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Herter J, Stübing F, Lüth V, Zimmermann J, Lederer AK, Hannibal L, Huber R, Storz MA. Bowel health, defecation patterns and nutrient intake following adoption of a vegan diet: a randomized-controlled trial. Ann Med 2024; 56:2305693. [PMID: 38327148 PMCID: PMC10854443 DOI: 10.1080/07853890.2024.2305693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The beneficial effects of a plant-based diet on gut microbiota diversity are well documented, however, its impact on clinical bowel health and defecation patterns are less well understood. Vegetarian diets have been associated with a higher bowel movement (BM) frequency as well as softer stools in cross-sectional studies. The effects of the de-novo adoption of a vegan diet on bowel health, however, have never been investigated in a randomized-controlled trial. MATERIALS AND METHODS The present study examined bowel health and defecation patterns in relation to diet and nutrient intake in a young and healthy sample of n = 65 physically-active German university students who were randomly assigned to either a vegan or a meat-rich diet for eight weeks. Bowel health assessment included the Bristol Stool Form Scale (BSFS), the Gastrointestinal Quality of Life Index (GIQLI) and the Cleveland Clinic Fecal Incontinence Score (CCFIS). Nutrient intake was assessed using weighed food diaries. The study was prospectively registered at the German Clinical Trial Register (DRKS00031541). RESULTS Weekly BM frequency slightly increased in vegans, whereas it remained unaltered in participants assigned to a meat-rich diet. Fiber intake increased significantly in vegans (34.89 (18.46) g/d) whereas it decreased in those assigned to the meat-rich group (22.79 (12.5) g/d). No significant intergroup differences in BSFS and CCFIS patterns were observed. Adoption of a vegan diet neither resulted in a transient increase in abdominal discomfort nor in a decreased gastrointestinal quality of life, which was comparable across the diet groups. CONCLUSIONS The short-term de-novo adoption of a vegan diet did not negatively affect markers of bowel health in this study.
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Affiliation(s)
- Julian Herter
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frieda Stübing
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Lüth
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Zimmermann
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ann-Kathrin Lederer
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luciana Hannibal
- Laboratory of Clinical Biochemistry and Metabolism, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Roman Huber
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Guo Y, Su D, Chen H, Ding Y, Zhang S, Sun H, Chen D, Yin W, Li X, Zeng G. Does an antihypertensive diet cost more? Analysis from the Chinese Heart-Healthy diet trial. Public Health Nutr 2024; 27:e73. [PMID: 38445388 DOI: 10.1017/s1368980024000430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To determine whether the Chinese heart-healthy diet (Sichuan cuisine version) (CHH diet-SC) was more expensive than the conventional Sichuan diet and explore the food groups and nutrients that mainly affected the cost of CHH diet-SC. DESIGN Cost analysis of 4-week intervention diets in the Sichuan center representing southwestern China in the CHH diet study. SETTING A multicentre, parallel-group, single-blind, randomised feeding trial evaluating the efficacy of lowering blood pressure with the cuisine-based CHH diet. PARTICIPANTS Totally, fifty-three participants with hypertension aged 25-75 years in the Sichuan center were randomised into the control group (n 26) or the CHH diet-SC group (n 27). RESULTS The CHH diet-SC was more expensive than the control diet (¥27·87 ± 2·41 v. ¥25·18 ± 2·79 equals $3·90 ± 0·34 v. $3·52 ± 0·39, P < 0·001), and the incremental cost-effectiveness ratio for a 1-mm Hg systolic blood pressure reduction was ¥9·12 ($1·28). Intakes and the cost of seafood, dairy products, fruits, soybeans and nuts, whole grains and mixed beans were higher for the CHH diet-SC than for the control diet (P < 0·001). Intakes of vitamin B1, vitamin B6, vitamin C, Mg and phosphorus were positively correlated with the cost (P < 0·05). CONCLUSIONS The CHH diet-SC costs more than the conventional Sichuan diet, partly due to the high cost of specific food groups. Positive correlations between the intakes of vitamin B1, vitamin B6, vitamin C, Mg, phosphorus and the dietary cost could be a direction to adjust the composition within the food groups to reduce the cost of the CHH diet-SC.
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Affiliation(s)
- Yishan Guo
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Danping Su
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanxi Ding
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyu Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dandi Chen
- West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Wenya Yin
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Li
- Sichuan Tourism University, Chengdu, Sichuan, China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Wetherill MS, Caywood LT, Hollman N, Carter VP, Gentges J, Sims A, Henderson CV. Food Is Medicine for Individuals Affected by Homelessness: Findings from a Participatory Soup Kitchen Menu Redesign. Nutrients 2023; 15:4417. [PMID: 37892492 PMCID: PMC10609710 DOI: 10.3390/nu15204417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/12/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of "food is medicine" interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities. We began by first conducting a nutrition needs assessment, including a collection of intercept surveys from a convenience sample of soup kitchen guests to better understand their nutrition-related health needs, dental issues, food preferences, and menu satisfaction (n = 112), as well as a nutrition analysis of the standard menu based on seven randomly selected meals. Most respondents reported at least one chronic health condition, with depressive disorders (50.9%) and cardiovascular diseases (49.1%) being the most common. Nearly all guests requested more fruits and vegetables at mealtimes, and results from the menu analysis revealed opportunities to lower meal contents of sodium, saturated fat, and added sugars and to raise micronutrient, fiber, and omega-3 content. We then applied these nutrition needs assessment findings to inform the second phase of the project. This phase included the identification of new food inventory items to help support cardiovascular and mental health-related nutrition needs, taste test sampling of new healthy menu items with soup kitchen guests, and hands-on culinary medicine training to kitchen staff on newly-developed "food is medicine" guidelines to support menu transformation. All taste tests of new menu items received over 75% approval, which exceeded satisfaction ratings of the standard menu collected during the phase 1 needs assessment. Findings from this community-based participatory research project confirm the great potential for hunger safety net providers to support critical nutrition needs within this vulnerable population through strategic menu changes. However, more research is needed on the longitudinal impacts of such changes on health indicators over time.
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Affiliation(s)
- Marianna S. Wetherill
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK 74135, USA
- Department of Family and Community Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA
- OU Culinary Medicine Program, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA;
| | - Lacey T. Caywood
- Department of Health Promotion Sciences, Hudson College of Public Health, University of Oklahoma Tulsa Schusterman Center, Tulsa, OK 74135, USA
| | - Nicholas Hollman
- Office of Research Development and Scholarly Activity, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA;
| | - Valarie P. Carter
- OU Culinary Medicine Program, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA;
| | - Joshua Gentges
- Department of Emergency Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA;
| | - Ashli Sims
- Iron Gate, Tulsa, OK 74103, USA; (A.S.); (C.V.H.)
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Pan J, Xu X, Wang Z, Ma T, Dong J. Dietary Potassium and Clinical Outcomes among Patients on Peritoneal Dialysis. Nutrients 2023; 15:4271. [PMID: 37836555 PMCID: PMC10574508 DOI: 10.3390/nu15194271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The association between dietary potassium and clinical prognosis is unclear in patients with chronic kidney disease (CKD). Here, we explored the association between dietary potassium intake and all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients. METHODS Here, we present a retrospective analysis of a prospective study. Patients that began incident PD in our center between 1 October 2002 and 31 August 2014 were screened. We recorded all demographic and clinical data at baseline. Repeated measurements were recorded at regular intervals to calculate time-averaged values. Spline regression analysis and Cox proportional regression models were used to evaluate the relationship between dietary potassium and mortality. RESULTS We followed 881 PD patients for 45.0 (21.5, 80.0) months; 467 patients died, of which 189 (40.5%) died of CV death and 93 were still on PD treatment. Compared with those who had baseline dietary potassium ≥1200 mg/d, the majority of patients with lower dietary potassium were female, older, or poorly educated. They were prone to have poorer nutritional status, CV disease, and diabetes mellitus (p < 0.05). In the unadjusted analysis, both baseline and time-averaged dietary potassium <1200 mg/d predicted higher all-cause and CV mortality (p < 0.001~0.01). After adjusting for demographic and laboratory data, the association between potassium intake and all-cause and CV mortality weakened, which even disappeared after additional adjustment for dietary fiber, protein, and energy intake. CONCLUSIONS Dietary potassium in PD patients was not independently associated with all-cause and CV mortality.
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Affiliation(s)
- Jinru Pan
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100871, China; (J.P.); (X.X.); (Z.W.); (T.M.)
- Key Laboratory of Renal Disease, Ministry of Health, Beijing 100034, China
- Key Laboratory of Renal Disease, Ministry of Education, Beijing 100034, China
| | - Xiao Xu
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100871, China; (J.P.); (X.X.); (Z.W.); (T.M.)
- Key Laboratory of Renal Disease, Ministry of Health, Beijing 100034, China
- Key Laboratory of Renal Disease, Ministry of Education, Beijing 100034, China
| | - Zi Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100871, China; (J.P.); (X.X.); (Z.W.); (T.M.)
- Key Laboratory of Renal Disease, Ministry of Health, Beijing 100034, China
- Key Laboratory of Renal Disease, Ministry of Education, Beijing 100034, China
| | - Tiantian Ma
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100871, China; (J.P.); (X.X.); (Z.W.); (T.M.)
- Key Laboratory of Renal Disease, Ministry of Health, Beijing 100034, China
- Key Laboratory of Renal Disease, Ministry of Education, Beijing 100034, China
| | - Jie Dong
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100871, China; (J.P.); (X.X.); (Z.W.); (T.M.)
- Key Laboratory of Renal Disease, Ministry of Health, Beijing 100034, China
- Key Laboratory of Renal Disease, Ministry of Education, Beijing 100034, China
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Yeung AWK. Food Composition Databases (FCDBs): A Bibliometric Analysis. Nutrients 2023; 15:3548. [PMID: 37630742 PMCID: PMC10459793 DOI: 10.3390/nu15163548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Food composition databases (FCDBs) are important tools that provide information on the nutritional content of foods. Previously, it was largely unclear what nutritional contents and which FCDBs were involved in highly cited papers. The bibliometric study aimed to identify the most productive authors, institutions, and journals. The chemicals/chemical compounds with high averaged citations and FCDBs used by highly cited papers were identified. In July 2023, the online database Web of Science Core Collection (WoSCC) was queried to identify papers related to FCDBs. A total of 803 papers were identified and analyzed. The first paper indexed in WoSCC was published in 1992 by Pennington, which described the usefulness of FCDB for researchers to identify core foods for their own studies. In that paper, the FCDB described was the USDA 1987-88 NFCS (the United States Department of Agriculture 1987-88 Nationwide Food Consumption Survey). The most productive author was Dr. Paul M. Finglas, the Head of the Food Databanks National Capability at the Quadram Institute (Norwich, UK) and the Managing Director of EuroFIR. His most cited paper among this dataset was about the development of an online Irish food composition database together with EuroFIR. The most productive institutions were the USDA and the World Health Organization (WHO) instead of universities. Flavonoid was the most recurring chemical class among the highly cited ones. The anti-oxidative properties and protective effects against heart disease and cancer of flavonoids might be some of the reasons for their popularity in research. Among the highly cited papers, the most heavily used FCDBs were the USDA database for the flavonoid content of selected foods, Fineli, the USDA National Nutrient Database for Standard Reference (USNDB), EuroFIR eBASIS-Bioactive Substances in Food Information Systems, and Phenol-Explorer. High-quality national and international FCDBs should be promoted and made more accessible to the research and public communities to promote better nutrition and public health on a global scale.
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Affiliation(s)
- Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Anyanwu OA, Naumova EN, Chomitz VR, Zhang FF, Chui K, Kartasurya MI, Folta SC. The Socio-Ecological Context of the Nutrition Transition in Indonesia: A Qualitative Investigation of Perspectives from Multi-Disciplinary Stakeholders. Nutrients 2022; 15:nu15010025. [PMID: 36615684 PMCID: PMC9823366 DOI: 10.3390/nu15010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/09/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Indonesia is undergoing a rapid nutrition transition—a shift in food consumption related to globalization, modernization, urbanization, and economic development—with potentially adverse impacts on diets, health, and the environment. This study sought to understand the perspectives of a multi-disciplinary group of experts on the effects of the nutrition transition on dietary behaviors, cardiovascular disease (CVD) risk factors, and the food environment in Indonesia. Methods: In-depth interviews were conducted online with 27 Indonesian experts, who are either healthcare providers, nutrition researchers, or environmental researchers. Interview question guides were developed based on a socio-ecological framework. We analyzed the data using deductive and inductive approaches. Results: Experts described a disconnect between awareness about and adherence to healthy diets among Indonesians. They highlighted a marked generational divide in food preferences between the younger population (<40y) and older population (40y+), due to the nutrition transition. Experts perceived that the nutrition transition has also resulted in more eating out, which promotes obesity, through the unhealthy menu offerings from restaurants. Experts also implied that traditional diets are no better than modern diets, due to unhealthy cooking practices, especially frying; suggesting that the combination of higher consumption of fast foods and unhealthy cooking practices may have worsened CVD risk factors in the population. Conclusion: Multi-disciplinary experts indicated that the nutrition transition has negatively impacted diets, health, and food environment in Indonesia. Our findings offer potential hypotheses that can be tested using quantitative approaches, to inform policy and the design of programs to reduce the adverse impacts of the nutrition transition in Indonesia.
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Affiliation(s)
- Oyedolapo A. Anyanwu
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA
- Correspondence:
| | - Elena N. Naumova
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA
| | - Virginia R. Chomitz
- Public Health & Community Medicine, School of Medicine, Tufts University, 136 Harrison Ave, Boston, MA 02111, USA
| | - Fang-Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA
| | - Kenneth Chui
- Public Health & Community Medicine, School of Medicine, Tufts University, 136 Harrison Ave, Boston, MA 02111, USA
| | - Martha I. Kartasurya
- Department of Public Health Nutrition, Universitas Diponegoro, Semarang 50275, Jawa Tengah, Indonesia
| | - Sara C. Folta
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA
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