analyzed with NutriGuide software, including the German Nutrient Data Base (German: Bundeslebensmittelschlüssel). Nutrient intake was compared before and after eight weeks as well as between the groups. The results for both groups were then contrasted to the current dietary recommendations published by the societies for nutrition in Germany, Austria, and Switzerland. Moreover, anthropometric/laboratory data and ambulatory blood pressure monitoring were determined at baseline and after 8 weeks. Data of a subsample (n = 18 in the PBD group and n = 19 in the control group) were used for the present analyses of the dietary intake data. A PBD yielded several benefits including (but not limited to) a lower energy density, a lower intake of cholesterol and saturated fat, an increased consumption of fiber, and a lower intake of salt. Recommended intakes of most vitamins and minerals were generally met, except for vitamin B12 in the PBD group. A low intake of several other critical nutrients (vitamin D, iodine) was observed in both groups. Compared with the control group, PBD resulted in a significant decrease in body weight, body mass index, waist circumference, HbA1c, and fasting blood glucose after 8 weeks. Overall, it can be concluded that a PBD had a more favorable nutrient composition for cardiovascular health than the omnivorous dietary pattern of the control group.

Nutritional quality and greenhouse gas emissions of vegetarian and non-vegetarian primary school meals: A case study in Dijon, France

Since 2018 in France, national regulation mandates that school canteens serve a weekly vegetarian meal to reduce school canteens' environmental impact in addition to previous regulations imposing nutritional composition guidelines. However, a lunch without meat is often perceived as inadequate to cover the nutritional needs of children. The present study aims to assess the nutritional quality and greenhouse gas emissions (GHGE) of vegetarian and non-vegetarian school meals served in primary schools in Dijon, France. The catering department provided the composition of 249 meals served in 2019. Nutritional content and GHGE were retrieved from national food databases. The portion size of each meal component was the standard portion size recommended by the relevant French authority (GEMRCN). Meals were classified into vegetarian meals, i.e., without meat or fish (n = 66), or non-vegetarian meals (n = 183). The nutritional adequacy of the meals for children aged from 6 to 11 years was estimated using the mean adequacy ratio (MAR/2,000 kcal) as the mean percentage of daily recommended intake for 23 nutrients and the mean excess ratio (MER/2,000 kcal) as the mean percentage of excess compared to the maximum daily recommended value for three nutrients. This analysis of actual school meals shows that both vegetarian and non-vegetarian meals had a similar good nutritional quality with MAR/2,000 kcal of 87.5% (SD 5.8) for vegetarian and of 88.5% (SD 4.5) for non-vegetarian meals, and a MER/2,000 kcal of 19.3% (SD 15.0) for vegetarian and of 19.1% (SD 18.6) for non-vegetarian meals. GHGE were more than twofold reduced in vegetarian compared to non-vegetarian meals (0.9 (SD 0.3) vs. 2.1 (SD 1.0) kgC0₂ eq/meal). Thus, increasing the frequency of vegetarian meals, by serving egg-based, dairy-based or vegan recipes more frequently, would reduce GHGE while maintaining adequate nutritional quality of primary school meals.

Retrospective assessment of metabolic syndrome components in early adult life on vegetarian dietary status

Background

Metabolic syndrome (MetS) encompasses several clinical presentations that include truncal obesity and insulin resistance at its core. MetS afflicts 23% of the adult US population, increasing their risk of diabetes and cardiovascular disease. Many studies have indicated the importance of a vegetarian diet in improving overall health and more specifically MetS components. Unfortunately, these findings have been inconsistent and cannot be extended to examine effects on MetS incidence in the younger adult population.

Objective

This study aimed to conduct a retrospective analysis of a vegetarian vs. non-vegetarian dietary status in young adults (age 18-24) based on MetS components in later adulthood (age 20-30). This study focuses on elucidating any relationship between a vegetarian diet and MetS components of central obesity, hypertension, and hyperlipidemia. Methods: Waves 3 and 4 data were acquired from AddHealth. One-to-one propensity score matched vegetarians to non-vegetarians in a cohort of 535 women and 159 men. Logistical regression assessed the relationship between vegetarian status and MetS components, including truncal obesity (cm), hypertension (normal, pre-HT, HT1, and HT2), and hyperlipidemia (high and low). Results MetS components from ages 20 to 30 are not associated with vegetarian dietary status. Truncal obesity [N = 694; M = 92.82 cm; OR 0.999; p = 0.893; 95% CI (0.980, 1.017)]; hypertension [N = 694; OR 0.949; p = 0.638; 95% CI (0.764, 1.179)]; hyperlipidemia [N = 694; OR 0.840; p = 0.581; 95% CI (0.453, 1.559)].

Conclusion

Current study results were consistent with previous findings suggesting that consumption of a vegetarian diet cannot be directly linked to MetS outcomes. However, further investigation should be completed as MetS is a risk factor for several chronic diseases.

Vegans, vegetarians and omnivores differ in nutrient hedonics, salt and sweet preference and flavouring

BACKGROUND

Dietary content can influence taste responses. Therefore, we compared nutrient hedonics (liking foods by nutrient content), and seasoning, including taste responses to the prime flavours salt and sweet in 30 vegan, 37 vegetarian and 56 omnivore men and women.

METHODOLOGY

Questionnaires and taste tests examined macronutrient and electrolyte intake and hedonics, seasoning, salt and sweet preferences and psychophysical taste responses.

RESULTS

Compared to omnivores, vegans had lower protein, Ca⁺⁺, Na⁺ intake, and increased carbohydrate (CHO) intake. Independently of intake, hedonics for protein Ca⁺⁺ and Na⁺ were reduced and increased for CHO. Psychophysical responses to NaCl and sucrose also differed slightly, vegans and vegetarians scoring high concentrations of sucrose as more intense, Vegans reported more sweetening and less salting of food, added more sucrose to a test tea, less salt to a test soup, but did not differ in seasoning with oil or hot spice.

PRINCIPAL CONCLUSIONS

Habitual vegan, vegetarian and omnivore diets may alter taste responses to nutrient content and salt and sweet, the latter more pronounced in vegan and vegetarian women. Recognising diet-dependent changes in taste hedonics can inform diets and products.

α-linolenic acid interconversion is sufficient as a source of longer chain ω-3 polyunsaturated fatty acids in humans: An opinion

α-linolenic acid (αLNA) conversion into the functionally important ω-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), has been regarded as inadequate for meeting nutritional requirements for these PUFA. This view is based on findings of small αLNA supplementation trials and stable isotope tracer studies that have been interpreted as indicating human capacity for EPA and, in particular, DHA synthesis is limited. The purpose of this review is to re-evaluate this interpretation. Markedly differing study designs, inconsistent findings and lack of trial replication preclude robust consensus regarding the nutritional adequacy of αLNA as a source of EPC and DHA. The conclusion that αLNA conversion in humans is constrained is inaccurate because it presupposes the existence of an unspecified, higher level of metabolic activity. Since capacity for EPA and DHA synthesis is the product of evolution it may be argued that the levels of EPA and DHA it maintains are nutritionally appropriate. Dietary and supra-dietary EPA plus DHA intakes confer health benefits. Paradoxically, such health benefits are also found amongst vegetarians who do not consume EPA and DHA, and for whom αLNA conversion is the primary source of ω-3 PUFA. Since there are no reported adverse effects on health or cognitive development of diets that exclude EPA and DHA, their synthesis from αLNA appears to be nutritionally adequate. This is consistent with the dietary essentiality of αLNA and has implications for developing sustainable nutritional recommendations for ω-3 PUFA.

Types of diet, obesity, and incident type 2 diabetes: Findings from the UK Biobank prospective cohort study

AIM

To investigate the associations between types of diet and incident type 2 diabetes and whether adiposity mediated these associations.

MATERIALS AND METHODS

In total, 203 790 participants from UK Biobank (mean age 55.2 years; 55.8% women) without diabetes at baseline were included in this prospective study. Using the dietary intake data self-reported at baseline, participants were categorized as vegetarians (n = 3237), fish eaters (n = 4405), fish and poultry eaters (n = 2217), meat eaters (n = 178 004) and varied diet (n = 15 927). The association between type of diet and incident type 2 diabetes was investigated using Cox-proportional hazards models with a 2-year landmark analysis. The mediation role of adiposity was tested under a counterfactual framework.

RESULTS

After excluding the first 2 years of follow-up, the median follow-up was 5.4 (IQR: 4.8-6.3) years, during which 5067 (2.5%) participants were diagnosed with type 2 diabetes. After adjusting for lifestyle factors, fish eaters (HR 0.52 [95% CI: 0.39-0.69]) and fish and poultry eaters (HR 0.62 [95% CI: 0.45-0.88]) had a lower risk of incident type 2 diabetes compared with meat eaters. The association for vegetarians was not significant. Varied diet had a higher risk of type 2 diabetes. Obesity partially mediated the association of fish (30.6%), fish and poultry (49.8%) and varied (55.2%) diets.

CONCLUSIONS

Fish eaters, as well as fish and poultry eaters, were at a lower risk of incident type 2 diabetes than meat eaters, partially attributable to lower obesity risk.

Socioeconomic differences associated with consumption of a plant-based diet: Results from the national health and nutrition examination survey

BACKGROUND

A plant-based diet (PBD) has been associated with potential health benefits, but factors that may affect access to and consumption of a PBD are not well defined.

AIM

To determine the association between socioeconomic status and plant-based dietary consumption among participants enrolled in the National Health and Nutrition Examination Survey (NHANES).

METHODS

This was a cross-sectional study using data obtained from the NHANES database. The following covariates were assessed: age, sex, race/ethnicity, educational level, marital status, smoking status, physical activity, alcohol use, history of diabetes, and hypertension. Socioeconomic status was categorized according to poverty-income ratio (PIR). Food frequency questionnaires were used to calculate previously validated plant-based diet index (PDI) and healthful plant-based diet index (hPDI). Multivariable-adjusted logistic regression was performed to determine the association between PIR, clinical, demographic, and plant-based diet indices.

RESULTS

A total of 5037 participants were in the final analytic sample. Median age of participants was 51 ± 18.5 years. Overall PDI and hPDI were 50 [46-54] and 52 [47-57], respectively. Median PDI index was significantly different among PIR groups (PDI, p = 0.018; hPDI, p < 0.001). On multivariable analysis, participants in the poorest socioeconomic group (PIR ≤ 130%) were more likely to have lower consumption of a healthful PBD (hPDI).

CONCLUSION

Lower socioeconomic status (PIR ≤ 130%) was associated with decreased consumption of a healthful plant-based diet. These data suggest that socioeconomic disparities may limit consumption of healthier food and contribute to the high prevalence of adverse health conditions that exist in certain population groups.

Nomogram and Carotid Risk Score for Predicting Moderate or High Carotid Atherosclerosis among Asymptomatic Elderly Recycling Volunteers

Carotid atherosclerosis is associated with cardiovascular and cerebrovascular events. We explored an appropriate method for selecting participants without ischemic cerebrovascular disease but with various comorbidities eligible for a carotid ultrasound. This was a retrospective subgroup analysis of the carotid plaque burden from a previous study involving a vascular and cognitive survey of 956 elderly recycling volunteers (778 women and 178 men; mean age: 70.8 years). We used carotid ultrasound to detect the carotid plaque and computed the carotid plaque score (CPS). A moderate or high degree of carotid atherosclerosis (MHCA) was defined as CPS > 5 and was observed in 22% of the participants. The CPS had positive linear correlations with age, systolic blood pressure, and fasting glucose. We stratified the participants into four age groups: 60−69, 70−74, 75−79, and ≥80 years. Multivariable analysis revealed that significant predictors for MHCA were age, male sex, hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, and a nonvegetarian diet. Coronary artery disease and advanced age were the two strongest predictors. We chose the aforementioned seven significant predictors to establish a nomogram for MHCA prediction. The area under the receiver operating characteristic curve in internal validation with 10-fold cross-validation and the classification accuracy of the nomogram were 0.785 and 0.797, respectively. We presumed people who have a ≥50% probability of MHCA warranted a carotid ultrasound. A flowchart table derived from the nomogram addressing the probabilities of all models of combinations of comorbidities was established to identify participants who had a probability of MHCA ≥ 50% (corresponding to a total nomogram score of ≥15 points). We further established a carotid risk score range from 0 to 17 comprising the seven predictors. A carotid risk score ≥ 7 was the most optimal cutoff value associated with a probability of MHCA ≥ 50%. Both total nomogram score ≥ 15 points and carotid risk score ≥ 7 can help in the rapid identification of individuals without stroke but who have a ≥50% probability of MHCA—these individuals should schedule a carotid ultrasound.

vegetarian adults: Results from the National Health and Nutrition Examination Survey

Dietary acid load (DAL) is an important determinant of systemic pH and acid–base homeostasis. Diets abundant in acidogenic foods, such as meat and meat products, induce a low‐grade metabolic acidosis state that has been associated with cardiovascular disease, type‐2‐diabetes, and an increased cancer risk. Fruits and vegetables have alkalizing properties and beneficially affect DAL. It has thus been suggested that a plant‐based diet (restricting or excluding animal products) may be a powerful tool in reducing DAL; yet studies in that particular field are scarce. To explore these associations in greater detail, we examined DAL in self‐identified vegetarians from the United States National Health and Nutrition Examination Survey (2007–2010). We compared dietary intake and two widely used markers of DAL (PRAL (potential renal acid load) and NEAP (net endogenous acid production; NEAP_F and NEAP_R)) among 8,398 nonvegetarians and 191 lacto‐ovo‐vegetarians with reliable dietary intake aged 18 years or older. Vegetarians had a more favorable body mass index and consumed fewer calories (1862.31 kcal/d) than nonvegetarians (2041.12 kcal/d). Vegetarians consumed fewer protein (34.17 g/1000 kcal) and phosphorus compared to nonvegetarians (39.50 g of protein/1000 kcal) but had a higher intake of magnesium and potassium. Nonvegetarians exhibited higher median DAL scores (PRAL: 11.90 mEq/d, NEAP_F: 53.59 mEq/d, NEAP_R: 55.67 mEq/d) than vegetarians (PRAL: −0.44 mEq/d, NEAP_F: 39.60 mEq/d, NEAP_R: 41.30 mEq/d). Vegetarians had more favorable DAL scores compared to nonvegetarians in this descriptive epidemiologic study. Future (interventional) trials are warranted to examine the varying acid load in different plant‐based dietary patterns.

Vitamin B12 and Plant-Predominant Diets

Vitamin B12 deficiencies are common in individuals consuming plant-predominant diets, including those who consume diary and/or eggs. Deficiencies can lead to megaloblastic anemia and peripheral neuropathy, among other multi-system manifestations. The prevalence, assessment and prevention of vitamin B12 deficiency in patients following plant-predominant diets will be discussed.

Replacing meat with alternative plant-based products (RE-MAP): a randomized controlled trial of a multicomponent behavioral intervention to reduce meat consumption

BACKGROUND

Reducing meat consumption could protect the environment and human health.

OBJECTIVES

We tested the impact of a behavioral intervention to reduce meat consumption.

METHODS

Adult volunteers who regularly consumed meat were recruited from the general public and randomized 1:1 to an intervention or control condition. The intervention comprised free meat substitutes for 4 weeks, information about the benefits of eating less meat, success stories, and recipes. The control group received no intervention or advice on dietary change. The primary outcome was daily meat consumption after 4 weeks, assessed by a 7-day food diary, and repeated after 8 weeks as a secondary outcome. Other secondary and exploratory outcomes included the consumption of meat substitutes, cardiovascular risk factors, psychosocial variables related to meat consumption, and the nutritional composition of the diet. We also estimated the intervention's environmental impact. We evaluated the intervention using generalized linear mixed-effects models.

RESULTS

Between June 2018 and October 2019, 115 participants were randomized. The baseline meat consumption values were 134 g/d in the control group and 130 g/d in the intervention group. Relative to the control condition, the intervention reduced meat consumption at 4 weeks by 63 g/d (95% CI: 44-82; P < 0.0001; n = 114) and at 8 weeks by 39 g/d (95% CI: 16-62; P = 0.0009; n = 113), adjusting for sex and baseline consumption. The intervention significantly increased the consumption of meat substitutes without changing the intakes of other principal food groups. The intervention increased intentions, positive attitudes, perceived control, and subjective norms of eating a low-meat diet and using meat substitutes, and decreased attachment to meat. At 8 weeks, 55% of intervention recipients identified as meat eaters, compared to 89% of participants in the control group.

CONCLUSIONS

A behavioral program involving free meat substitutes can reduce meat intake and change psychosocial constructs consistent with a sustained reduction in meat intake.

Dietary Habits and Self-Reported Health Measures Among Norwegian Adults Adhering to Plant-Based Diets

Background

As plant-based diets is increasing, we aimed to investigate dietary habits, dietary motivation and self-reported health of Norwegian adults who adhere to different types of plant-based diets.

Methods

In 2020, 808 subjects (530 women and 278 men) participated in an online survey, including vegans (8%), lacto-ovo vegetarians (16%), pescatarians (23%), and flexitarians (53%).

Results

Half of the participants reported to consume fruits daily, three quarters consumed vegetables daily, and one quarter consumed whole grain products daily. Half of the participants reported weekly consumption of sweets and salted snacks, and 10% reported daily consumption of sugary drinks. Daily consumption of milk and dairy substitutes were reported by vegans (49%), lacto-ovo vegetarians (33%), pescatarians (32%), and flexitarians (25%). Daily consumption of meat replacement products was reported by vegans (3%), lacto-ovo vegetarians (5%), pescatarians (2%). Reported supplement use was highest among vegans (62%) and lowest among flexitarians (28%). Dietary motivations were driven by environmental (71%), health (64%), and animal welfare (49%) concerns, across all dietary groups. 75% reported their self-perceived health to be good or very good.

Conclusion

We found that Norwegian adults adhering to plant-based diets consumed less fruit, vegetables, and whole grain products, together with more sugar than recommended in the Norwegian dietary guidelines. The participants reported their self-perceived health to be good or very good.

Associations between Christian Orthodox Church Fasting and Adherence to the World Cancer Research Fund's Cancer Prevention Recommendations

Objective: Studies regarding the health effects of religious fasting have increased in the last decade. The aim of this research was to investigate the relationship between Christian Orthodox Church (COC) fasting recommendations and cancer risk, with a specific focus on fibre, fruit, vegetables, and red and processed meat consumption. Methods: In this cross-sectional study, participants included 361 individuals from Northern Greece. One hundred and seventy-six participants followed the COC fasting regime for more than 10 years, and 185 participants did not follow any restrictive dietary patterns. Diet was assessed using a 114-item food frequency questionnaire. Results: Fasters had a more favourable dietary intake compared to non-fasters, with fasters having a higher consumption of fruit and vegetables (p = 0.009) and a significantly lower consumption of total processed meat (p < 0.001) compared to non-fasters. No significant differences were observed in the consumption of fibre and red meat consumption between the two groups. Conclusions: Following the World Cancer Research Fund Cancer Recommendations, fasters are at a potentially lowering risk of developing colorectal cancer than non-fasters due to their more favourable dietary intake. Furthermore, higher consumption of fruit and vegetables with a lower consumption of total processed meat contributes to lower the risk of metabolic syndrome. Public health strategies based on following the structured COC fasting recommendations might hopefully contribute to the prevention of metabolic syndrome and colorectal cancer.

Why They Eat What They Eat: Comparing 18 Eating Motives Among Omnivores and Veg*ns

While the diets of most people include meat, millions of individuals follow a meat-free diet. But why do people eat what they eat? Here we explored differences and commonalities in the eating motives of omnivores and veg^*ns (i.e., both vegetarians and vegans). Specifically, we compared mean levels and rank order of 18 eating motives in two samples (Study 1: 294 omnivores, 321 veg^*ns; Study 2: 112 omnivores, 622 veg^*ns). We found that omnivores were more motivated than veg^*ns by the eating motives of Traditional Eating and Habits, while veg^*ns were more motivated by Animal Protection and Environmental Protection. Differences among groups in Health were inconsistent across studies. Despite these differences in mean levels, the rank order of the eating motives was very similar: Two of the top four eating motives of both diet groups in both studies were Liking and Health, while Social Norms, Social Image, and Religion were among the four least important motives of both groups. Overall, while we did find differences in the absolute importance of certain motives, we also found striking similarities in the relative importance of eating motives, suggesting that including a wide range of eating motives could be beneficial when examining dietary behaviors.

A Cross-Sectional Assessment of Human Milk Oligosaccharide Composition of Vegan, Vegetarian, and Nonvegetarian Mothers

Purpose: Recently, maternal nutrient intake has been associated with human milk oligosaccharides (HMOs) composition. The goal of this study was to assess HMO composition in breast milk samples from vegan, vegetarian, and nonvegetarian lactating women. Second, we assessed impact of maternal body mass index (BMI), age, parity, and lactation stage on HMO composition. Materials and Methods: A cross-sectional analysis of HMO composition from vegan (n = 26), vegetarian (n = 22), and nonvegetarian (n = 26) lactating women was carried out. The majority of participants took dietary supplements. Results: In an unadjusted bivariate model, there was no difference in individual HMO composition, total HMO-bound fucose and HMO-bound sialic acid, or diversity and evenness scores by diet group. When adjusting for factors that significantly differed between groups (maternal BMI and lactation stage), no differences in HMO composition were observed. Secretor status was significant for 13 of the outcome variables with the strongest positive relationship with total HMO (β = 0.922) and HMO-bound fucose (β = 0.910), and the strongest negative relationship with sialyl-lacto-N-tetraose b (LSTb) (β = -0.544). Lactation stage was significant for eight analytes, with the strongest positive impact on 3'sialyllactose (3'SL) (β = 0.433), and the strongest negative impact on 6'sialyllactose (6'SL) (β = -0.519). Maternal BMI had a significant positive relationship with total HMO composition (β = 0.113) and 3'SL (β = 0.325). Conclusions: Lactating women who consume plant-based diets do not produce different breast milk as it relates to HMO composition.

Ultra-processed food intake and animal-based food intake and mortality in the Adventist Health Study-2

BACKGROUND

Both ultra-processed foods and animal-derived foods have been associated with mortality in some studies.

OBJECTIVES

We aimed to examine the association of 2 dietary factors (ultra-processed foods and animal-based foods), adjusted for each other, with all-cause mortality.

METHODS

The setting is an observational prospective cohort study in North America, recruited from Seventh-day Adventist churches, comprised of 95,597 men and women, yielding an analytic sample of 77,437 participants after exclusions. The exposure of interest was diet measured by FFQ, in particular 2 dietary factors: 1) proportion of dietary energy from ultra-processed foods (other processing levels and specific substitutions in some models) and 2) proportion of dietary energy from animal-based foods (red meat, poultry, fish, and eggs/dairy separately in some models). The main outcome was all-cause mortality. Mortality data through 2015 were obtained from the National Death Index. Analyses used proportional hazards regression.

RESULTS

There were 9293 deaths. In mutually adjusted continuous linear models of both dietary factors (ultra-processed and animal-based foods), the HR for the 90th compared with the 10th percentile of the proportion of dietary energy from ultra-processed food was 1.14 (95% CI: 1.07, 1.21, comparing 47.7% with 12.1% dietary energy), whereas for animal-based food intake (meats, dairy, eggs) it was 1.01 (95% CI: 0.95, 1.07, comparing 25.0% with 0.4% dietary energy). There was no evidence of interaction (P = 0.36). Among animal-based foods, only red meat intake was associated with mortality (HR: 1.14; 95% CI: 1.08, 1.22, comparing 6.2% with 0% dietary energy).

CONCLUSIONS

Greater consumption of ultra-processed foods was associated with higher all-cause mortality in this health-conscious Adventist population with many vegetarians. The total of animal-based food consumption (meat, dairy, eggs) was not associated with mortality, but higher red meat intake was. These findings suggest that high consumption of ultra-processed foods may be an important indicator of mortality.

Changes in Bone Mineral Density and Trabecular Bone Score over Time between Vegetarian and Non-Vegetarian Middle-Aged and Older Women: A Three-Year Retrospective Medical Record Review

The effect of a vegetarian diet on bone health remains controversial. This retrospective medical record review compared changes in bone mineral density (BMD) and trabecular bone score (TBS) between vegetarian and non-vegetarian middle-aged and older women who underwent two general health examinations (T1 and T2) that were approximately three years apart. Generalized estimating equations were used to compare the change in lumbar spine and bilateral hip BMD and TBS over time. At T1, the mean age of the patients was 56.6 years (standard deviation 9.7 years) and the mean interval between T1 and T2 was 2.7 years. For women aged 40–55 years, compared with non-vegetarians, vegetarians were significantly associated with a larger reduction in lumbar spine BMD (p < 0.001) and left hip femoral neck BMD (p = 0.015) over the three-year interval. On the contrary, changes in BMD were not significant at any site in women aged ≥ 56 years. Moreover, the changes in BMD and TBS over the three-year interval did not significantly differ between vegetarian and non-vegetarian women aged 65–90 years. In conclusion, for women aged 40–55 years, vegetarian diets reduced bone quantity, as measured by BMD, but not bone quality, as measured by TBS.

The Biology of Veganism: Plasma Metabolomics Analysis Reveals Distinct Profiles of Vegans and Non-Vegetarians in the Adventist Health Study-2 Cohort

It is unclear how vegetarian dietary patterns influence plasma metabolites involved in biological processes regulating chronic diseases. We sought to identify plasma metabolic profiles distinguishing vegans (avoiding meat, eggs, dairy) from non-vegetarians (consuming ≥28 g/day red meat) of the Adventist Health Study-2 cohort using global metabolomics profiling with ultra-performance liquid chromatography mass spectrometry (UPLC-MS/MS). Differences in abundance of metabolites or biochemical subclasses were analyzed using linear regression models, adjusting for surrogate and confounding variables, with cross-validation to simulate results from an independent sample. Random forest was used as a learning tool for classification, and principal component analysis was used to identify clusters of related metabolites. Differences in covariate-adjusted metabolite abundance were identified in over 60% of metabolites (586/930), after adjustment for false discovery. The vast majority of differentially abundant metabolites or metabolite subclasses showed lower abundance in vegans, including xanthine, histidine, branched fatty acids, acetylated peptides, ceramides, and long-chain acylcarnitines, among others. Many of these metabolite subclasses have roles in insulin dysregulation, cardiometabolic phenotypes, and inflammation. Analysis of metabolic profiles in vegans and non-vegetarians revealed vast differences in these two dietary groups, reflecting differences in consumption of animal and plant products. These metabolites serve as biomarkers of food intake, many with potential pathophysiological consequences for cardiometabolic diseases.

Vegetarians: A 4-Year Data Report from the National Health and Nutrition Examination Survey (NHANES)

Dietary fiber is of paramount importance in the prevention of large-bowel diseases, yet fiber intake in many high income countries is well below daily recommendations. Vegetarian diets high in fiber-rich plant-foods have been associated with a higher frequency of bowel movements and softer stools. Thus, vegetarians appear to suffer less frequently from constipation and other bowel disorders. The number of studies investigating these associations, however, is limited. The present study sought to investigate bowel health and constipation prevalence in a self-identified vegetarian population from the U.S. National Health and Nutrition Examination Survey (2007−2010). Bowel health assessment included Bristol Stool Scale (BSS), Bowel Movement (BM) frequency and Fecal Incontinence Severity Index (FISI). The present study included 9531 non-vegetarians and 212 vegetarians. We found no associations between vegetarian status and all examined bowel health items (BM frequency, BSS and FISI). Vegetarians consumed significantly more fiber than omnivores (21.33 vs. 16.43 g/d, p < 0.001) but had a lower moisture intake (2811.15 vs. 3042.78 g/d, p = 0.045). The lack of an association of vegetarian status and bowel health is surprising, and may be a result of the relatively low fiber intake in this particular vegetarian cohort, which did not meet the daily fiber recommendations.

Cross-Sectional Study of the Prevalence of Cobalamin Deficiency and Vitamin B12 Supplementation Habits among Vegetarian and Vegan Children in the Czech Republic

Vegetarian (VG) and vegan (VN) diets in childhood are of growing interest due to their perceived health and environmental benefits. Concerns remain due to the possible disruption of healthy growth and development of children because of the scarcity of evidence-based studies. Among the nutrients of special concern is vitamin B12. Therefore, the Czech Vegan Children Study (CAROTS) decided to examine the relationship between B12 metabolism parameters and B12 intake through diet and supplementation. We analyzed laboratory parameters within n = 79 VG, n = 69 VN, and n = 52 omnivores (OM) children (0−18 years old). There were no significant differences in levels of holotranscobalamin (aB12), folate, homocysteine (hcys), or mean corpuscular volume. However, there was a significant difference in levels of cyanocobalamin (B12) (p = 0.018), even though we identified only n = 1 VG and n = 2 VN children as B12 deficient. On the other hand, we identified n = 35 VG, n = 28 VN, and n = 9 OM children with vitamin B12 hypervitaminosis (p = 0.004). This finding was related to a high prevalence of over-supplementation in the group (mean dose for VG 178.19 ± 238.5 µg per day; VN 278.35 ± 394.63 µg per day). Additionally, we found a significant (p < 0.05) difference between B12, aB12, and hcys levels of supplemented vs. non-supplemented VG/VN children. This can show that the intake of vitamin B12 via diet in the VG group might not be sufficient. Secondly, we analyzed a relation between supplement use in pregnancy and breastfeeding and its impact on vitamin B12 levels of children aged 0−3 years. Out of n = 46 mothers, only n = 3 (e.g., 6.5%) were not supplemented at all. We have not identified any clinical manifestation of B12 deficiency and only n = 1 child with low serum cobalamin, a child who did not receive vitamin B12 supplementation and whose mother took only low doses of vitamin B12 (25/µg/day).To conclude, we did not observe any life-threatening or severe consequences of laboratory-stated vitamin B12 deficiency; thus, our group was well supplemented. On the other hand, we have identified many subjects with vitamin B12 hypervitaminosis of unknown impact on their health. Further research and new guidelines for B12 supplementation among VG and VN children are needed.

Identifiable Dietary Patterns of Pregnant Women: A Canadian Sample

Purpose: To estimate the percentage of a sample of pregnant women in Canada following a vegetarian, vegan, low-carbohydrate, gluten-free, Mediterranean, or well-balanced diet, before and during pregnancy and to explore if pregnant women received and were satisfied with nutrition information received from health care providers (HCPs).Methods: Participants were conveniently sampled through Facebook and Twitter. An online survey collected data on sociodemographic characteristics, maternal diet, and whether women received and were satisfied with nutrition information from their HCPs. The McNemar test assessed changes in the proportion of diets followed before and during pregnancy.Results: Of 226 women, most followed a well-balanced diet before (76.9%) and during (72.9%) pregnancy (p = 0.26). Vegetarian, gluten-free, vegan, and low-carbohydrate diets were the least followed diets before and during pregnancy (vegetarian: 7.6% vs 5.3%; gluten-free: 4.9% vs 4.0%; vegan: 2.7% vs 2.2%; low-carbohydrate:4.0% vs 0.4%). Overall, the number of women following restrictive diets before pregnancy was significantly reduced throughout pregnancy (19.1% vs 12.0%, p < 0.001). Only 52.0% of women received nutrition information from their primary HCP, and 35.6% were satisfied with the nutrition information received.Conclusions: Most women followed a well-balanced diet before and during pregnancy and approximately one-third were satisfied with the information received from HCPs.

Plate Waste Evaluation of Plant-Based Protein Entrees in National School Lunch Program

OBJECTIVE

To assess plate waste of plant-based protein entrees compared with regularly served meat-based entrees in the National School Lunch Program (NSLP).

DESIGN

Plate waste data were collected before and after introducing the plant-based entrees, using digital photography and the quarter-waste method.

PARTICIPANTS

National School Lunch Program participants in grades 6-8.

INTERVENTION

Two newly developed plant-based protein entrees were introduced into the menu cycle by replacing 2 regularly served meat-based entrees.

MAIN OUTCOME MEASURE

Student plate waste of plant-based entrees compared with entrees regularly served in the NSLP meal pattern.

ANALYSIS

A total of 4,138 meal observations were analyzed. Ordinary least-squares regressions and 2-sample unpaired t tests were used to determine significant differences in waste.

RESULTS

National School Lunch Program participants wasted plant-based entrees more than all other entrees served during lunch. Students wasted all or none of the plant-based entrees more than partial servings. There were no significant differences in waste between demographic groups for the plant-based entrees.

CONCLUSIONS AND IMPLICATIONS

Plant-based entrees served as a part of the NSLP may lead to increased plate waste than meat-based entrees. Novel food pairings and visibility of legumes may have led to increased plate waste.

Life of a vegetarian college student: Health, lifestyle, and environmental perceptions

Objective To examine health behavior and environmental perception differences among vegetarian and nonvegetarian students. Participants: First-year university students (n = 1078) from eight United States universities. Methods: Data were obtained from base 2015 and followup 2016 assessments. Vegetarians and nonvegetarians were compared for anthropometrics, lifestyle behaviors, and campus environmental perceptions (CEPS). Results: Vegetarians had smaller waist circumference, lower systolic blood pressure, higher fruit and vegetable consumption, lower percentage of energy obtained from fat, and higher perceived stress. Vegetarians expressed a lower rating of perceptions of health policies on campus. Conclusion: A clear difference in indicators of physical health does not appear, however, vegetarian students show positive dietary patterns which can promote positive health outcomes. Further, vegetarians had lower perceptions of health policies on campus. Results can be used by administrators to ensure policies are in place to support health of students as currently vegetarian students see limitations in the environmental health policies.

Effectiveness of strategies to decrease animal sourced protein and/or increase plant sourced protein in foodservice settings: a systematic literature review

BACKGROUND

Effective population-based strategies are required to move towards healthy sustainable diets which replace a proportion of animal- with plant-based protein. Foodservice can support this using a variety of strategies across the food supply chain.

OBJECTIVE

This systematic review aimed to evaluate the effectiveness of strategies to decrease animal protein and/or increase plant protein in foodservice settings on uptake, satisfaction, financial, environmental, and dietary intake outcomes.

METHODS

Seven databases were searched in November 2020 with no restriction on study dates to identify peer-reviewed study designs conducted in commercial and institutional foodservices using any strategy to decrease beef, lamb, pork, poultry, eggs, fish or seafood and/or increase legumes/pulses, legume/pulse-based meat substitutes or nuts and reported this review's primary outcome, uptake by consumers either quantitatively or qualitatively. Secondary outcomes were satisfaction and financial, environmental, and dietary intake outcomes. Titles/abstracts then full texts were screened independently by two authors. The Mixed Methods Appraisal Tool was used for quality appraisal. Results were described using a narrative synthesis by strategy type. The protocol is registered with PROSPERO (CRD42021235015).

RESULTS

From 20,002 records identified, 38 studies met eligibility criteria, of which 16% were high quality. Strategies included forced restriction (n=4), menu re-design (n=6), recipe re-design (n=6), service re-design (n=4), menu labelling (n=7), prompt at point of sale (n=7) and multi-pronged strategies (n=4). Menu labelling, prompting at the point of sale and re-designing menus, recipes, and service increased uptake of target foods in most studies with the largest consistent changes in menu re-design. Few studies explored secondary outcomes. Recipe re-design, prompt at the point of sale and menu labelling strategies that measured satisfaction found a positive or neutral effect.

CONCLUSIONS

The most promising strategies are likely in menu re-design, followed by menu labelling and service re-design. Satisfaction appears to not be negatively impacted by recipe re-design, prompting at the point of sale and menu labelling. More studies are needed to evaluate financial, environmental, and dietary outcomes.

Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review

Health authorities increasingly recommend a more plant-based diet, rich in fruits, vegetables, pulses, whole grains and nuts, low in red meat and moderate in dairy, eggs, poultry and fish which will be beneficial for both health and the environment. A systematic review of observational and intervention studies published between 2000 and January 2020 was conducted to assess nutrient intake and status in adult populations consuming plant-based diets (mainly vegetarian and vegan) with that of meat-eaters. Mean intake of nutrients were calculated and benchmarked to dietary reference values. For micronutrient status, mean concentrations of biomarkers were calculated and compared across diet groups. A total of 141 studies were included, mostly from Europe, South/East Asia, and North America. Protein intake was lower in people following plant-based diets compared to meat-eaters, but well within recommended intake levels. While fiber, polyunsaturated fatty acids (PUFA), folate, vitamin C, E and magnesium intake was higher, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake was lower in vegetarians and vegans as compared to meat-eaters. Intake and status of vitamin B12, vitamin D, iron, zinc, iodine, calcium and bone turnover markers were generally lower in plant-based dietary patterns compared to meat-eaters. Vegans had the lowest vitamin B12, calcium and iodine intake, and also lower iodine status and lower bone mineral density. Meat-eaters were at risk of inadequate intakes of fiber, PUFA, α-linolenic acid (ALA), folate, vitamin D, E, calcium and magnesium. There were nutrient inadequacies across all dietary patterns, including vegan, vegetarian and meat-based diets. As plant-based diets are generally better for health and the environment, public health strategies should facilitate the transition to a balanced diet with more diverse nutrient-dense plant foods through consumer education, food fortification and possibly supplementation.

Vegetarians: A National Health and Nutrition Examination Survey (NHANES) Data Report

An increasing number of individuals adopt plant-based diets for their potential health benefits. Understanding vegetarians' dietary behavior in the context of their socioeconomic background is essential for pro-vegetarian messaging and to influence public beliefs about plant food consumption. Thus, this study sought to investigate diet and consumer behaviors in U.S. vegetarians. This is a cross-sectional, population-based study with data from the Nutrition and Health Examination Surveys (2007-2010). Selected items from three modules (diet and nutrition behavior, consumer behavior, and food security) were compared between vegetarians (n = 352) and the general population (n = 14,328). U.S. vegetarians consumed significantly fewer calories and less cholesterol but more fiber than their omnivorous counterparts. Moreover, vegetarians had significantly fewer soft drinks and salty snacks available at home. We also observed significant intergroup differences with regard to the availability of fruit and dark green vegetables. Vegetarians spent less money on eating out and indicated a lower number of not-home-prepared meals and ready-to-eat foods. We found no differences regarding money spent at supermarkets or grocery stores. Our study contributes to a better understanding of dietary and consumer behaviors in vegetarians. We shed a new light on the economic feasibility of vegetarian diets, highlighting that these diets are not necessarily more expensive than an omnivorous diet.

A Modern Flexitarian Dietary Intervention Incorporating Web-Based Nutrition Education in Healthy Young Adults: Protocol for a Randomized Controlled Trial

BACKGROUND

The trend of flexitarian eating patterns is on the rise, with young adults among the biggest adopters claiming health and environmental reasons to reduce red meat intake. Nutrient-dense meat and animal products are often the lynchpin of these diets, even when consumed only occasionally and in moderate amounts. Red meat provides forms and concentrations of essential proteins, lipids, and micronutrients that are scarce in exclusively vegetarian regimens.

OBJECTIVE

The aim of this study is to consider the effects of moderate consumption of lean red meat as part of an otherwise vegetarian balanced diet and its impact on biomarkers of sustained health and well-being.

METHODS

A cohort of healthy, young (20-34 years old, n=80) male and female participants will take part in a 2-arm, parallel randomized controlled trial (RCT) for a duration of 12 weeks, with a 3-month posttrial follow-up. The trial will commence with a 2-week assessment period followed by allocation to the intervention arms. The intervention will include the consumption of red meat or meat alternatives 3 times per week for 10 weeks. Blood samples of the participants will be collected to measure changes in erythrocyte fatty acid distribution, circulating amino acids, neurotransmitters, markers of mineral status, and inflammatory markers. Questionnaires to assess well-being and mental health will be undertaken every 2 weeks. Body composition, physical function, and blood parameters will be assessed at allocation (t₀), week 5 into the intervention (t₅), and post intervention (t₁₀).

RESULTS

The protocol has been developed using the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) checklist and the outcomes will be reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The trial was approved by the New Zealand Ministry of Health's Health and Disability Ethics Committees (protocol 20/STH/157). The results of this study will be communicated via publication.

CONCLUSIONS

To our knowledge, this is the first RCT investigating the overarching health consequences of consuming pasture-fed red meat or no meat as part of a healthy diet.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04869163; https://clinicaltrials.gov/ct2/show/NCT04869163.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/30909.

Associations between Avocado Consumption and Diet Quality, Dietary Intake, Measures of Obesity and Body Composition in Adolescents: The Teen Food and Development Study

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12-18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (β [SE] = 0.11 [0.03]) and moderation (β [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.

Plant-Based Diet as a Strategy for Weight Control

According to the World Health Organization, obesity has nearly tripled since the 1970s. Obesity and overweight are major risk factors for cardiovascular diseases, diabetes, inflammatory-mediated diseases, and other serious medical conditions. Moreover, recent data suggest that obesity, overweight, diabetes, and cardiovascular diseases are risk factors for COVID-19-related mortality. Different strategies for weight control have been introduced over the last two decades. Unfortunately, these strategies have shown little effect. At the same time, many studies show that plants might be the key to a successful strategy for weight control. Following the PRISMA guidelines for conducting systematic reviews, a search was conducted in PubMed, Web of Science, Scopus, and Embase using the following keywords: obesity, globesity, vegan, plant-based diet, etc. Our results show that vegan diets are associated with improved gut microbiota symbiosis, increased insulin sensitivity, activation of peroxisome proliferator-activated receptors, and over-expression of mitochondrial uncoupling proteins. The key features of this diet are reduced calorie density and reduced cholesterol intake. The combination of these two factors is the essence of the efficiency of this approach to weight control. Our data suggest that plant-based/vegan diets might play a significant role in future strategies for reducing body weight.

The Relationship between Modern Fad Diets and Kidney Stone Disease: A Systematic Review of Literature

Objectives: Kidney stone disease (KSD) has a strong association with diet metabolic syndrome. This review aims at exploring the lithogenic risk posed by the current most popular diets. Our approach was to search for the effect of each diet type on the major urinary risk factors, to try to draw conclusions regarding the association of a specific diet type and KSD. Methods: This systematic review searched for the available literature exploring the association between the existing popular fad diets and KSD. Articles in English, French and Spanish were included, without restriction of the search period with the final search done in August 2021. Results: Total number of studies and studies for each diet type was as follows: 22 articles for the low carbohydrate diet, 20 articles for high protein diets, 26 articles for vegetarian and vegan diets. There exists a substantial variability in different low carbohydrate and high protein diets, and considerable overlap between modern popular fad diets. High carbohydrate intake might increase urine uric acid, calcium and oxalate levels. High protein diets increase urine calcium and uric acid and lower urine pH and citrate. Consumption of fruits and vegetables increases the urinary volume and urinary citrate. In vegan diets, sufficient daily calcium intake is important to avoid possible secondary hyperoxaluria. Conclusions: Few studies evaluated the direct relationship between modern fad diets and KSD. In general, the reduction of carbohydrate in the diet, and counterbalancing protein rich diets with sufficient intake of fruits and vegetables, seem to play a protective role against KSD formation. Maintaining sufficient calcium intake in vegan and vegetarian diets is important. Additional research is needed to directly evaluate the link between KSD and each diet type.

Nutritional Quality of Plant-Based Meat Products Available in the UK: A Cross-Sectional Survey

Plant-based meat (PBM) has been gaining popularity due to increasing concerns over health, animal welfare, and environmental issues linked to animal foods. This study aimed to compare the nutrient profile of PBM with equivalent meat products. We conducted a cross-sectional survey of 207 PBM and 226 meat products available from 14 retailers in the UK. We extracted data on energy density, total and saturated fat, protein, fiber, and salt per 100 g from product packaging and calculated the nutrient profile of each product. Compared to meat, PBM had significantly lower energy density, total fat, saturated fat, protein, and significantly higher fiber. Salt content was significantly higher in five out of six PBM categories. Based on the UK’s Nutrient Profiling Model, 14% of PBM and 40% of meat products were classified as “less healthy” (p < 0.001). When considering the UK’s front-of-pack labelling criteria 20% of the PBM and 46% of meat products were considered high in either total fat, saturated fat, or salt (p < 0.001). Nearly three quarters of PBM products did not meet the current UK salt targets. PBM products have a better nutrient profile compared to meat equivalents. However, more progress is needed to reduce salt in these products.

Sleeping Disorders in Healthy Individuals with Different Dietary Patterns and BMI, Questionnaire Assessment

The COVID-19 pandemic and abiding restrictions have affected every life domain. Sleep disturbances are a major health issue that is linked with a higher prevalence of metabolic syndrome, obesity, and psychological burdens. Research of sleeping disorders among vegetarian and non-vegetarian subpopulations is limited. The aim of the study was to assess the prevalence of sleeping disorders during the COVID-19 pandemic among people with different dietary patterns. Using a web-based cross-sectional survey, data were collected from 1987 people. A total of 1956 respondents met all study conditions. The questionnaire consisted of sociodemographic information, assessment of dietary habits, and assessment of the prevalence of insomnia and sleepiness, based on the Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale (ESS). A total of 36.04% (n = 705) respondents declared that they noticed a change in the quality of their sleep during the last year. According to AIS and ESS, non-vegetarians suffered from insomnia or sleepiness more often than vegetarians. Insomnia and sleepiness were also more prevalent among those respondents who declared consumption of fruit and vegetables less often than once a day compared with those who consumed fruit and vegetables daily. Respondents with BMI within the recommended limit (18.5–24.99) suffered from insomnia less often when compared with underweight (BMI < 18.5) or obese (BMI ≥ 25) respondents. Those results may be useful for public health workers and medical professionals in terms of establishing new instruments that help treat sleeping disorders.

The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals

Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.

Effects of Plant-Based Diets on Weight Status in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Excessive adiposity is a major risk factor for type 2 diabetes (T2D), and dietary patterns are important determinants of weight status. Plant-based dietary patterns (PBDs) are known for their therapeutic effects on T2D. The aim is to systematically review RCTs to investigate the effects of various PBDs compared to regular meat-eating diets (RMDs), in individuals who normally consume a RMD on body weight, BMI, and waist circumference in T2D. RCTs investigating PBDs and body weight, BMI, WC for ≥6 weeks in adults with T2D since 1980 were eligible for inclusion. Seven trials (n = 269) were included in the meta-analysis using random-effects models and expressed as MD (95%Cls). Compared to RMDs, PBDs significantly lowered body weight (-2.35 kg, 95% CI: -3.51, -1.19, p < 0.001), BMI (-0.90 kg/m2, 95% CI: -1.42, -0.38, p = 0.001) and WC (-2.41 cm, 95% CI: -3.72, -1.09, p < 0.001). PBDs alone significantly reduced body weight by 5.1% (-4.95 kg, 95% CI: -7.34, -2.55, p < 0.001), BMI by 5.4% (-1.87 kg/m2, 95% CI: -2.78, -0.95, p < 0.001) and WC by 4.3%(-4.23, 95% CI: -6.38, -2.07, p < 0.001). Interventions not limiting energy intake led to a significant reduction in body weight (-2.54 kg, 95% CI: -4.16, -0.92, p < 0.005) and BMI (-0.91 kg/m2, 95% CI: -1.56, -0.25, p < 0.005). Trials ≥16 weeks had a pronounced reduction in body weight (-2.93 kg, 95% CI: -5.00, -0.87, p = 0.005) and BMI (-1.13 kg/m2, 95% CI: -1.89, -0.38, p < 0.005). These findings provide evidence for the implementation of PBDs for better management of central adiposity in individuals with T2D.

The Impact of Vegan and Vegetarian Diets on Physical Performance and Molecular Signaling in Skeletal Muscle

Muscular adaptations can be triggered by exercise and diet. As vegan and vegetarian diets differ in nutrient composition compared to an omnivorous diet, a change in dietary regimen might alter physiological responses to physical exercise and influence physical performance. Mitochondria abundance, muscle capillary density, hemoglobin concentration, endothelial function, functional heart morphology and availability of carbohydrates affect endurance performance and can be influenced by diet. Based on these factors, a vegan and vegetarian diet possesses potentially advantageous properties for endurance performance. Properties of the contractile elements, muscle protein synthesis, the neuromuscular system and phosphagen availability affect strength performance and can also be influenced by diet. However, a vegan and vegetarian diet possesses potentially disadvantageous properties for strength performance. Current research has failed to demonstrate consistent differences of performance between diets but a trend towards improved performance after vegetarian and vegan diets for both endurance and strength exercise has been shown. Importantly, diet alters molecular signaling via leucine, creatine, DHA and EPA that directly modulates skeletal muscle adaptation. By changing the gut microbiome, diet can modulate signaling through the production of SFCA.

Differences Between Omnivores and Vegetarians in Personality Profiles, Values, and Empathy: A Systematic Review

Numerous medical studies have documented vegetarian diets as having various health benefits. Studies have also compared vegetarians with other dietary groups from a socio-psychological perspective. The objective of this review is to investigate the differences between vegetarians and omnivores in terms of their personality profiles, values, and empathy skills. A search was conducted across three electronic databases. Non-randomized, observational, cross-sectional, and cohort studies were eligible. Outcomes provided information about the differences between the above-mentioned dietary groups regarding their personality profiles, values, and empathy skills. A shortened version of the Newcastle–Ottawa Scale was used to assess the risk of bias for the included studies. Of the 2,513 different studies found, 25 (total number of participants n = 23,589) were ultimately included. These studies indicate that vegetarians significantly differ from omnivores in their personalities, values, and ability to be empathetic. Omnivorism is associated with an increased orientation toward social dominance, greater right-wing authoritarianism, and, in line with this, a stronger tendency to be prejudiced. Vegetarianism is associated with greater openness and empathy. The values of vegetarians are based more on universalism, hedonism, stimulation, and self-direction, whereas the values of omnivores are based more on the idea of power. To answer a narrowly defined and clear question, issues such as animal ethics, animal rights, and environmental protection are not considered in this review. The findings of this review, showing marked differences in personality correlating to the choice of diet and the increasing influence of plant-based diets on a global level, indicate that further studies about vegetarianism are warranted.

A Vegan Diet Is Associated with a Significant Reduction in Dietary Acid Load: Post Hoc Analysis of a Randomized Controlled Trial in Healthy Individuals

The composition of diet strongly affects acid–base homeostasis. Western diets abundant in acidogenic foods (meat and cheese) and deficient in alkalizing foods (fruits and vegetables) increase dietary acid load (DAL). A high DAL has been associated with numerous health repercussions, including cardiovascular disease and type-2-diabetes. Plant-based diets have been associated with a lower DAL; however, the number of trials exploring this association is limited. This randomized-controlled trial sought to examine whether an isocaloric vegan diet lowers DAL as compared to a meat-rich diet. Forty-five omnivorous individuals were randomly assigned to a vegan diet (n = 23) or a meat-rich diet (n = 22) for 4 weeks. DAL was determined using potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores at baseline and after 3 and 4 weeks, respectively. After 3 weeks, median PRAL (−23.57 (23.87)) and mean NEAP_R (12.85 ± 19.71) scores were significantly lower in the vegan group than in the meat-rich group (PRAL: 18.78 (21.04) and NEAP_R: 60.93 ± 15.51, respectively). Effects were mediated by a lower phosphorus and protein intake in the vegan group. Our study suggests that a vegan diet is a potential means to reduce DAL, whereas a meat-rich diet substantially increases the DAL burden.

Total protein, not amino acid composition, differs in plant-based versus omnivorous dietary patterns and determines metabolic health effects in mice

Plant-based dietary patterns are associated with improved cardiometabolic health, but causal dietary components are unclear. Protein has been proposed to play a role, but the importance of protein quantity versus quality remains unknown. We investigated the contributions of total protein amount, amino acid (AA) composition, and plant versus animal source. Analysis of total protein and AA composition of food items and dietary patterns revealed differences between individual food items, but few differences between AA profiles of vegan versus omnivorous dietary patterns. Effects of protein quantity, but not quality, on cardiometabolic health markers were observed in mice using semi-purified diets with crystalline AAs in plant versus animal-based ratios and naturally sourced diets with whole-food ingredients. Our data show relatively little difference in protein quality between plant-based and omnivorous dietary patterns and that reduced total protein intake in plant-based dietary patterns may be a contributor to the benefits of plant-based diets.

Risk of Incident Stroke among Vegetarians Compared to Nonvegetarians: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Vegetarian dietary patterns provide health benefits for cardiovascular health; however, the studies examining the association of vegetarian diets with stroke incidence showed inconsistent findings. We systematically evaluated the risk of incident stroke among vegetarians (diets excluding meat, poultry, fish, and seafood) compared among nonvegetarians. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was performed until 20 May 2021. Prospective cohort studies comparing the risk estimates for incident stroke between vegetarians and nonvegetarians were included. Of 398 articles identified in the database search, data from seven cohort studies (408 total stroke cases in 29,705 vegetarians and 13,026 total stroke cases in 627,728 nonvegetarians) were included. The meta-analysis revealed no significant association between adhering to the vegetarian dietary patterns and the risk of incident stroke (HR = 0.86; 95% CI = 0.67-1.11; I² = 68%, n = 7). Subgroup analyses suggested that studies conducted in Asia and those with a mean baseline age of participants 50-65 years showed a lower risk of stroke in vegetarians. Moreover, no significant association between vegetarian diets and the risk of ischemic stroke (HR = 0.56; 95% CI = 0.22-1.42; I² = 82%, n = 3) or hemorrhagic stroke (HR = 0.77; 95% CI = 0.19-3.09; I² = 85%, n = 2) was found. To be conclusive, no strong relationship between vegetarian diets and the incidence of stroke was observed. Given the limited certainty of evidence from NutriGrade, future well-designed studies are warranted to provide solid evidence on this topic.

Cross-sectional comparisons of subgingival microbiome and gingival fluid inflammatory cytokines in periodontally healthy vegetarians versus non-vegetarians

BACKGROUND

Vegetarian diets are known to reduce inflammation. The objective of this study was to test the hypothesis that reduced inflammation associated with a vegetarian diet would promote a more commensal subgingival bacterial profile.

METHODS

A total of 39 periodontally healthy subjects (PD ≤3 mm, bleeding on probing <10%) were enrolled. Dietary intake was assessed by a food frequency questionnaire. A comprehensive periodontal examination was performed. Gingival crevicular fluid (GCF) and subgingival plaque samples were collected. GCF samples were assessed for interleukin-1β, interleukin-6, interleukin-8, tumor necrosis factor-alpha, and interleukin-10. Plaque samples were analyzed for bacteria using 16S rDNA sequencing on an Illumina platform. GenBank database was used for taxonomy classification.

RESULTS

Twenty-three subjects were categorized as vegetarian and 16 non-vegetarians. Clinical periodontal measures and GCF cytokine levels were statistically comparable between the two groups. Measures of microbial richness and alpha diversity were also comparable between the two dietary groups. Vegetarians harbored higher levels of phyla associated with gingival health (Actinobacteria, and Proteobacteria). Two species known to be associated with periodontitis (Mogibacterium timidum and Veillonella rogosae) were prominent in non-vegetarians. Pearson's correlations between GCF inflammatory cytokines and microbial taxa differed between vegetarians and non-vegetarians. In vegetarians, the anti-inflammatory cytokine IL-10 positively correlated with two species known to be associated with periodontal health (Peptidiphaga sp. HMT183 and Rothia aeria).

CONCLUSIONS

Diet is directly and indirectly associated with the microbial composition of subgingival plaque. A vegetarian diet may promote a subgingival microbiota associated with periodontal health.

Sex Differences in Supplement Intake in Recreational Endurance Runners-Results from the NURMI Study (Step 2)

It has been well-documented that female and male athletes differ in many physiological and psychological characteristics related to endurance performance. This sex-based difference appears to be associated with their nutritional demands including the patterns of supplement intake. However, there is a paucity of research addressing the sex differences in supplement intake amongst distance runners. The present study aimed to investigate and compare supplement intake between female and male distance runners (10 km, half-marathon, (ultra-)marathon) and the potential associations with diet type and race distance. A total of 317 runners participated in an online survey, and 220 distance runners (127 females and 93 males) made up the final sample after a multi-stage data clearance. Participants were also assigned to dietary (omnivorous, vegetarian, vegan) and race distance (10-km, half-marathon, marathon/ultra-marathon) subgroups. Sociodemographic characteristics and the patterns of supplement intake including type, frequency, dosage, and brands were collected using a questionnaire. One-way ANOVA and logistic regression were used for data analysis. A total of 54.3% of female runners and 47.3% male runners reported consuming supplements regularly. The frequency of supplement intake was similar between females and males (generally or across dietary and distance subgroups). There was no significant relationship for sex alone or sex interactions with diet type and race distance on supplement intake (p < 0.05). However, a non-significant higher intake of vitamin and mineral (but not CHO/protein) supplements was reported by vegan and vegetarian (but not by omnivorous) females compared to their male counterparts. In summary, despite the reported findings, sex could not be considered as a strong modulator of supplement intake among different groups of endurance runners.

A Comparison of Key Essential Nutrients in Commercial Plant-Based Pet Foods Sold in Canada to American and European Canine and Feline Dietary Recommendations

Simple Summary

Plant-based pet foods appear to be growing in popularity, but it is unclear how suitable these products are for dogs and cats, considering both species naturally consume diets rich in, or exclusively comprised of, animal tissues. Laboratory analyses of essential nutrients were performed on 26 plant-based diets available in Ontario, Canada in 2018, including 18 canine products (13 products labelled for adult maintenance, four for all life stages, one for puppy growth), 5 feline products (two for adult maintenance and three for all life stages), and 3 products labelled for both dogs and cats (one for adult maintenance and two for all life stages). The nutrient measurements were compared to industry standard nutrient profiles. Four products met the recommendations of the Association of American Feed Control Officials and one product the nutrient recommendations of the European Pet Food Industry Federation for adult dogs. No diets met recommended nutrient content for adult cats or growing puppies or kittens. Nutrients most commonly found to be insufficient were: sulfur amino acids, taurine, arachidonic acid, EPA and DHA, calcium phosphorus and vitamin D. These nutrients are all typically found in animal tissues, though non-animal sources are available, and require careful formulation or supplementation in products made without animal-derived ingredients. Compliance with Canadian labelling regulation and guidelines was poor. These problems do not appear to be exclusive to plant-based foods and have been demonstrated previously in commercially available animal-based products as well. This study demonstrates areas where manufacturers of plant-based pet foods must improve formulation and/or manufacturing practices to produce products appropriate for feeding cats and dogs.

Abstract

Plant-based foods intended for feeding dogs and cats are available in Canada, though few studies have examined the suitability of plant-based foods for dogs and cats. All commercial plant-based extruded and wet pet food products available in Ontario, Canada, in 2018 (n = 26) were acquired and analysed for energy, crude protein, crude fat, crude fibre, ash, amino acids, fatty acids, minerals and vitamins A, B₁₂, D₂ and D₃. Results were compared with recommendations of the Association of American Feed Control Officials (AAFCO) and the European Pet Food Industry Federation (FEDIAF). Thirteen products were labelled for adult canine maintenance, four for canine all life stages, one for puppy growth, two for adult feline maintenance, three for feline all life stages, one for adult maintenance of dogs and cats and two for all life stages of dogs and cats. Four products met AAFCO and one product met FEDIAF nutrient recommendations for canine maintenance. No diets met AAFCO or FEDIAF recommendations for feline maintenance or growth for either species. Nutrients most commonly found insufficient were: sulfur amino acids, taurine, arachidonic acid, EPA and DHA, calcium phosphorus and vitamin D. There were no nutrients unable to be provided from non-animal sources. Compliance with labelling guidelines was also poor, similar to other findings with commercial animal-based pet products. The results from this study indicate areas where producers of plant-based pet foods must improve to meet the industry recommended nutrient profiles and labelling requirements.

[ω-3 Fatty acids intake level of vegetarians in Shanghai]

OBJECTIVE

To assess the ω-3 fatty acids intake level of vegetarians in Shanghai, and compare with the sex and age matched omnivores.

METHODS

The present observational study included 282 vegetarians aged 18 to 60 years old who had been vegetarian for at least one year and 282 sex and age matched omnivores recruited among Shanghai citizens. Daily food consumption was assessed through frequency and average intake of 149 kinds of food by food frequency questionnaire(FFQ) conducted by experienced dietitians. Dietary intake of ALA, EPA and DHA was calculated by R(Software). The differences of ω-3 fatty acids dietary intake between vegetarians and omnivores were analyzed with non-parametric test.

RESULTS

The ALA intake of vegetarian group was(1669.00±1340.67)mg/d, which was significantly higher than that of omnivore group((1298.56±1041.96)mg/d). However, the EPA intake of vegetarian group((8.45±12.69)mg/d) was significantly less than the omnivore group((128.63±144.15)mg/d). The DHA intake of vegetarian group((28.75±35.38)mg/d) was also significantly less than the omnivore group((236.88±223.05)mg/d). Most of the dietary intake of EPA and DHA was supplied by seafood.

CONCLUSION

Vegetarians EPA and DHA intake was significantly lower than omnivores.

Unintended Consequences: Nutritional Impact and Potential Pitfalls of Switching from Animal- to Plant-Based Foods

Consumers are shifting towards plant-based diets, driven by both environmental and health reasons. This has led to the development of new plant-based meat alternatives (PBMAs) that are marketed as being sustainable and good for health. However, it remains unclear whether these novel PBMAs to replace animal foods carry the same established nutritional benefits as traditional plant-based diets based on pulses, legumes and vegetables. We modelled a reference omnivore diet using NHANES 2017–2018 data and compared it to diets that substituted animal products in the reference diet with either traditional or novel plant-based foods to create flexitarian, vegetarian and vegan diets matched for calories and macronutrients. With the exception of the traditional vegan diet, all diets with traditional plant-based substitutes met daily requirements for calcium, potassium, magnesium, phosphorus, zinc, iron and Vitamin B12 and were lower in saturated fat, sodium and sugar than the reference diet. Diets based on novel plant-based substitutes were below daily requirements for calcium, potassium, magnesium, zinc and Vitamin B12 and exceeded the reference diet for saturated fat, sodium and sugar. Much of the recent focus has been on protein quality and quantity, but our case study highlights the risk of unintentionally increasing undesirable nutrients while reducing the overall nutrient density of the diet when less healthy plant-based substitutes are selected. Opportunities exist for PBMA producers to enhance the nutrient profile and diversify the format of future plant-based foods that are marketed as healthy, sustainable alternatives to animal-based products.

Plasma and Urinary Amino Acid Profile in Children with Infantile Tremor Syndrome

BACKGROUND

Infantile Tremor Syndrome (ITS) is a disorder of infancy, and characterized by developmental delay and/or regression, pallor, skin hyperpigmentation and hypopigmented hair. It is commonly seen in infants in whom exclusive breastfeeding is given inappropriately for longer durations than recommended. ITS is predominantly reported from the Indian subcontinent and in children from a lower socioeconomic background. It is a clinical diagnosis and vitamin B12 deficiency is the most commonly accepted etiology of this entity.

OBJECTIVES

The primary objectives of study were to compare the plasma and urine amino acid levels among children with ITS spectrum with those of healthy children. The secondary objectives were to compare the plasma and urine amino acid levels among children with ITS and Pre-ITS.

STUDY DESIGN

This cross-sectional, observational study was carried out at a tertiary care hospital in North India.

PARTICIPANTS

A total of 50 children aged < 36 months with ITS/Pre-ITS were enrolled. Children with Pre-ITS and ITS were compared with healthy age-matched study subjects.

RESULTS

Thirty-nine (78%) cases and twelve (24%) healthy children had low serum vitamin B12 levels. Folate levels were normal in all the controls, while only one case had folate deficiency. There were significant differences (p < 0.05) in the values of 32 amino acids in plasma. Among 44 urinary amino acids, levels of 30 amino acids were significantly different in the cases compared with the controls (p < 0.05).

CONCLUSIONS

Several changes in amino acids in the children suffering from ITS were observed. These changes may be a reflection of the metabolic derangements in ITS.

What Role Do Plant-Based Diets Play in Supporting the Optimal Health and Well-being of Canadians? A Scoping Review

In Canada, unhealthy diets are associated with several chronic conditions, such as type 2 diabetes, cardiovascular disease, and obesity, and thus negatively impact the health and well-being of Canadians. Consequently, unhealthy diets are associated with an increased risk of morbidity and mortality in Canada. Recently, plant-based diets have gained in popularity due to their ability to provide a diet that is nutritionally adequate and health-conscious in addition to supporting environmental sustainability. The adoption of plant-based diets may address the substantial need to improve the health and well-being of Canadians, while also having a positive global environmental impact such as reducing greenhouse gas emissions. The aim of this scoping review was to identify current knowledge on the nutritional adequacy of plant-based diets and their relation with chronic conditions to support improved health and well-being of Canadians while identifying gaps in knowledge. Canadian peer-reviewed literature on diet, nutritional quality, and chronic conditions published between the years 2010 and 2020 were systematically examined. Sixteen articles met the inclusion criteria, with the majority pertaining to the relation between animal- or plant-based nutrition and cancer. Epidemiological studies support the practice of plant-based diets, in comparison to omnivore diets, as a strategy to improve nutritional adequacy and reduce the development of chronic conditions such as obesity, type 2 diabetes, cardiovascular diseases, osteoporosis, and select cancers such as endometrial, colorectal, and breast cancers. Overall, plant-based diets offer an opportunity to improve the health and well-being of Canadians while simultaneously working to counteract climate change, which may have a global reach. Gaps in knowledge were identified and mainly pertained to the lack of valid Canadian quantitative assessments of the long-term health impacts of plant-based diets. Further research should be completed to quantify the long-term health effects of the practice of a plant-based diet across all demographics of the Canadian population.