Red meat intake and risk of coronary heart disease among US men: prospective cohort study

Red meat consumption and all-cause and cardiovascular mortality: results from the UK Biobank study

PURPOSE

To investigate the prospective associations between red meat consumption and all-cause and cardiovascular diseases (CVD) mortality, and to assess the modification effects of lifestyle and genetic risk factors.

METHODS

180,642 individuals free of CVD or cancer were enrolled from 2006 to 2010 and followed up to 2018 in the UK Biobank. Information on demographics, lifestyles, and medical history was collected through a baseline touchscreen questionnaire. The information on diet was collected through a single touchscreen food-frequency questionnaire. A total of ten single-nucleotide polymorphisms were used to calculate the genetic risk score (GRS) of trimethylamine N-oxide (TMAO), a gut microbiota metabolite from red meat. Adjusted Cox proportional hazard regression models were used to assess the association of red meat consumption with mortality.

RESULTS

We documented 3596 deaths [655 CVD deaths, 285 coronary heart disease (CHD) deaths, and 149 stroke deaths] during median 8.6 years of follow-up. Compared with the lowest red meat intake (< 1.5 times/week), the highest red meat intake (≥ 3.0 times/week) was associated with a 20%, 53%, and 101% elevated risk for CVD, CHD, and stroke mortality (P for trend = 0.04, 0.007, and 0.02, respectively), but not all-cause mortality. We found that the associations between red meat intake and mortality were not modified by dietary and lifestyle factors, as well as TMAO GRS. In addition, substitution analyses showed that a decrease in red meat consumption and an increase in the consumption of poultry or cereal was significantly associated with 9%-16% lower CVD or CHD mortality risk.

CONCLUSION

Our results indicated that red meat consumption was associated with higher risks of CVD, CHD, and stroke mortality, and the associations were not modified by lifestyle and genetic risk factors. Replacing red meat by poultry or cereal was related to lower risks of CVD and CHD mortality.

Dietary Habits of Patients with Coronary Artery Disease: A Case-Control Study from Pakistan

Background: Adults in South Asian countries have high chances of developing coronary artery disease (CAD) as compared to the developed nations. CAD is among the primary non-communicable causes of death in this region. Dyslipidemia, obesity, smoking hypertension, diabetes are considered as important risk factors for CVD. Methods: A case-control study was conducted, with data was collected from the Punjab Institute of Cardiology in Lahore and the University of Lahore Teaching Hospital. A total of 500 subjects were selected, of which 250 were coronary artery disease patients and 250 were healthy controls. The CAD patients were selected from the outpatient department (OPD) and emergency unit of the Punjab Institute of Cardiology and the University of Lahore Teaching Hospital. Results: The mean age of CAD patients was 57.83 ± 7.51 years and that of the controls was 55.32 ± 6.40 years. There was a significant difference in the mean values of biochemical parameters among cases and controls except for fasting blood sugar levels while there was a significant difference (p-value: 0.000) in the mean values of systolic blood pressure among cases and controls. Similarly, the values of diastolic blood pressure were also significantly different (p-value: 0.000) among cases and controls. The values of total blood cholesterol, LDL, triglycerides and HDL were also significantly different among cases and controls. There was a significant relationship between consumption of chicken, eggs, beef, yogurt, junk food, fresh vegetables, and fruits, and incidence of CAD. Consuming milk every day, and consuming fish weekly and consuming ghee had no significant association with the risk of coronary artery disease. On the other hand, from the findings of the unadjusted model, there was a significant association between CAD risk and intake of chicken, beef, egg, yogurt, junk food, fish, vegetables, and fruits. Conclusions: Diet is a risk factor for coronary artery disease and can be adjusted to reduce the risk of CAD. A key finding is that consumption of chicken, beef, eggs and junk food are associated with a high risk of CAD whereas consumption of ghee is not associated with the risk of CAD.

Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes

BACKGROUND

Plant-based diets are increasingly popular and have many well-established benefits for health and environmental sustainability. Our objective was to perform a systematic review of plant-based diets and prostate cancer.

METHODS

We performed a systematic database and citation search in February 2022. Studies were included if they reported primary data on plant-based dietary patterns (i.e., vegan, vegetarian, plant-based) and incidence among at-risk men for prostate cancer, or oncologic, general health/nutrition, or quality of life outcomes among patients with prostate cancer or caregivers.

RESULTS

A total of 32 publications were eligible for the qualitative synthesis, representing 5 interventional and 11 observational studies. Interventional studies primarily focused on lifestyle modification including plant-based diets for men on active surveillance for localized prostate cancer or with biochemical recurrence after treatment, showing improvements in short-term oncologic outcomes alongside improvements in general health and nutrition. Observational studies primarily focused on prostate cancer risk, showing either protective or null associations for plant-based dietary patterns. Studies of the vegan diet consistently showed favorable associations with risk and/or outcomes. Gaps in the current literature include impact for long-term disease-specific outcomes.

CONCLUSIONS

Interventional studies showed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Observational studies demonstrated either a lower risk of prostate cancer or no significant difference. These results are encouraging in light of the many benefits of plant-based diets for overall health, as well as environmental sustainability and animal welfare.

Gut microbiota signatures of long-term and short-term plant-based dietary pattern and cardiometabolic health: a prospective cohort study

BACKGROUND

The interplay among the plant-based dietary pattern, gut microbiota, and cardiometabolic health is still unclear, and evidence from large prospective cohorts is rare. We aimed to examine the association of long-term and short-term plant-based dietary patterns with gut microbiota and to assess the prospective association of the identified microbial features with cardiometabolic biomarkers.

METHODS

Using a population-based prospective cohort study: the China Health and Nutrition Survey, we included 3096 participants from 15 provinces/megacities across China. We created an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). The average PDIs were calculated using repeat food frequency questionnaires collected in 2011 and 2015 to represent a long-term dietary pattern. Short-term dietary pattern was estimated using 3-day 24-h dietary recalls collected in 2015. Fecal samples were collected in 2015 and measured using 16S rRNA sequencing. We investigated the association of long-term and short-term plant-based dietary patterns with gut microbial diversity, taxonomies, and functional pathways using linear mixed models. Furthermore, we assessed the prospective associations between the identified gut microbiome signatures and cardiometabolic biomarkers (measured in 2018) using linear regression.

RESULTS

We found a significant association of short-term hPDI with microbial alpha-diversity. Both long-term and short-term plant-based diet indices were correlated with microbial overall structure, whereas long-term estimates explained more variance. Long-term and short-term PDIs were differently associated with microbial taxonomic composition, yet only microbes related to long-term estimates showed association with future cardiometabolic biomarkers. Higher long-term PDI was associated with the lower relative abundance of Peptostreptococcus, while this microbe was positively correlated with the high-sensitivity C-reactive protein and inversely associated with high-density lipoprotein cholesterol.

CONCLUSIONS

We found shared and distinct gut microbial signatures of long-term and short-term plant-based dietary patterns. The identified microbial genera may provide insights into the protective role of long-term plant-based dietary pattern for cardiometabolic health, and replication in large independent cohorts is needed.

Renal health benefits of sustainable diets in Japan: a review

Global warming may reduce food production and force people to adopt dietary habits of inadequate quantity or quality. Such dietary habits could trigger chronic kidney disease through inappropriate nutrition or lifestyle diseases. Livestock farming and other types of food production are responsible for many greenhouse gases. These problems are being emphasized as a diet-environment-health trilemma to be addressed on a global scale, with various methods being proposed toward its resolution. Diets like plant-based and low-protein diets not only potentially prevent the progression of chronic kidney disease, but are also rational from an environmental preservation perspective. Evidence from Japan on resolutions for this trilemma is sparse, but one concrete proposal is the use of traditional Japanese diets like washoku, the Okinawa diet, and the traditional Buddhist diet. However, traditional Japanese diets also have several problems, such as excessive salt content and caloric deficiencies, and need to be modified and incorporated into the current lifestyle. The progression of chronic kidney disease needs to be prevented with appropriate dietary treatment and environmental friendly manner.

Reconsidering Meat Intake and Human Health: A Review of Current Research

Meat consumption is gradually increasing and its impact on health has attracted widespread attention, resulting in epidemiological studies proposing a reduction in meat and processed meat intake. This review briefly summarizes recent advances in understanding the effects of meat or processed meat on human health, as well as the underlying mechanisms. Meat consumption varies widely among individuals, populations, and regions, with higher consumption in developed countries than in developing countries. However, increasing meat consumption may not be the main cause of increasing incidence of chronic disease, since the development of chronic disease is a complex physiological process that involves many factors, including excessive total energy intake and changes in food digestion processes, gut microbiota composition, and liver metabolism. In comparison, unhealthy dietary habits and a sedentary lifestyle with decreasing energy expenditure are factors more worthy of reflection. Meat and meat products provide high-value protein and many key essential micronutrients. In short, as long as excessive intake and overprocessing of meats are avoided, meat remains an indispensable source of nutrition for human health.

Associations of the consumption of unprocessed red meat and processed meat with the incidence of cardiovascular disease and mortality, and the dose-response relationship: A systematic review and meta-analysis of cohort studies

OBJECTIVES

The aim of this study was to examine the associations of unprocessed red meat and processed meat consumption with cardiovascular disease (CVD) incidence and mortality, and the dose-response relationship.

METHODS

Published literature was retrieved through a structured search of 10 electronic databases: MEDLINE/PubMed, Scopus, SciELO, LILACS, ScienceDirect, Web of Science, Cochrane (CENTRAL), WHOLIS, PAHO and Embase, without language or year of publication restrictions. In addition, we searched the references of published studies. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes: The PRISMA Statement.

RESULTS

Twenty-one prospective cohort studies were included in the systematic review. The CVDs evaluated in the inserted studies were stroke, heart failure (HF) and coronary heart disease (CHD). Considering the heterogeneity found in the studies, for the meta-analysis, 9 articles were included. The results presented in the meta-analysis of the association of consumption of unprocessed red meat and CVD indicated that there was a significant association with total stroke incidence (RR 1.10; 95%; CI 1.01 to 1.19; p = 0.02). There was no association with Ischemic stroke incidence, nor CHD Mortality with consumption of unprocessed red meat. However, for Hemorrhagic Stroke Mortality the assessment in the consumption of unprocessed red meat showed an association of protection for women (RR 0.64; 95%; CI 0.45 to 0.91; p = 0.01). As for the results of the meta-analysis of the association between consumption of processed meat and CVD, they indicated that there was a significant association with total stroke incidence (RR 1.17; 95%; CI 1.08 to 1.26; p < 0.0001). There was no association with Ischemic stroke, nor with CHD Mortality with consumption of processed meat. Some studies that showed no association of risk, presented a significant linear trend dose response for the association of the consumption of unprocessed red meat (Bernstein et al. 2010; Nagao et al. 2012) or processed meat (Bernstein et al. 2012) and CVD.

CONCLUSION

According to the results found in the meta-analysis, the consumption of unprocessed red meat and processed meat are associated with the incidence of stroke, however, no positive association was observed in relation to mortality from CVD. This systematic review and meta-analysis protocol was registered on the PROSPERO (number: CRD42019100914).

Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver scientific advice related to nutrient profiling for the development of harmonised mandatory front‐of‐pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. This Opinion is based on systematic reviews and meta‐analyses of human studies on nutritionally adequate diets, data from the Global Burden of Disease framework, clinical practice guidelines, previous EFSA opinions and the priorities set by EU Member States in the context of their Food‐Based Dietary Guidelines and associated nutrient/food intake recommendations. Relevant publications were retrieved through comprehensive searches in PubMed. The nutrients included in the assessment are those likely to be consumed in excess or in inadequate amounts in a majority of European countries. Food groups with important roles in European diets have been considered. The Panel concludes that dietary intakes of saturated fatty acids (SFA), sodium and added/free sugars are above, and intakes of dietary fibre and potassium below, current dietary recommendations in a majority of European populations. As excess intakes of SFAs, sodium and added/free sugars and inadequate intakes of dietary fibre and potassium are associated with adverse health effects, they could be included in nutrient profiling models. Energy could be included because a reduction in energy intake is of public health importance for European populations. In food group/category‐based nutrient profiling models, total fat could replace energy in most food groups owing to its high‐energy density, while the energy density of food groups with low or no fat content may be well accounted for by the inclusion of (added/free) sugars. Some nutrients may be included in nutrient profiling models for reasons other than their public health importance, e.g. as a proxy for other nutrients of public health importance, or to allow for a better discrimination of foods within the same food category.

Awareness of and reactions to health and environmental harms of red meat among parents in the United States

OBJECTIVE

Evidence of the health and environmental harms of red meat is growing, yet little is known about which harms may be most impactful to include in meat reduction messages. This study examined which harms consumers are most aware of and which most discourage them from wanting to eat red meat.

DESIGN

Within-subjects randomised experiment. Participants responded to questions about their awareness of, and perceived discouragement in response to, eight health and eight environmental harms of red meat presented in random order. Discouragement was assessed on a 1-to-5 Likert-type scale.

SETTING

Online survey.

PARTICIPANTS

544 US parents.

RESULTS

A minority of participants reported awareness that red meat contributes to health harms (ranging from 8 % awareness for prostate cancer to 28 % for heart disease) or environmental harms (ranging from 13 % for water shortages and deforestation to 22 % for climate change). Among specific harms, heart disease elicited the most discouragement (mean = 2·82 out of 5), followed by early death (mean = 2·79) and plants and animals going extinct (mean = 2·75), though most harms elicited similar discouragement (range of means, 2·60-2·82). In multivariable analyses, participants who were younger, identified as Black, identified as politically liberal, had higher general perceptions that red meat is bad for health and had higher usual red meat consumption reported being more discouraged from wanting to eat red meat in response to health and environmental harms (all P < 0·05).

CONCLUSIONS

Messages about a variety of health and environmental harms of red meat could inform consumers and motivate reductions in red meat consumption.

Nutrient-Optimized Beef Enhances Blood Levels of Vitamin D and Selenium among Young Women

Bovine meat provides healthy nutrients but has also been negatively linked to greenhouse gases and non-communicable diseases. A double-blind intervention study was carried out to compare beef meat from bulls fed with feed supplemented with selenium, vitamin D, E, K (SeDEK-feed), and n-3, or REGULAR feed. Thirty-four young healthy women (19–29 years old) consumed 300 g of these beef types per day for 6 days in a cross-over design. Diet registrations, blood samples, anthropometric measurements, and clinical data were collected four times. Both beef diets were higher than their habitual diet in protein, fat, saturated fat, and several micronutrients; contained more vegetables and fewer carbohydrates and were followed by a higher feeling of satiety. The SeDEK beef had higher amounts of selenium, vitamin 25-hydroxyvitamin D3 (25(OH)D3), E, and K (MK4), and increased serum selenium and 25(OH)D3 from the participants’ normal values if they were below 85 µg/L of selenium and 30 nmol of 25(OH)D3/L, respectively. Our study showed that optimized beef increased serum selenium in young women having moderate selenium levels and improved blood 25(OH)D3 in a woman having low to normal 25(OH)D3. Meat should be optimized to increase specific consumer groups’ needs for selenium and vitamin D.

European Society of Cardiology: cardiovascular disease statistics 2021

AIMS

This report from the European Society of Cardiology (ESC) Atlas Project updates and expands upon the widely cited 2019 report in presenting cardiovascular disease (CVD) statistics for the 57 ESC member countries.

METHODS AND RESULTS

Statistics pertaining to 2019, or the latest available year, are presented. Data sources include the World Health Organization, the Institute for Health Metrics and Evaluation, the World Bank, and novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery. New material in this report includes sociodemographic and environmental determinants of CVD, rheumatic heart disease, out-of-hospital cardiac arrest, left-sided valvular heart disease, the advocacy potential of these CVD statistics, and progress towards World Health Organization (WHO) 2025 targets for non-communicable diseases. Salient observations in this report: (i) Females born in ESC member countries in 2018 are expected to live 80.8 years and males 74.8 years. Life expectancy is longer in high income (81.6 years) compared with middle-income (74.2 years) countries. (ii) In 2018, high-income countries spent, on average, four times more on healthcare than middle-income countries. (iii) The median PM2.5 concentrations in 2019 were over twice as high in middle-income ESC member countries compared with high-income countries and exceeded the EU air quality standard in 14 countries, all middle-income. (iv) In 2016, more than one in five adults across the ESC member countries were obese with similar prevalence in high and low-income countries. The prevalence of obesity has more than doubled over the past 35 years. (v) The burden of CVD falls hardest on middle-income ESC member countries where estimated incidence rates are ∼30% higher compared with high-income countries. This is reflected in disability-adjusted life years due to CVD which are nearly four times as high in middle-income compared with high-income countries. (vi) The incidence of calcific aortic valve disease has increased seven-fold during the last 30 years, with age-standardized rates four times as high in high-income compared with middle-income countries. (vii) Although the total number of CVD deaths across all countries far exceeds the number of cancer deaths for both sexes, there are 15 ESC member countries in which cancer accounts for more deaths than CVD in males and five-member countries in which cancer accounts for more deaths than CVD in females. (viii) The under-resourced status of middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, ablation procedures, device implantation, and cardiac surgical procedures.

CONCLUSION

Risk factors and unhealthy behaviours are potentially reversible, and this provides a huge opportunity to address the health inequalities across ESC member countries that are highlighted in this report. It seems clear, however, that efforts to seize this opportunity are falling short and present evidence suggests that most of the WHO NCD targets for 2025 are unlikely to be met across ESC member countries.

Healthy Aging and Dietary Patterns

A number of factors contribute to the complex process of aging, which finally define whether someone will or not develop age-associated chronic diseases in late life. These determinants comprise genetic susceptibility as well as various behavioral, environmental, and dietary factors, all of which have been shown to influence specific pathways regulating the aging process and the extension of life, which makes longevity a multidimensional phenomenon. Although a “miraculous elixir” or a “nutrition pill” are not plausible, researchers agree on the notion that nutritional factors have major impact on the risk of age-associated chronic non-communicable diseases and mortality. In recent years nutrition research in relation to health outcomes has considerably changed from focusing exclusively on single nutrients to considering combinations of foods rather than nutrients in isolation. Although research on specific nutrients is scientifically valid providing crucial evidence on the mechanisms by which nutrition impacts health, the recent switch targeting the multifaceted synergistic interplay among nutrients, other dietary constituents, and whole foods, has promoted emerging interest on the actions of total dietary patterns. This narrative review aims to describe some specific dietary patterns with evidence of associations with reduction in the incidence of chronic diseases allowing older adults to live a long-lasting and healthier life, and confirming the powerful impact nutrition can exert on healthy aging.

Trending Nutrition Controversies #3: Top Controversies in 2021

Each year, patients are bombarded with diverging and even contradictory reports concerning the impact of certain additives, foods, and nutrients on cardiovascular health and its risk factors. Accordingly, this third review of nutrition controversies examines the impact of artificial sweeteners, cacao, soy, plant-based meats, nitrates, and meats from grass compared to grain-fed animals on cardiovascular and other health outcomes with the goal of optimizing clinician-led diet counseling.

Is Eating Less Meat Possible? Exploring the Willingness to Reduce Meat Consumption among Millennials Working in Polish Cities

Reducing the consumption of meat constitutes an important part of the global shift towards more sustainable food systems. At the same time, meat is firmly established in the food culture of most human beings, and better understanding of individual behaviors is essential to facilitate a durable change in contemporary eating patterns. To determine the level and nature of attachment to meat among consumers, the Meat Attachment Questionnaire (MAQ) in relation to the phases of behaviour change in the meat consumption reduction process was utilised. Data collected through a survey carried out among Poles aged 25–40 years living in cities were analysed with the use of Spearman’s correlations and one-way ANOVA with Tukey’s post-hoc tests. The biggest share of the studied group of millennials (N = 317) never considered reducing their meat consumption (Phase 1–41%) and was described by the highest level of MAQ score in all its categories: hedonism, affinity, dependence, and entitlement. More than half of the respondents in Phase 2 participants (“planners”) declared a willingness to cut down meat consumption but had not yet put their intentions into practice. Respondents qualified in Phase 3 declared the highest willingness to reduce meat consumption and were significantly less attached to meat regarding all MAQ categories than respondents in Phase 1. The 9% of the study participants (Phase 4) had already limited the frequency of their meat consumption to “several times a week”, this however still remains insufficient compared to the ambitious goals of sustainable healthy diets. Results indicated that meat attachment categories, especially hedonism and dependence, were identified as predictors of willingness to reduce meat consumption. Research exploring the determinants of change and possibilities of effective communication about meat reduction on an individual level in different cultural settings are needed.

Life Cycle Environmental Impacts and Health Effects of Protein-Rich Food as Meat Alternatives: A Review

The food sector is responsible for a considerable impact on the environment in most environmental contexts: the food supply chain causes greenhouse gas emissions, water consumption, reduction in cultivable land, and other environmental impacts. Thus, a change in food supply is required to reduce the environmental impacts caused by the food supply chain and to meet the increasing demand for sufficient and qualitative nutrition. Large herds of livestock are inappropriate to achieve these goals due to the relevant impact of meat supply chain on the environment, e.g., the land used to grow feed for animals is eight times more than that for human nutrition. The search for meat alternatives, especially for the intake of critical nutrients such as protein, is a consequent step. In the above context, this paper summarizes the health aspects of protein-rich food alternatives to meat and carries out a literature review on the life-cycle environmental impacts of this alternative food.

The Influence of Animal- or Plant-Based Diets on Blood and Urine Trimethylamine-N-Oxide (TMAO) Levels in Humans

PURPOSE OF REVIEW

The aim of the review was to evaluate which diets are associated with higher TMAO levels.

RECENT FINDINGS

Several studies have shown that plasma and urinary levels of trimethylamine N-oxide (TMAO) are a reliable indicator of cardiovascular disease risk. Diet certainly has a strong influence on TMAO levels, but there is still uncertainty about which diet is the most effective in reducing this risk factor. PubMed, Web of Science and Scopus were searched for studies that were published up until July 1, 2021 using specific keywords. In total, 447 studies were evaluated, of which papers on individual foods or supplements, or conducted in children, in vitro or in animal model studies were excluded. Twenty-five studies were included in this review. Three studies showed that caloric restriction and (visceral) weight loss improve TMAO levels. Six out of eight studies revealed beneficial effects of plant-based diets on plasma or urinary TMAO concentrations. Most of the studies demonstrated that a diet high in protein, particularly of animal origin, such as diets rich in fish or red meat, have negative effects on TMAO levels. Most studies that have evaluated the relationship between diet and plasma or urinary concentrations of TMAO seem to indicate that plant-based diets (Mediterranean, vegetarian and vegan) are effective in improving TMAO levels, while animal-based diets appear to have the opposite effect. Further long-term studies are needed to assess whether vegetarian or vegan diets are more effective than the Mediterranean diet in reducing TMAO levels.

Association of Red Meat Consumption, Metabolic Markers, and Risk of Cardiovascular Diseases

Objective

The metabolic mechanism of harmful effects of red meat on the cardiovascular system is still unclear. The objective of the present study is to investigate the associations of self-reported red meat consumption with plasma metabolic markers, and of these markers with the risk of cardiovascular diseases (CVD).

Methods

Plasma samples of 4,778 participants (3,401 CVD cases and 1,377 controls) aged 30-79 selected from a nested case-control study based on the China Kadoorie Biobank were analyzed by using targeted nuclear magnetic resonance to quantify 225 metabolites or derived traits. Linear regression was conducted to evaluate the effects of self-reported red meat consumption on metabolic markers, which were further compared with the effects of these markers on CVD risk assessed by logistic regression.

Results

Out of 225 metabolites, 46 were associated with red meat consumption. Positive associations were observed for intermediate-density lipoprotein (IDL), small high-density lipoprotein (HDL), and all sizes of low-density lipoprotein (LDL). Cholesterols, phospholipids, and apolipoproteins within various lipoproteins, as well as fatty acids, total choline, and total phosphoglycerides, were also positively associated with red meat consumption. Meanwhile, 29 out of 46 markers were associated with CVD risk. In general, the associations of metabolic markers with red meat consumption and of metabolic markers with CVD risk showed consistent direction.

Conclusions

In the Chinese population, red meat consumption is associated with several metabolic markers, which may partially explain the harmful effect of red meat consumption on CVD.

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.

Effect of different selenium sources and concentrations on glutathione peroxidase activity and cholesterol metabolism of beef cattle

The objective of this study was to investigate the effects of different Se sources and concentrations on glutathione forms and cholesterol metabolism in beef cattle. Sixty-three Nellore bulls (412 ± 19 kg BW; 24 months old) were randomly assigned to a completely randomized design in a 2×3 + 1 factorial arrangement (63 pens; one animal/pen) with two Se sources (sodium selenite, ING and Se-yeast, ORG), three concentrations (0.3, 0.9 and 2.7 mg supplemental Se/kg DM), and control treatment (without Se supplementation) fed for 90 days. Blood samples were collected on d 0, 28, 56, and 84. Muscle and liver samples were collected at harvest. Hepatic GSSG (P = 0.004), GSH/GSSG ratio (P = 0.030), and GSH-Px (P = 0.004) were affected by Se source x concentration interaction. Oxidized glutathione was higher in the ORG group vs. ING at concentration 2.7 mg supplemental Se/kg DM, but at 0.3 mg supplemental Se/kg DM the ING group was higher than ORG. The liver GSH-Px activity was higher in the ORG group vs. ING at concentration 0.9 and 2.7 mg supplemental Se/kg DM. The GSH/GSSG ratio was the highest in animals fed 0.3 mg supplemental Se/kg DM of ORG. Selenium liver concentration increased linearly with the supplemental Se concentration in the diet (y = 0.0583 + 0.4254x, R 2 = 0.92, P < 0.0001), regardless of source. Total meat cholesterol was greater (P < 0.001) in CON (control) vs. SUP (supplemented, regardless source) group. The muscle GSH-Px activity was higher (P < 0.001) in SUP vs. CON and increased (P < 0.004) with increasing supplemental Se concentrations. There was an increase on VLDL, glucose, and triglycerides in ORG vs. ING (P ≤ 0.035). In general, serum Se was higher (P < 0.001) in SUP vs. CON and increased with increasing supplemental Se concentration. Lastly, the HMGCR concentration was lower (P = 0.002) in SUP (0.39 ng/mL) vs. CON (0.55 ng/mL). Selenium supplementation with different sources and concentrations has the potential to affect cholesterol metabolism by affecting GSH/GSSG ratio, GSH-Px, and the HMGCR.

Familial factors, diet, and risk of cardiovascular disease: a cohort analysis of the UK Biobank

BACKGROUND

Both diet and familial factors have a major role in the development of cardiovascular disease (CVD). However, it remains unclear whether familial predisposition to CVD modifies the association between dietary factors and CVD.

OBJECTIVES

The aim was to assess whether the association between diet and CVD varies with familial predisposition to CVD.

METHODS

In this prospective cohort of the UK Biobank, 462,155 CVD-free participants were included in 2006-2010 and followed for CVD incidence until 2020. Food intake was measured using a short food-frequency questionnaire. Familial predisposition was measured by self-reported family history of CVD and by polygenic risk score (PRS) for CVD based on summary statistics of independent genome-wide association studies.

RESULTS

During a median follow-up of 11.2 y, 46,164 incident CVD cases were identified. A moderately higher risk of CVD was associated with more frequent processed-meat consumption, with an adjusted HR of 1.07 (95% CI: 1.03, 1.11; highest vs. lowest level). Conversely, intakes of fish, cheese, vegetables, and fruit were each associated with reduced CVD risk [HR (95% CI): 0.92 (0.89, 0.96), 0.90 (0.86, 0.94), 0.98 (0.95, 1.00), and 0.93 (0.89, 0.96), respectively]. Stratification analyses by family history of CVD and by PRS for CVD revealed an inverse association between CVD and intakes of fish and cheese, for both subgroups with and without a familial predisposition to CVD. Notably, while the association between processed-meat intake and CVD was restricted to individuals with a familial predisposition to CVD [e.g., HR: 1.11 (1.05, 1.16) and 1.03 (0.97, 1.10) for with and without a family history, respectively, P-interaction < 0.001], the risk reduction of CVD associated with vegetable and fruit intake was only noted among participants without a CVD familial predisposition [e.g., HR for fruit consumption: 1.00 (0.97, 1.03) and 0.91 (0.87, 0.95), respectively, P < 0.001].

CONCLUSIONS

Familial factors modify the association between diet and CVD, underscoring the need for personalized dietary guidelines for CVD prevention.

"Food Doesn't Have Power Over Me Anymore!" Self-Efficacy as a Driver for Dietary Adherence Among African American Adults Participating in Plant-Based and Meat-Reduced Dietary Interventions: A Qualitative Study

BACKGROUND

African American (AA) adults are disproportionately affected by cardiovascular disease risk factors. Many nutrition interventions aim to promote healthier eating to reduce cardiovascular disease incidences among participants. However, little is known about what influences individuals' nutrition self-efficacy while participating in these interventions.

OBJECTIVE

The objective of this study is to explore the drivers and barriers of nutrition self-efficacy among Nutritious Eating With Soul (NEW Soul) participants. The NEW Soul study was funded from the National Heart, Lung, and Blood Institute.

DESIGN

A purposive-current study sampling was used to conduct 4 audio-recorded focus groups for this qualitative study. Bandura's self-efficacy theory of behavior change guided the framework. This theory asserts that individual self-efficacy is influenced by 4 factors: (1) mastery experiences, (2) vicarious experiences, (3) social persuasion, and (4) somatic and emotional states.

PARTICIPANTS/SETTING

Inclusion criteria for the NEW Soul program included being an AA, being between 18 and 65 years old, and having a body mass index between 25 and 49.9. Participants in cohort 2 (n = 84) of the NEW Soul program were asked to participate in focus groups. In total, 28 individuals (16 vegan, 12 omnivorous participants) took part in 4 in-person focus groups, which contained 3 to 13 participants. Focus groups took place in the southeastern United States.

MAIN OUTCOME MEASURE

Perception of drivers and barriers of following the diet.

STATISTICAL ANALYSIS

Responses were analyzed qualitatively using principles of content analysis.

RESULTS

Nine themes influenced participants' confidence in their ability to follow their diet: food preference, planning and preparation, identity and tradition, mindfulness, representation, social support, social influence, accountability, and state of mind.

CONCLUSION

In this study, self-efficacy played a prominent role in participants' motivations toward following the diet. Mastery experiences, vicarious experiences, social persuasion, and positive psychological arousal were all common themes in participant-reported sources of motivation. Nutrition interventions are likely to elicit positive behavioral outcomes if these 4 factors that enhance self-efficacy are incorporated into program development.

Leveraging vibration of effects analysis for robust discovery in observational biomedical data science

Hypothesis generation in observational, biomedical data science often starts with computing an association or identifying the statistical relationship between a dependent and an independent variable. However, the outcome of this process depends fundamentally on modeling strategy, with differing strategies generating what can be called "vibration of effects" (VoE). VoE is defined by variation in associations that often lead to contradictory results. Here, we present a computational tool capable of modeling VoE in biomedical data by fitting millions of different models and comparing their output. We execute a VoE analysis on a series of widely reported associations (e.g., carrot intake associated with eyesight) with an extended additional focus on lifestyle exposures (e.g., physical activity) and components of the Framingham Risk Score for cardiovascular health (e.g., blood pressure). We leveraged our tool for potential confounder identification, investigating what adjusting variables are responsible for conflicting models. We propose modeling VoE as a critical step in navigating discovery in observational data, discerning robust associations, and cataloging adjusting variables that impact model output.

Nutritional Enhancement of Health Beneficial Omega-3 Long-Chain Polyunsaturated Fatty Acids in the Muscle, Liver, Kidney, and Heart of Tattykeel Australian White MARGRA Lambs Fed Pellets Fortified with Omega-3 Oil in a Feedlot System

Simple Summary

The problem addressed in this research was the possibility of enhancing the nutritional value and health beneficial omega-3 long-chain fatty acid content of lamb and its edible components. The aims and objectives were to evaluate the omega-3 contents of muscle, liver, kidney, and heart of lot-fed Tattykeel Australian White lambs of the MARGRA brand, in response to dietary supplementation with or without omega-3 oil fortified pellets. The findings demonstrate that the inclusion of omega-3 oil in feedlot diets of lambs enhances the human health beneficial omega-3 long-chain polyunsaturated fatty acid profiles of edible muscle tissue and organs without compromising meat quality or shelf life. These results are valuable to society because of increased functionality, health benefits, micro-marbling, tender, mouth-melting taste, and high-end eating quality experience of MARGRA lamb tissues and organs.

Abstract

The aim of this research was to evaluate the nutritional enhancement of omega-3 long-chain polyunsaturated fatty acid (n-3 LC-PUFA) composition of edible lamb Longissimus thoracis et lumborum muscle, heart, kidney, and liver in response to dietary supplementation of lot-fed lambs with or without omega-3 oil fortified pellets. The hypothesis tested was that fortifying feedlot pellets with omega-3 oil will enhance the human health beneficial n-3 LC-PUFA composition of edible lamb muscle tissue and organs. Seventy-five Tattykeel Australian White lambs exclusive to the MARGRA brand, with an average body weight of 30 kg at six months of age, were randomly assigned to the following three dietary treatments of 25 lambs each, and lot-fed as a cohort for 47 days in a completely randomized experimental design: (1) Control grain pellets without oil plus hay; (2) Omega-3 oil fortified grain pellets plus hay; and (3) Commercial whole grain pellets plus hay. All lambs had ad libitum access to the basal hay diet and water. Post-slaughter fatty acid composition of the Longissimus thoracis et lumborum muscle, liver, kidney, and heart were determined using thee gas chromatography–mass spectrophotometry technique. Results indicated significant variations (p < 0.05) in fatty acid profiles between tissues and organs. Omega-3 oil fortified pellets significantly (p < 0.05) increased ≥C20 n-3 LC-PUFA (C20:5n-3 eicosapentaenoate, EPA + C22:5n3 docosapentaenoate, DPA + C22:6n3 docosahexanoate DHA); C18:3n-3 alpha-linolenate, ALA; C18:2 conjugated linoleic acid, CLA; total monounsaturated fatty acids, MUFA; polyunsaturated fatty acids, PUFA contents; and reduced the ratio of omega-6 to omega-3 fatty acids in all lamb organs and tissues without impacting shelf-life. The findings demonstrate that the inclusion of omega-3 oil in feedlot diets of lambs enhances the human health beneficial omega-3 long-chain polyunsaturated fatty acid profiles of edible muscle tissue and organs without compromising meat quality.

Consumption of Preserved Egg Is Associated with Modestly Increased Risk of Nonalcoholic Fatty Liver Disease in Chinese Adults

BACKGROUND

Although preserved egg is a traditional Chinese delicacy widely consumed in China and Southeast Asian countries, whether habitual preserved egg consumption is associated with nonalcoholic fatty liver disease (NAFLD) remains unknown.

OBJECTIVES

This study aimed to examine the association between preserved egg consumption and risk of NAFLD in a cohort of Chinese adults.

METHODS

This prospective cohort study included 15,883 participants aged 19-88 y (58% women) from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study who were free of liver diseases, cancer, and cardiovascular disease at baseline. Preserved egg consumption was assessed using an FFQ at baseline. NAFLD was diagnosed by transabdominal sonography during an annual health examination. Multivariable Cox proportional hazards regression models were used to calculate HRs and 95% CIs across categories of preserved egg consumption.

RESULTS

During 56,002 person-years of follow-up, 3683 first incident cases of NAFLD were recorded. After adjustment for sociodemographic characteristics, lifestyle risk factors, total energy intake, egg intake, and eating patterns, the multivariable HRs (95% CIs) of incident NAFLD according to categories of preserved egg consumption were 1.00 (reference) for never, 1.05 (0.98, 1.14) for <1 time/wk, 1.09 (0.96, 1.24) for 1 time/wk, and 1.26 (1.09, 1.46) for ≥2 times/wk (P-trend < 0.01). The results were robust to a series of sensitivity analyses.

CONCLUSIONS

Habitual preserved egg consumption is associated with a modestly higher risk of NAFLD among the Chinese adult population. The mechanism underlying this association warrants further research.This trial was registered at www.umin.ac.jp/ctr/ as UMIN000027174.

Meat consumption and risk of ischemic heart disease: A systematic review and meta-analysis

There is uncertainty regarding the association between unprocessed red and processed meat consumption and the risk of ischemic heart disease (IHD), and little is known regarding the association with poultry intake. The aim of this systematic review and meta-analysis was to quantitatively assess the associations of unprocessed red, processed meat, and poultry intake and risk of IHD in published prospective studies. We systematically searched CAB Abstract, MEDLINE, EMBASE, Web of Science, bioRxiv and medRxiv, and reference lists of selected studies and previous systematic reviews up to June 4, 2021. All prospective cohort studies that assessed associations between 1(+) meat types and IHD risk (incidence and/or death) were selected. The meta-analysis was conducted using fixed-effects models. Thirteen published articles were included (n_total = 1,427,989; n_cases = 32,630). Higher consumption of unprocessed red meat was associated with a 9% (relative risk (RR) per 50 g/day higher intake, 1.09; 95% confidence intervals (CI), 1.06 to 1.12; n_studies = 12) and processed meat intake with an 18% higher risk of IHD (1.18; 95% CI, 1.12 to 1.25; n_studies = 10). There was no association with poultry intake (n_studies = 10). This study provides substantial evidence that unprocessed red and processed meat, though not poultry, might be risk factors for IHD.

Food for Thought or Feeding a Dogma? Diet and Coronary Artery Disease: a Clinician's Perspective

PURPOSE OF REVIEW

To provide an overview of nutrition studies evaluating the association of dietary saturated fat and meat intake with the development of coronary artery disease (CAD) and discuss implications of recent data.

RECENT FINDINGS

Recent studies have led to the re-evaluation of the role of saturated fat in CAD. Randomized controlled trials (RCTs) support Mediterranean diet to reduce cardiovascular risk. Recent data revealed significant association of intake of meat or poultry with increased risk, but fish consumption was associated with lower risk of incident CAD. In this review, we provide a brief overview of the studies and data that have led to the re-evaluation of the link between saturated fat and CAD. Due to conflicting data from long-term prospective cohort studies and significant heterogeneity, associations of unprocessed meat with CAD are less clear compared to the role of processed meat. Pooled data from prospective cohort studies have overcome some of these limitations and show association of both processed and unprocessed meat and poultry intake but not fish consumption with incident CAD. These findings were also validated recently in a large UK Biobank prospective study. While recognizing the limitations of these cohort studies, we discuss relevant landmark RCTs. We finally consider the challenges with RCTs in nutrition research to improve the quality of evidence and need for evidence-based dietary guidelines with respect to saturated fat intake from a clinical perspective.

Total and whole grain intake in Latin America: findings from the multicenter cross-sectional Latin American Study of Health and Nutrition (ELANS)

PURPOSE

Understanding whole-grain intake and its associated factors is essential to tackle the double burden of malnutrition faced by Latin American countries. This study aimed to characterize total and whole grain intake in Latin American countries and to investigate foods contributing to these intake in the region.

METHODS

Data were obtained from the multicenter cross-sectional survey Latin American Study of Nutrition and Health (ELANS), including 9128 participants residing in urban areas of eight Latin American countries. Data collection was performed via two household visits using a standardized questionnaire and two 24 h dietary recalls. Usual dietary intake of total grain foods and foods containing whole grains was estimated. The association between the intake of grain food groups and sociodemographic variables was investigated using multiple linear regression models with random intercepts.

RESULTS

Mean intake of total grain foods and foods containing whole grains was 318.6 g/d and 14.7 g/d, respectively. Total grain foods were less consumed by participants at older ages (-9.8 g/d), and females (-9.9 g/d), and more consumed by those in the lowest socioeconomic category (24.8 g/d). Foods containing whole grains were more consumed by participants at older ages (3.3 g/d), and females (4.0 g/d), while those in the lowest socioeconomic category consumed 2.9 g/d less. Major contributors to energy provided from foods containing whole grains were oatmeal, masa harina, whole-wheat bread, corn chips, and wheat crackers.

CONCLUSION

The intake of grain foods represented a substantial part of the Latin American population's diet, but the intake of foods containing whole grains was extremely low in all assessed countries.

Dietary recommendations for prevention of atherosclerosis

This review aims at summarizing updated evidence on cardiovascular disease (CVD) risk associated with consumption of specific food items to substantiate dietary strategies for atherosclerosis prevention. A systematic search on PubMed was performed to identify meta-analyses of cohort studies and RCTs with CVD outcomes. The evidence is highly concordant in showing that, for the healthy adult population, low consumption of salt and foods of animal origin, and increased intake of plant-based foods-whole grains, fruits, vegetables, legumes, and nuts-are linked with reduced atherosclerosis risk. The same applies for the replacement of butter and other animal/tropical fats with olive oil and other unsaturated-fat-rich oil. Although the literature reviewed overall endorses scientific society dietary recommendations, some relevant novelties emerge. With regard to meat, new evidence differentiates processed and red meat-both associated with increased CVD risk-from poultry, showing a neutral relationship with CVD for moderate intakes. Moreover, the preferential use of low-fat dairies in the healthy population is not supported by recent data, since both full-fat and low-fat dairies, in moderate amounts and in the context of a balanced diet, are not associated with increased CVD risk; furthermore, small quantities of cheese and regular yogurt consumption are even linked with a protective effect. Among other animal protein sources, moderate fish consumption is also supported by the latest evidence, although there might be sustainability concerns. New data endorse the replacement of most high glycemic index (GI) foods with both whole grain and low GI cereal foods. As for beverages, low consumption not only of alcohol, but also of coffee and tea is associated with a reduced atherosclerosis risk while soft drinks show a direct relationship with CVD risk. This review provides evidence-based support for promoting appropriate food choices for atherosclerosis prevention in the general population.

Does a high intake of green leafy vegetables protect from NAFLD? Evidence from a large population study

BACKGROUND AND AIMS

Results of in vitro and in vivo studies showed that green leafy vegetables (GLV) could attenuate liver steatosis. However, little is known regarding the association between GLV intake and nonalcoholic fatty liver disease (NAFLD) in human. We examined the association of GLV intake with NAFLD in a large-scale adult population.

METHODS AND RESULTS

This cross-sectional study investigated 26,891 adults in China who participated in health examinations from 2013 to 2017. Newly diagnosed NAFLD was detected by liver ultrasonography. Dietary intake was assessed by using a validated and standardized food frequency questionnaire. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) across categories of GLV intake. After adjustment for sociodemographic characteristics, lifestyle factors, and other dietary intakes, the OR (95% CI) for comparing the highest vs. lowest GLV intake categories (≥7 times/week vs. almost never) was 0.72 (0.59, 0.90) (P < 0.0001). In addition, a linear inverse association was demonstrated between GLV intake and NAFLD in women (P for trend = 0.04), but ORs for any intake category did not reach significance. Stratified analyses suggested a potential effect modification by obesity status; the ORs (95% CIs) for comparing the highest vs. lowest GLV intake categories was 0.72 (0.54, 0.97) in normal/overweight individuals and 1.04 (0.65, 1.65) in obese individuals (P-interaction < 0.0001).

CONCLUSION

This large population-based study shows that high GLV intake is inversely associated with NAFLD, particularly in women and non-obese participants.

Indicators and Recommendations for Assessing Sustainable Healthy Diets

Research coupling human nutrition and sustainability concerns is a rapidly developing field, which is essential to guide governments' policies. This critical and comprehensive review analyzes indicators and approaches to "sustainable healthy diets" published in the literature since this discipline's emergence a few years ago, identifying robust gauges and highlighting the flaws of the most commonly used models. The reviewed studies largely focus on one or two domains such as greenhouse gas emissions or water use, while overlooking potential impact shifts to other sectors or resources. The present study covers a comprehensive set of indicators from the health, environmental and socio-economic viewpoints. This assessment concludes that in order to identify the best food option in sustainability assessments and nutrition analysis of diets, some aspects such as the classification and disaggregation of food groups, the impacts of the rates of local food consumption and seasonality, preservation methods, agrobiodiversity and organic food and different production systems, together with consequences for low-income countries, require further analysis and consideration.

Effects of the Consumption of Low-Fat Cooked Ham with Reduced Salt Enriched with Antioxidants on the Improvement of Cardiovascular Health: A Randomized Clinical Trial

The aim of the study was to analyze how cardiovascular risk factors can be modified using nutritionally improved cooked ham enriched with a pool of antioxidants to influence relevant metabolic targets. Sixty-five untreated subjects (49.2% males, 50.8% females, mean age 40.92 ± 9.03 years) with total cholesterol level ≥180 mg/dL or LDL cholesterol ≥130 mg/dL participated in a 8-weeks randomized, double-blind controlled trial. Participant in the intervention group (51.5% males, 48.5% females, mean age 41.6 ± 9.8 years and mean BMI 25.1 ± 3.6 kg/m²) consumed cooked ham enriched with antioxidants (100 g/d) and controls (49.9% males, 53.1% females, mean age 40.2 ± 8.3 years and mean BMI 26.3 ± 3.2 kg/m²) received placebo. At 8 weeks, oxidized LDL decreased significantly between experimental and placebo groups (p < 0.036). Experimental group differences were also significant (p < 0.05). Similar findings in malondialdehyde, total cholesterol, high-sensitivity C-reactive protein, and interleukin 6 were observed in the intervention group. Significant between-group differences in these variables were also found, except for total cholesterol and interleukin 6. The effects on inflammation and oxidation support the direct action of these antioxidants on the etiopathogenic factors of atheromatous plaque. We also observed an improvement in the lipid profiles among the subjects.

Enhancing the Nutritional Value of Red Meat through Genetic and Feeding Strategies

Consumption of red meat contributes to the intake of many essential nutrients in the human diet including protein, essential fatty acids, and several vitamins and trace minerals, with high iron content, particularly in meats with high myoglobin content. Demand for red meat continues to increase worldwide, particularly in developing countries where food nutrient density is a concern. Dietary and genetic manipulation of livestock can influence the nutritional value of meat products, providing opportunities to enhance the nutritional value of meat. Studies have demonstrated that changes in livestock nutrition and breeding strategies can alter the nutritional value of red meat. Traditional breeding strategies, such as genetic selection, have influenced multiple carcass and meat quality attributes relevant to the nutritional value of meat including muscle and fat deposition. However, limited studies have combined both genetic and nutritional approaches. Future studies aiming to manipulate the composition of fresh meat should aim to balance potential impacts on product quality and consumer perception. Furthermore, the rapidly emerging fields of phenomics, nutrigenomics, and integrative approaches, such as livestock precision farming and systems biology, may help better understand the opportunities to improve the nutritional value of meat under both experimental and commercial conditions.

[Diet and Nutrition in the Prevention of Non-Communicable Diseases (NCD)]

Today, more than 50 % of adults in Germany are overweight, 20 million people are obese and 10 to 30 % suffer from non-communicable diseases (NCD). Unhealthy dietary patterns contribute to NCD, thus, NCD are at least partly avoidable. During the last decades nutrition research has changed from nutrients to foods identifying healthy food patterns characterizing healthy diets, e. g., Mediterranean diet, DASH diet and/or the New Nordic Diet. Scientifically, these diets have been shown to be effective strategies of primary and secondary prevention of NCD. Based on this evidence prevention of NCD is now urgently needed at the population level. However, effective public health strategies of prevention and health promotion go beyond daily medical practice and require re-thinking of our food system within a greater context of our environment and climate. To become sustainable, strategies and measures of behavior prevention addressing individuals have to be extended to measures against the obesogenic environment and its systemic drivers within our food system. Thus, social and political changes are needed for a better future health of the nation. Physicians may take the leadership to be prepared to add to a whole of society approach of prevention and health promotion.

Optimum Additive Composition to Minimize Fat in Functional Goat Meat Nuggets: A Healthy Red Meat Functional Food

Optimally designed functional foods are considered the most important part of a balanced and healthy diet. Goat meat nuggets, an otherwise healthy option, are packed with undesirable saturated and unsaturated fats. The present work suggests an optimal functional formulation to reduce the surplus fat content of goat meat nuggets by adding two optimally calculated functional ingredients, namely, fenugreek leaves (FL) and psyllium husk (PH). Response surface optimization was performed to determine the optimal content of the functional ingredients (FL and PH), resulting in minimum fat content without affecting the overall acceptability (OA) and other properties representing the taste and texture (e.g., ash content, pH, crude fiber content, and moisture content) of the nuggets. Functional additives at optimum levels successfully reduced the fat content of the weight-conserved nuggets by almost 39% compared with the control nuggets. Minimal and acceptable effects were observed regarding OA and other properties representative of the taste and texture of the nuggets. An optimally designed, fat-attenuated goat meat nugget formulation is therefore prescribed, which complies with the nutritional standards of a balanced diet.

Plant Protein and Plant-Based Meat Alternatives: Consumer and Nutrition Professional Attitudes and Perceptions

Plant-based and flexitarian eating patterns are increasingly popular, and the food supply system has responded with a wide range of convenience products despite a lack of understanding regarding consumer views. The aim of this study was to explore consumer and nutrition professional (NP) perceptions and attitudes to plant protein, including plant-based meat alternatives (PBMA) within an Australian context. Using an online survey promoted via social media, 679 responses (89% completion rate), achieved an even spread across key age groups. A total of sixty percent reported following a special diet, with 25% vegan and 19% flexitarian. ‘Health’ was a key driver for diet type among the NPs (53.3%) and they were less likely to follow a special diet, while “ethical” reasons were cited by consumers (69%). Plant-based eating was considered a vegan dietary pattern and the most frequently consumed plant-based proteins were whole grains. Most (74%) had tried PBMA, but they were more frequently chosen by consumers, with burger patties then sausages and mince selected as a ‘trendy’ choice; taste was very important across both groups. Products mimicking chicken and fish were of less interest. Plant-based claims were observed by 78% but these were also of greater interest to consumers. Participants reported looking for whole ingredients and iron content and expected that both iron and vitamin B12 would be comparable to red meat. Sodium was the nutrient of greatest interest to NPs and, together, these results help inform the direction for product innovation, while also highlighting the need to assess the adequacy of the dietary pattern when promoting sustainable plant-based eating.

Consumption Preferences of Pulses in the Diet of Polish People: Motives and Barriers to Replace Animal Protein with Vegetable Protein

Today, with easy access to information, people are aware of the health benefits of pulses and their significant role in sustainable consumption. Despite this, the consumption of pulses still remains low in many developed and developing countries. The authors of the study attempted to fill the gaps in knowledge about determinants that influence the consumption of pulses. The study was conducted to identify the motives and barriers which, according to a consumer, influence the level of consumption of pulses. An attempt was made to determine to what extent a consumer is influenced by culinary trends (using the multiple linear regression equation). The survey was conducted on a sample of 1067 Polish respondents. The sample was representative and selected to reflect the social demographic distribution of the respondents. In the research, descriptive statistics were used, as well as a t-test, linear regression statistics, and discriminant function analysis. Pulses are more often considered by women to be healthy and nutritious products as well as a good alternative to meat products. The price of pulses products is very important. Men also consider those qualities to be encouraging to consume pulses, but to a lesser extent than women. The lack of knowledge and skills to prepare tasty meals from pulses is one of the most important barriers which, both in the case of women and men, prevents consumers from eating pulses more often. Identified types of diets of the respondents in the research sample showed differences in the regularity of consumption of different selected pulse products. The obtained results indicated that Polish consumers are influenced by other cuisines of the world in their preferences. The most influential cuisines were the Middle Eastern and Mediterranean, with a variety of dishes that are prepared based on pulse products. It should be emphasized that to increase the consumption of pulses, it is necessary to continue educating society through various channels, e.g., culinary, health, information programs, or by inviting celebrities who enjoy the great trust of the society to take part in the advertisement.