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Li R, Li M, Fly AD, Bidulescu A, Luo J. Vegetarian diets and risk of nonalcoholic fatty liver disease: An observational study of National Health and Nutrition Examination Survey 2005-2018 using propensity score methods. J Hum Nutr Diet 2024; 37:643-654. [PMID: 38348568 DOI: 10.1111/jhn.13290] [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: 07/28/2023] [Accepted: 01/24/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Studies on the association between vegetarian diets and nonalcoholic fatty liver disease (NAFLD) are limited and have inconsistent results. This study aims to explore the association between vegetarian diets and NAFLD and compare the stage of fibrosis between vegetarians and nonvegetarians in a US representative sample. METHODS Cross-sectional data from 23,130 participants aged ≥20 years were obtained from the National Health and Nutrition Examination Survey, 2005-2018. Vegetarian status was classified based on two 24-h dietary recalls. We examined the association between vegetarian diets and the risk of NAFLD using the propensity score weighting method. RESULTS Vegetarian diets were significantly associated with decreases in hepatic steatosis index (HSI), US fatty liver index and nonalcoholic fatty liver disease fibrosis score with mean differences of -2.70 (95% confidence interval [CI]: -3.69, -1.70), -3.03 (95% CI: -7.15, -0.91) and -0.12 (95% CI: -0.26, -0.01), respectively. While modelling the risk of NAFLD, we estimated that vegetarians were 53% less likely to have NAFLD assessed by HSI (odds ratios [OR]: 0.47; 95% CI: 0.34, 0.65). The effect of vegetarian diets was higher among individuals with lower waist circumferences (OR: 0.20) than among those with higher waist circumferences (OR: 0.53,p interaction ${p}_{\text{interaction}}\,$ = 0.004). However, the association was largely attenuated after adjusting for body mass index and diabetes status. No significant association was identified between vegetarian diets and advanced fibrosis. CONCLUSIONS Vegetarian diets were associated with a lower prevalence of NAFLD among US adults, and the association appeared to be stronger in people with lower waist circumferences. Further studies are warranted to replicate our findings.
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Affiliation(s)
- Rui Li
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, Indiana, USA
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Ming Li
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Alyce D Fly
- Department of Nutrition and Health Science, Ball State University, Muncie, Indiana, USA
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, Indiana, USA
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Bez NS, Haddad J, Tedde GS, Rose K, Ivanov AV, Milazzo M, Wickart J, Casale G, D'Ascanio M, Van der Horst K, Herter-Aeberli I, Bogl LH. Development of a diet quality score and adherence to the Swiss dietary recommendations for vegans. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:17. [PMID: 38291526 PMCID: PMC10829326 DOI: 10.1186/s41043-024-00498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Vegan diets have recently gained popularity in Switzerland as well as globally. The aim of the present study was to develop a diet quality score for vegans (DQS-V) based on the Swiss dietary recommendations for vegans. METHODS The dataset included 52 healthy vegan adults. Dietary intake data were assessed by three-day weighed food records. Body weight and height were measured, and a venous blood sample for the analysis of vitamin and mineral status was collected. Spearman rank correlation coefficients were used due to not-normally distributed data. Dietary patterns were identified using principal component analysis (PCA). RESULTS The DQS-V score (mean ± SD) was 48.9 ± 14.7. Most vegans adhered to the recommended portions of vegetables, vitamin C-rich vegetables, fruits, omega-3-rich nuts, fats and oils, and iodized salt. However, the intake of green leafy vegetables, vitamin C-rich fruits, wholegrains, legumes, nuts and seeds, selenium-rich nuts, zero caloric liquid, and calcium-fortified foods was suboptimal. The sample overconsumed sweet-, salty-, fried foods, and alcohol. The DQS-V had a significantly positive correlation with intakes of fibre, polyunsaturated fatty acids, potassium, zinc, and phosphorus intakes (p's < 0.05) but was negatively correlated with vitamin B12 and niacin intakes (p's < 0.05). Two dietary patterns were derived from PCA: 1) refined grains and sweets and 2) wholegrains and nuts. The correlation between the DQS-V and the first dietary pattern was negative (- 0.41, p = 0.004) and positive for the second dietary pattern (0.37, p = 0.01). The refined grains and sweets dietary pattern was inversely correlated with beta-carotene status (- 0.41, p = 0.004) and vitamin C status (r = - 0.51, p = 0.0002). CONCLUSION The newly developed DQS-V provides a single score for estimating diet quality among vegan adults. Further validation studies examining the DQS-V in relation to an independent dietary assessment method and to biomarkers of nutritional intake and status are still needed before the general application of the DQS-V.
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Affiliation(s)
- Natalie S Bez
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Joyce Haddad
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Giulia S Tedde
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Karolin Rose
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Aljoscha V Ivanov
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Marina Milazzo
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Joëlle Wickart
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Giulia Casale
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Michele D'Ascanio
- Swiss Working Group for Vegetarian Diets, Swiss Association of Registered Dietitians (SVDE), Altenbergstrasse 29, 3000, Bern, Switzerland
| | - Klazine Van der Horst
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | | | - Leonie H Bogl
- Department Nutrition and Dietetics, Faculty of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
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Conrad Z, Drewnowski A, Belury MA, Love DC. Greenhouse gas emissions, cost, and diet quality of specific diet patterns in the United States. Am J Clin Nutr 2023:S0002-9165(23)46847-5. [PMID: 37075848 DOI: 10.1016/j.ajcnut.2023.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Major policy agendas are calling for accelerated investment in research that addresses the impact of diet patterns on multiple domains of sustainability. OBJECTIVE To evaluate the comparative greenhouse gas emissions, diet cost, and diet quality of plant-based, low grain, restricted carbohydrate, low fat, and time restricted diet patterns on a daily per capita basis. DESIGN Dietary data from the National Health and Nutrition Examination Survey (2013-2016, n=4,025) were merged with data on greenhouse gas emissions (GHGE) and food prices from multiple databases. The Healthy Eating Index-2015 was used to measure diet quality. RESULTS The plant-based diet pattern had the lowest GHGE (3.5 kg CO2eq, 95% CI: 3.3, 3.8 kg CO2eq) and among the lowest diet cost ($11.51, 95% CI: $10.67, $12.41), but diet quality (45.8, 95% CI: 43.3, 48.5) was similar (P>0.005) to most other diet patterns. All of the sustainability impacts of the low grain diet pattern were intermediate. The restricted carbohydrate diet pattern had the highest diet cost ($18.46, 95% CI: $17.80, $19.13) but intermediate diet quality (46.8, 95% CI: 45.7, 47.9) and moderate-to-high GHGE (5.7 kg CO2eq, 95% CI: 5.4, 5.9 kg CO2eq). The low fat diet pattern had the highest diet quality (52.0, 95% CI: 50.8, 53.1) and intermediate GHGE (4.4 kg CO2eq, 95% CI: 4.1, 4.6 kg CO2eq) and diet cost ($14.53, 95% CI: $13.73, $15.38). The time restricted diet pattern had among the lowest diet quality score (42.6, 95% CI: 40.8, 44.6), had GHGE similar to most other diet patterns (4.6 kg CO2eq, 95% CI: 4.2, 5.0 kg CO2eq), and low-to-moderate diet cost ($12.34, 95% CI: $11.38, $13.40). CONCLUSIONS Most diet patterns were associated with sustainability trade-offs. The nature of those trade-offs can help inform discussions on food and nutrition policy in the US, including the National Strategy on Hunger, Nutrition, and Health, and future Dietary Guidelines for Americans.
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Affiliation(s)
- Zach Conrad
- Department of Kinesiology, William & Mary, Williamsburg, VA 23185, USA; Global Research Institute, William & Mary, Williamsburg, VA 23185, USA.
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
| | - Martha A Belury
- Program of Human Nutrition, The Ohio State University, Columbus, OH 43221, USA.
| | - David C Love
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21202, USA; Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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O'Malley K, Willits-Smith A, Rose D. Popular diets as selected by adults in the United States show wide variation in carbon footprints and diet quality. Am J Clin Nutr 2023; 117:701-708. [PMID: 36868999 PMCID: PMC10131583 DOI: 10.1016/j.ajcnut.2023.01.009] [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: 07/15/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Carbon footprints of vegetarian, pescatarian, and other popular diets have been studied previously, but mostly as idealized versions modeled to meet dietary recommendations. Less is known about the footprints of popular diets as they are consumed by US adults, and thus the potential trade-offs with diet quality for free-living individuals. OBJECTIVES This study estimated the carbon footprint and diet quality of popular diets as selected by a nationally representative sample of US consumers, including the recently trending keto- and paleo-style diets. METHODS The 2005-2010 NHANES 24-h recall data were used to categorize individual adult diets (n = 16,412) into 6 types: vegan, vegetarian, pescatarian, paleo, keto, and all other diets, referred to here as omnivore diets. Average daily greenhouse gas emissions in kilograms of carbon dioxide equivalents per 1000 kcal (kg CO2-eq/1000 kcal) were calculated for each diet by matching our previously developed database to NHANES individual diet data. Diet quality was determined using the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index. Survey-weighted ordinary least-squares regression was used to assess mean differences in diets. RESULTS The average carbon footprints of vegan (0.69 ± 0.05 kg CO2-eq/1000 kcal) and vegetarian (1.16 ± 0.02) diets were lower (P < 0.05) than those of the pescatarian (1.66 ± 0.04), omnivore (2.23 ± 0.01), paleo (2.62 ± 0.33), or keto (2.91 ± 0.27) diets. Mean HEI scores were highest for pescatarian diets (58.76 ± 0.79) and higher (P < 0.05) for vegetarian (51.89 ± 0.74) than for omnivore (48.92 ± 0.33) or keto (43.69 ± 1.61) diets. CONCLUSIONS Our results highlight the nuances when evaluating the nutritional quality of diets and their carbon footprints. On average, pescatarian diets may be the healthiest, but plant-based diets have lower carbon footprints than other popular diets, including keto- and paleo-style diets.
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Affiliation(s)
- Keelia O'Malley
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Amelia Willits-Smith
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
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Kohl IS, Luft VC, Patrão AL, Molina MDCB, Nunes MAA, Schmidt MI. Association between meatless diet and depressive episodes: A cross-sectional analysis of baseline data from the longitudinal study of adult health (ELSA-Brasil). J Affect Disord 2023; 320:48-56. [PMID: 36162679 DOI: 10.1016/j.jad.2022.09.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/03/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The association between vegetarianism and depression is still unclear. We aimed to investigate the association between a meatless diet and the presence of depressive episodes among adults. METHODS A cross-sectional analysis was performed with baseline data from the ELSA-Brasil cohort, which included 14,216 Brazilians aged 35 to 74 years. A meatless diet was defined from in a validated food frequency questionnaire. The Clinical Interview Schedule-Revised (CIS-R) instrument was used to assess depressive episodes. The association between meatless diet and presence of depressive episodes was expressed as a prevalence ratio (PR), determined by Poisson regression adjusted for potentially confounding and/or mediating variables: sociodemographic parameters, smoking, alcohol intake, physical activity, several clinical variables, self-assessed health status, body mass index, micronutrient intake, protein, food processing level, daily energy intake, and changes in diet in the preceding 6 months. RESULTS We found a positive association between the prevalence of depressive episodes and a meatless diet. Meat non-consumers experienced approximately twice the frequency of depressive episodes of meat consumers, PRs ranging from 2.05 (95%CI 1.00-4.18) in the crude model to 2.37 (95%CI 1.24-4.51) in the fully adjusted model. LIMITATIONS The cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS Depressive episodes are more prevalent in individuals who do not eat meat, independently of socioeconomic and lifestyle factors. Nutrient deficiencies do not explain this association. The nature of the association remains unclear, and longitudinal data are needed to clarify causal relationship.
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Affiliation(s)
- Ingrid S Kohl
- Postgraduate Program in Collective Health, Universidade do Vale do Rio dos Sinos, Brazil; Postgraduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Brazil
| | - Vivian C Luft
- Postgraduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Brazil; Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil; Center for Food and Nutrition Studies (CESAN), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
| | - Ana Luísa Patrão
- Center for Psychology, Faculty of Psychology and Education Science, University of Porto, Porto, Portugal; Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Maria Del Carmen B Molina
- Federal University of Ouro Preto, Minas Gerais, Brazil; Federal University of Espírito Santo, Brazil
| | | | - Maria I Schmidt
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil
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Dussiot A, Fouillet H, Perraud E, Salomé M, Huneau JF, Kesse-Guyot E, Mariotti F. Nutritional issues and dietary levers during gradual meat reduction - A sequential diet optimization study to achieve progressively healthier diets. Clin Nutr 2022; 41:2597-2606. [PMID: 36306564 DOI: 10.1016/j.clnu.2022.09.017] [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: 03/25/2022] [Revised: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Reducing meat consumption is a current trend and a strong prospect for the future in Western countries, but its dietary modalities and nutrient challenges remain poorly documented. Using diet optimization under a broad set of constraints, we tried to identify a sequential meat reduction transition and analyze its nutrient issues and dietary levers. METHODS Based on the consumption of French adults (INCA3, n = 1 125, 18-64 years old), we modeled a transition towards a nutritionally adequate healthy dietary pattern under the constraint of a gradual reduction in meat consumption in successive 10% steps. Using a multi-criteria optimization procedure, the diet modeled at each meat reduction step was to be healthier but close to the previous diet. RESULTS The most significant changes occurred early in the modeled transition process, with drastic reductions in processed and red meats in favor of poultry, which rapidly became the predominant meat before gradually decreasing from 50% to 100% meat reduction. At the same time, whole grain products, fruits and vegetables consumption increased rapidly to reach a plateau from 50% meat reduction onwards. Some nutrients were limiting, in particular bioavailable iron and zinc, and vitamin A, but sufficient intakes were achieved by restructuring diets based on food groups other than meat. Other nutrients mainly supplied by meat such as vitamin B6 and B12, protein and indispensable amino acids, were never limiting. CONCLUSION Healthy and nutritionally adequate food patterns can be identified throughout a transition to complete meat reduction. After a 50% reduction in meat consumption, poultry is almost the only meat remaining and its further reduction makes the diet only marginally healthier.
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Affiliation(s)
- Alison Dussiot
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Hélène Fouillet
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Elie Perraud
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Marion Salomé
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Jean-François Huneau
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | | | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France.
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Nutritional Status and Habits among People on Vegan, Lacto/Ovo-Vegetarian, Pescatarian and Traditional Diets. Nutrients 2022; 14:nu14214591. [PMID: 36364853 PMCID: PMC9657343 DOI: 10.3390/nu14214591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background: This study assessed the possible dependencies between nutritional habits and body composition among subjects with different dietary habits. Materials: A total of 196 healthy (aged 18−50 yrs) participants were enrolled in the study and divided into 4 groups according to their diet: vegans-VEGAN (n = 53), lacto/ovo-vegetarians—VEGE (n = 52), pescatarians-PESCA (n = 28), and omnivores-OMN (n = 43). Methods: The Food Frequency Questionnaire (FFQ) was used, and body composition was assessed on the In-Body120 analyzer. Results: Our result revealed in OMN + PESCA groups a higher average consumption frequency of sweets (p = 0.024), cheese/plant cheese (p < 0.001), eggs and egg dishes/egg substitutes (p < 0.001), butter, margarine/plant margarine (p < 0.001), cream /plant cream (p = 0.018), wine and cocktails (p = 0.028), vodka (p = 0.039) and lower of natural cottage cheese/tofu/tempeh (p < 0.001), vegetable oils (p = 0.036), legumes (p < 0.001) and nuts and seeds(p < 0.001) compared to the VEGAN + VEGE groups. The body composition analysis showed significant differences in skeletal muscle mass (SMM) (p = 0.019) and the content of minerals (p = 0.048) between groups. VEGAN disclosed the lowest average values of body fat mass (BFM), percentage body fat (PBF), and visceral adipose tissue (VAT) than other studied groups. Conclusions: The body composition analysis showed mean values within normal ranges in all of the groups, but some average results of OMN, PESCA, and VEGE compared to VEGAN were not highly satisfactory (in addition to eating behavior outcomes).
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Conrad Z, Kowalski C, Dustin D, Johnson LK, McDowell A, Salesses M, Nance J, Belury MA. Quality of Popular Diet Patterns in the United States: Evaluating the Effect of Substitutions for Foods High in Added Sugar, Sodium, Saturated Fat, and Refined Grains. Curr Dev Nutr 2022; 6:nzac119. [PMID: 36105765 PMCID: PMC9464903 DOI: 10.1093/cdn/nzac119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background Many Americans have adopted popular diet patterns for general health improvement that restrict specific foods, macronutrients, or eating time. However, there is limited evidence to characterize the quality of these diet patterns. Objectives This study 1) evaluated the quality of popular diet patterns in the United States and 2) modeled the effect of targeted food substitutions on diet quality. Methods Dietary data from 34,411 adults ≥20 y old were acquired from the NHANES, 2005-2018. Dietary intake was assessed using the National Cancer Institute's usual intake methodology, and the Healthy Eating Index-2015 was used to evaluate diet quality. A diet model was used to evaluate the effect of targeted food substitutions on diet quality. Results A pescatarian diet pattern had the highest diet quality (65.2; 95% CI: 64.0, 66.4), followed by vegetarian (63.0; 95% CI: 62.0, 64.0), low-grain (62.0; 95% CI: 61.6, 62.4), restricted-carbohydrate (56.9; 95% CI: 56.6, 57.3), time-restricted (55.2; 95% CI: 54.8, 55.5), and high-protein (51.8; 95% CI: 51.0, 62.7) diet patterns. Modeled replacement of ≤3 daily servings of foods highest in added sugar, sodium, saturated fat, and refined grains with alternative foods led to an increase in diet quality and a decrease in energy intake for most diet patterns. Conclusions Low diet quality was observed for all popular diet patterns evaluated in this study. Modeled dietary shifts that align with recommendations to choose foods lower in added sugar, sodium, saturated fat, and refined grains led to modest improvements in diet quality and larger reductions of energy intake. Greater efforts are needed to encourage the adoption of dietary patterns that emphasize consumption of a variety of high-quality food groups.
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Affiliation(s)
- Zach Conrad
- Department of Kinesiology, William & Mary, Williamsburg, VA, USA
- Global Research Institute, William & Mary, Williamsburg, VA, USA
| | - Corina Kowalski
- College of Arts & Sciences, William & Mary, Williamsburg, VA, USA
| | - Dakota Dustin
- Program of Human Nutrition, The Ohio State University, Columbus, OH, USA
| | | | - Acree McDowell
- College of Arts & Sciences, William & Mary, Williamsburg, VA, USA
| | | | - Julie Nance
- Department of Kinesiology, William & Mary, Williamsburg, VA, USA
| | - Martha A Belury
- Program of Human Nutrition, The Ohio State University, Columbus, OH, USA
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Bruns A, Mueller M, Schneider I, Hahn A. Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians, Vegans and Omnivores in Germany. Nutrients 2022; 14:nu14153038. [PMID: 35893892 PMCID: PMC9330316 DOI: 10.3390/nu14153038] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 12/10/2022] Open
Abstract
Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, in this cross-sectional study, the food intake of 94 participants aged between 25–45 years was recorded via a validated food frequency questionnaire and 28 self-designed questions about the consumption of plant-based alternatives. An adapted Healthy Eating Index, HEI-flex, was developed to evaluate the diet quality of flexitarians, vegans and omnivores. Higher score points (SP) of the HEI-flex are associated with higher compliance with the official diet recommendations (Vmax = 100 SP). Finally, flexitarians scored significantly more highly when compared to omnivores (54 ± 8 vs. 47 ± 9 SP; p = 0.008) but lower than vegans (54 ± 8 vs. 61 ± 10 SP; p = 0.010). The results showed that the HEI-flex is a useful tool for assessing and comparing the diet quality of flexitarians, vegans and omnivores. Despite the consumption of highly processed plant-based alternatives, reduction in meat and meat products seems to be accompanied by increased overall diet quality.
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Vanderlee L, Gómez-Donoso C, Acton RB, Goodman S, Kirkpatrick SI, Penney T, Roberto CA, Sacks G, White M, Hammond D. Meat-Reduced Dietary Practices and Efforts in 5 Countries: Analysis of Cross-Sectional Surveys in 2018 and 2019. J Nutr 2022; 152:57S-66S. [PMID: 35544274 PMCID: PMC9188860 DOI: 10.1093/jn/nxac057] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Diets that reduce reliance on animal-source foods are recommended in some contexts. OBJECTIVES This study aimed to compare proportions of respondents who reported following meat-reduced dietary practices (i.e., vegetarian, vegan, or pescatarian diets) and/or making efforts to reduce animal-source foods, and to examine sociodemographic correlates across 5 countries. METHODS Online surveys were conducted in November and December 2018 and 2019 with 41,607 adults from Australia (n = 7926), Canada (n = 8031), Mexico (n = 8110), the United Kingdom (n = 9129), and the United States (n = 8411) as part of the International Food Policy Study. Respondents were asked whether they would describe themselves as vegetarian, vegan, or pescatarian, and whether they had made efforts to consume less red meat, less of all meats, or less dairy in the past year. Logistic regressions examined differences in the likelihood of each behavior between countries and sociodemographic subgroups. RESULTS Approximately 1 in 10 respondents reported following a vegetarian, vegan, or pescatarian diet, ranging from 8.6% (Canada) to 11.7% (UK). In the past 12 months, the proportions of respondents who reported efforts to consume less red meat ranged from 34.5% (Australia) to 44.4% (Mexico), less of all meats ranged from 27.9% (US) to 35.2% (Mexico), and to consume less dairy ranged from 20.6% (UK) to 41.3% (Mexico). Respondents were more likely to report efforts to consume less animal-source products in 2019 compared to 2018 in most countries. Sociodemographic patterns varied by country; in general, women, those with higher education levels, and those in minority ethnic groups were more likely to report following meat-reduced dietary practices or efforts to consume fewer animal-source products. CONCLUSIONS Nearly half of respondents reported following a meat-reduced diet or efforts to reduce animal-source products, with differences between countries and population subgroups. Population-level approaches and policies that support meat reduction may further reduce consumption of animal-source products.
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Affiliation(s)
| | - Clara Gómez-Donoso
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - Rachel B Acton
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Samantha Goodman
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | | | - Tarra Penney
- Faculty of Health, York University, Toronto, Canada
| | - Christina A Roberto
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gary Sacks
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Martin White
- Centre for Diet and Activity Research, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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11
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Magkos F. Meat in the human diet: in transition from evolutionary hallmark to scapegoat. Am J Clin Nutr 2022; 115:1263-1265. [PMID: 35348609 DOI: 10.1093/ajcn/nqac041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
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12
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Abstract
Diet sustainability analyses are stronger when they incorporate multiple food systems domains, disciplines, scales, and time/space dimensions into a common modeling framework. Few analyses do this well: there are large gaps in food systems data in many regions, accessing private and some public data can be difficult, and there are analytical challenges, such as creating linkages across datasets and using complex analytical methods. This article summarizes key data sources across multiple domains of food system sustainability (nutrition, economic, environment) and describes methods and tools for integrating them into a common analytic framework. Our focus is the United States because of the large number of publicly available and highly disaggregated datasets. Thematically, we focus on linkages that exist between environmental and economic datasets to nutrition, which can be used to estimate the cost and agricultural resource use of food waste, interrelationships between healthy eating and climate impacts, diets optimized for cost, nutrition, and environmental impacts, and others. The limitations of these approaches and data sources are described next. By enhancing data integration across these fields, researchers can be better equipped to promote policy for sustainable diets.
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13
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Torna E, Smith E, Lamothe M, Langkamp-Henken B, Andrade JM. Comparison of diet quality of US adults based on primary motivation for following a vegetarian diet: A cross-sectional online study. Nutr Res 2021; 90:13-23. [PMID: 34023804 DOI: 10.1016/j.nutres.2021.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 12/19/2022]
Abstract
Adults adopt a vegetarian diet for various motivations, but it is unknown their overall diet quality based on a primary motivation. The purpose of the study was to compare overall diet quality, nutrient intake and related food groups based on primary motivation for following a vegetarian diet. It was hypothesized that vegetarians who chose the diet for health-related motivations would have a higher diet quality based on the Healthy Eating Index (HEI)-2015 scores compared to those following the diet for other motivations. A cross-sectional study was conducted online in the United States. Participants (n = 511) completed an 18-item questionnaire and a 24-hour recall using the Automated Self-Administered 24-hour Dietary Recall (ASA24-2018) and were divided into one of three groups (Health, Animal, Other [family, religious beliefs, or environment]) based on their primary motivation for following a vegetarian diet. Total HEI-2015 scores were determined and Kruskal-Wallis ANOVA on Ranks with a Dunn's Method for all pairwise comparisons (p < 0.05) were conducted. Results showed that total HEI-2015 scores differed among groups (p = 0.022) with the Health group having a higher score than the Other group (70.2 [57.0, 79.1] versus 63.6 [52.2, 77.1], median 25th, 75th) but not the animal rights group (66.5 [55.1, 77.0]). Higher component scores for total protein foods, seafood and plant proteins and fatty acids contributed to the significant difference. Adults who were motivated by health to follow a vegetarian diet had a higher diet quality than those who cited Other as their primary motivation. As motivations may impact diet quality of vegetarians, it is necessary to account for them.
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Affiliation(s)
- Elena Torna
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32606, USA
| | - Elena Smith
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32606, USA
| | - Meagan Lamothe
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32606, USA
| | - Bobbi Langkamp-Henken
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32606, USA
| | - Jeanette M Andrade
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32606, USA.
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14
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Blaurock J, Kaiser B, Stelzl T, Weech M, Fallaize R, Franco RZ, Hwang F, Lovegrove J, Finglas PM, Gedrich K. Dietary Quality in Vegetarian and Omnivorous Female Students in Germany: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1888. [PMID: 33669236 PMCID: PMC7919835 DOI: 10.3390/ijerph18041888] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/25/2022]
Abstract
Vegetarian diets have gained in popularity, especially among highly educated women, and are considered beneficial to health. Comparative studies assessing the diet of vegetarians against omnivores are rather limited and often provide ambivalent results. Therefore, this study examined the nutrient intake and nutritional quality of vegetarian and omnivorous diets in a group of 61 female students in Germany. Habitual dietary intake was evaluated using a validated graphical online food frequency questionnaire (FFQ). Differences in nutrient intakes were analyzed by Mann-Whitney-U-Tests. Odds Ratios (OR) were calculated for vegetarians exceeding dietary reference values (DRV) compared to omnivores. The overall nutritional quality was assessed using the Healthy-Eating-Index-2015 (HEI-2015). In omnivores, intakes of total energy from saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), long-chain omega-3 polyunsaturated fatty acids (LC-n3-PUFA), cholesterol, sucrose, lactose, retinol, and cobalamin were significantly higher than in vegetarians. Significantly lower intakes were observed for fiber, magnesium, and beta-carotene. Significant OR were detected for total fat (OR = 0.29), SFA (OR = 0.04), beta-carotene (OR = 4.55), and cobalamin (OR = 0.32). HEI-2015 scores were higher for vegetarians than for omnivores (79 points versus 74 points) and significant differences were recorded for the HEI-2015 components dairy, seafood & plant proteins, fatty acids, added sugars, and saturated fatty acids.
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Affiliation(s)
- Julia Blaurock
- ZIEL-Institute for Food & Health, Technical University of Munich, 85354 Freising, Germany; (J.B.); (B.K.)
| | - Birgit Kaiser
- ZIEL-Institute for Food & Health, Technical University of Munich, 85354 Freising, Germany; (J.B.); (B.K.)
| | - Tamara Stelzl
- Analytical Food Chemistry, Technical University of Munich, 85354 Freising, Germany;
| | - Michelle Weech
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (M.W.); (R.F.); (J.L.)
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (M.W.); (R.F.); (J.L.)
| | | | - Faustina Hwang
- Biomedical Engineering, School of Biological Sciences, University of Reading, Reading RG6 6DH, UK;
| | - Julie Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (M.W.); (R.F.); (J.L.)
| | | | - Kurt Gedrich
- ZIEL-Institute for Food & Health, Technical University of Munich, 85354 Freising, Germany; (J.B.); (B.K.)
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15
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Parker HW, Vadiveloo MK. Diet quality of vegetarian diets compared with nonvegetarian diets: a systematic review. Nutr Rev 2020; 77:144-160. [PMID: 30624697 DOI: 10.1093/nutrit/nuy067] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective Vegetarian diets are consistently associated with improved health outcomes, and higher diet quality may contribute to improved health outcomes. This systematic review aims to qualitatively compare the a priori diet quality of vegetarian and nonvegetarian diets. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, 2 online databases (Web of Science and PubMed) were searched for English language studies comparing diet quality among vegetarian and nonvegetarian adults using an a priori diet quality index. Two reviewers assessed study eligibility. Comparisons were made between total and component (when available) diet quality scores among the 12 studies meeting inclusion criteria. Conclusions Lacto-ovo vegetarians or vegans had higher overall diet quality (4.5-16.4 points higher on the Healthy Eating Index 2010 [HEI-2010]) compared with nonvegetarians in 9 of 12 studies. Higher HEI-2010 scores for vegetarians were driven by closer adherence to recommendations for total fruit, whole grains, seafood and plant protein, and sodium. However, nonvegetarians had closer adherence to recommendations for refined grains and total protein foods. Higher diet quality in vegetarian diets may partially explain improvements in health outcomes compared with nonvegetarians; however, more research controlling for known confounders like health consciousness is needed.
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Affiliation(s)
- Haley W Parker
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Maya K Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island, USA
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16
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Miki AJ, Livingston KA, Karlsen MC, Folta SC, McKeown NM. Using Evidence Mapping to Examine Motivations for Following Plant-Based Diets. Curr Dev Nutr 2020; 4:nzaa013. [PMID: 32110769 PMCID: PMC7042611 DOI: 10.1093/cdn/nzaa013] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/06/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
Motivations to adopt plant-based diets are of great public health interest. We used evidence mapping to identify methods that capture motivations to follow plant-based diets and summarize demographic trends in dietary motivations. We identified 56 publications that described 90 samples of plant-based diet followers and their dietary motivations. We categorized the samples by type of plant-based diet: vegan (19%), vegetarian (33%), semivegetarian (24%), and other, unspecified plant-based diet followers (23%). Of 90 studies examined, 31% administered multiple-choice questions to capture motivations, followed by rate items (23%), Food Choice Questionnaire (17%), free response (9%), and rank choices (10%). Commonly reported motivations were health, sensory/taste/disgust, animal welfare, environmental concern, and weight loss. The methodological variation highlights the importance of using a structured questionnaire to investigate dietary motivations in epidemiological studies. Motivations among plant-based diet followers appear distinct, but evidence on the association between age and motivations appears limited.
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Affiliation(s)
- Akari J Miki
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Kara A Livingston
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | | | - Sara C Folta
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Friedman School of Nutrition Science and Policy at Tufts University, Boston, MA, USA
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17
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Mariotti F. Animal and Plant Protein Sources and Cardiometabolic Health. Adv Nutr 2019; 10:S351-S366. [PMID: 31728490 PMCID: PMC6855969 DOI: 10.1093/advances/nmy110] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/24/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
The sources or types of protein in the diet have long been overlooked regarding their link to cardiometabolic health. The picture is complicated by the fact that animal and plant proteins are consumed along with other nutrients and substances which make up the "protein package" so plant and animal protein come with clear nutrient clusters. This review aimed at deciphering the relation between plant and animal protein and cardiometabolic health by examining different nutritional levels (such as amino acids, protein type, protein foods, protein patterns, and associated overall dietary and nutrient patterns) and varying levels of scientific evidence [basic science, randomized controlled trials (RCTs), observational data]. Plant protein in Western countries is a robust marker of nutrient adequacy of the diet, whereas the contribution of animal protein is highly heterogeneous. Yet recent data from large cohorts have confirmed that total and animal proteins are associated with the risk of cardiovascular disease and diabetes, even when fully adjusting for lifestyle and dietary or nutritional factors. Here again, there is marked variability depending on the type of animal protein. Protein from processed red meat and total red meat on the one hand, and from legumes, nuts, and seeds on the other, are often reported at the extremes of the risk range. RCTs using purified proteins have contributed little to the topic to date, inasmuch as the findings cannot readily be extrapolated to current or near-future diets, but RCTs studying whole protein foods have shown a beneficial effect of pulses. Despite the fact that many of the benefits of plant protein reported in observational or interventional studies may stem from the protein package that they convey and the nutrients that they displace, there are also important indications that protein per se may affect cardiometabolic health via the many amino acids that are present in typically contrasting levels in plant compared with animal proteins.
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Affiliation(s)
- François Mariotti
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France
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18
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Karlsen MC, Rogers G, Miki A, Lichtenstein AH, Folta SC, Economos CD, Jacques PF, Livingston KA, McKeown NM. Theoretical Food and Nutrient Composition of Whole-Food Plant-Based and Vegan Diets Compared to Current Dietary Recommendations. Nutrients 2019; 11:nu11030625. [PMID: 30875784 PMCID: PMC6471973 DOI: 10.3390/nu11030625] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 12/16/2022] Open
Abstract
Public interest in popular diets is increasing, in particular whole-food plant-based (WFPB) and vegan diets. Whether these diets, as theoretically implemented, meet current food-based and nutrient-based recommendations has not been evaluated in detail. Self-identified WFPB and vegan diet followers in the Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey reported their most frequently used sources of information on nutrition and cooking. Thirty representative days of meal plans were created for each diet. Weighted mean food group and nutrient levels were calculated using the Nutrition Data System for Research (NDSR) and data were compared to DRIs and/or USDA Dietary Guidelines/MyPlate meal plan recommendations. The calculated HEI-2015 scores were 88 out of 100 for both WFPB and vegan meal plans. Because of similar nutrient composition, only WFPB results are presented. In comparison to MyPlate, WFPB meal plans provide more total vegetables (180%), green leafy vegetables (238%), legumes (460%), whole fruit (100%), whole grains (132%), and less refined grains (−74%). Fiber level exceeds the adequate intakes (AI) across all age groups. WFPB meal plans failed to meet the Recommended Dietary Allowances (RDA)s for vitamin B12 and D without supplementation, as well as the RDA for calcium for women aged 51–70. Individuals who adhere to WFBP meal plans would have higher overall dietary quality as defined by the HEI-2015 score as compared to typical US intakes with the exceptions of calcium for older women and vitamins B12 and D without supplementation. Future research should compare actual self-reported dietary intakes to theoretical targets.
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Affiliation(s)
- Micaela C Karlsen
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
| | - Gail Rogers
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
| | - Akari Miki
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| | - Alice H Lichtenstein
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Department of Medicine, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Department of Medicine, Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, USA.
| | - Paul F Jacques
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| | - Kara A Livingston
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| | - Nicola M McKeown
- Friedman School of Nutrition Science and Policy, Tufts University,150 Harrison Ave, Boston, MA 02111, USA.
- Nutritional Epidemiology Program at Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
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19
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Johnston CS, Bliss C, Knurick JR, Scholtz C. Rapid Eating Assessment for Participants [shortened version] scores are associated with Healthy Eating Index-2010 scores and other indices of diet quality in healthy adult omnivores and vegetarians. Nutr J 2018; 17:89. [PMID: 30266095 PMCID: PMC6162919 DOI: 10.1186/s12937-018-0399-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/25/2018] [Indexed: 01/19/2023] Open
Abstract
The Healthy Eating Index-2010 is a measure of diet quality as portrayed by the Dietary Guidelines for Americans; however, computing the Healthy Eating Index score is time consuming and requires trained personnel. The Rapid Eating Assessment for Participants [shortened version] is a simple measure that quickly, in less than 10 min, assesses diet quality in a clinical or research setting. This research evaluated the degree of correlation between these two methods of scoring diet quality, as well as between these methods and other indicators of diet quality, including the nutrient density of the diet, the dietary potential renal acid load, urine pH, and plasma vitamin C concentrations. The research design was a secondary data analysis, and participants were healthy adults (n = 81) self-classified as omnivorous, vegetarian, or vegan. Confounding variables were identified and controlled using partial correlations. The two methods of scoring diet quality were significantly correlated (r = 0.227, p = 0.047). Both the Healthy Eating Index and the Rapid Eating Assessment for Participants scoring methods were correlated to nutrient density of the diets (r = 0.474 and r = 0.472 respectively, p < 0.001) as well as to the dietary potential renal acid load and urinary pH (r ranging from 0.304-0.341, p ≤ 0.002). The Rapid Eating Assessment for Participants, but not the Healthy Eating Index, was significantly correlated to plasma vitamin C concentrations (r = 0.500, p < 0.001 and 0.192, p = 0.095 respectively). These results in combination with ease of use and low cost suggest that the Rapid Eating Assessment for Participants measure is a useful tool for assessing diet quality.
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Affiliation(s)
- Carol S Johnston
- Nutrition Program, College of Health Solutions, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85004, USA.
| | - Courtney Bliss
- Feeding Bliss ℅ Thrive Therapy, 3420 E. Shea Blvd. Unit 188, Phoenix, AZ, 85028, USA
| | - Jessica R Knurick
- Toolbox Genomics, 75 Broadway Street #251, San Francisco, CA, 94115, USA
| | - Cameron Scholtz
- Nutrition Program, College of Health Solutions, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85004, USA
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20
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Karlsen MC, Lichtenstein AH, Economos CD, Folta SC, Rogers G, Jacques PF, Livingston KA, Rancaño KM, McKeown NM. Web-Based Recruitment and Survey Methodology to Maximize Response Rates from Followers of Popular Diets: the Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey. Curr Dev Nutr 2018; 2:nzy012. [PMID: 29955724 PMCID: PMC5998370 DOI: 10.1093/cdn/nzy012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/01/2018] [Accepted: 02/27/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although there is interest in popular diets such as vegan and vegetarian, Paleo, and other "whole food" diets, existing cohort studies lack data for these subgroups. The use of electronic data capture and Web-based surveys in nutrition research may be valuable for future studies by allowing targeting of specific dietary subgroups. OBJECTIVE The aim was to perform a Feasibility Survey (FS) to assess the practicality of Web-based research methods to gather data and to maximize response rates among followers of popular diets. METHODS The FS was an open, voluntary, 15-min survey conducted over 8 wk in the summer of 2015. Recruitment targeted self-identified followers of popular diets from a convenience sample, offering no incentives, via social media and e-newsletters shared by recruitment partners. Feasibility was assessed by number of responses, survey completion rate, distribution of diets, geographic location, and willingness to participate in future research. RESULTS A total of 14,003 surveys were initiated; 13,787 individuals consented, and 9726 completed the survey (71% of consented). The numbers of unique visitors to the questionnaire site, view rate, and participation rate were not captured. Among respondents with complete demographic data, 83% were female and 93% were white. Diet designations were collapsed into the following groups: whole-food, plant-based (25%); vegan and raw vegan (19%); Paleo (14%); try to eat healthy (11%); vegetarian and pescatarian (9%); whole food (8%); Weston A Price (5%); and low-carbohydrate (low-carb) (4%). Forced-response, multiple-choice questions produced the highest response rates (0-2% selected "prefer not to answer"). The percentage who were willing to complete future online questionnaires was 86%, diet recall was 93%, and food diary was 75%; the percentages willing to provide a finger-stick blood sample, venipuncture blood sample, urine sample, and stool sample were 60%, 44%, 58%, and 42%, respectively. CONCLUSIONS This survey suggests that recruiting followers of popular diets is feasible with the use of Web-based methods. The unbalanced sample with respect to sex and race/ethnicity could be corrected with specific recruitment strategies using targeted online marketing techniques.
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Affiliation(s)
- Micaela C Karlsen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Alice H Lichtenstein
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
- Tufts University School of Medicine, Boston, MA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | | | - Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Gail Rogers
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Paul F Jacques
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | | | - Katherine M Rancaño
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Nicola M McKeown
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
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21
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Abstract
OBJECTIVE Excess meat consumption, particularly of red and processed meats, is associated with nutritional and environmental health harms. While only a small portion of the population is vegetarian, surveys suggest many Americans may be reducing their meat consumption. To inform education campaigns, more information is needed about attitudes, perceptions, behaviours and foods eaten in meatless meals. DESIGN A web-based survey administered in April 2015 assessed meat reduction behaviours, attitudes, what respondents ate in meatless meals and sociodemographic characteristics. SETTING Nationally representative, web-based survey in the USA. SUBJECTS US adults (n 1112) selected from GfK Knowledgeworks' 50 000-member online panel. Survey weights were used to assure representativeness. RESULTS Two-thirds reported reducing meat consumption in at least one category over three years, with reductions of red and processed meat most frequent. The most common reasons for reduction were cost and health; environment and animal welfare lagged. Non-meat reducers commonly agreed with statements suggesting that meat was healthy and 'belonged' in the diet. Vegetables were most often consumed 'always' in meatless meals, but cheese/dairy was also common. Reported meat reduction was most common among those aged 45-59 years and among those with lower incomes. CONCLUSIONS The public and environmental health benefits of reducing meat consumption create a need for campaigns to raise awareness and contribute to motivation for change. These findings provide rich information to guide intervention development, both for the USA and other high-income countries that consume meat in high quantities.
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22
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Gavelle ED, Huneau JF, Mariotti F. Patterns of Protein Food Intake Are Associated with Nutrient Adequacy in the General French Adult Population. Nutrients 2018; 10:nu10020226. [PMID: 29462965 PMCID: PMC5852802 DOI: 10.3390/nu10020226] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/13/2018] [Accepted: 02/14/2018] [Indexed: 01/21/2023] Open
Abstract
Protein food intake appears to partially structure dietary patterns, as most current emergent diets (e.g., vegetarian and flexitarian) can be described according to their levels of specific protein sources. However, few data are available on dietary protein patterns in the general population and their association with nutrient adequacy. Based on protein food intake data concerning 1678 adults from a representative French national dietary survey, and non-negative-matrix factorization followed by cluster analysis, we were able to identify distinctive dietary protein patterns and compare their nutrient adequacy (using PANDiet probabilistic scoring). The findings revealed eight patterns that clearly discriminate protein intakes and were characterized by the intakes of one or more specific protein foods: ‘Processed meat’, ‘Poultry’, ‘Pork’, ‘Traditional’, ‘Milk’, ‘Take-away’, ‘Beef’ and ‘Fish’. ‘Fish eaters’ and ‘Milk drinkers’ had the highest overall nutrient adequacy, whereas that of ‘Pork’ and ‘Take-away eaters’ was the lowest. Nutrient adequacy could often be accounted for by the characteristics of the food contributing to protein intake: ‘Meat eaters’ had high probability of adequacy for iron and zinc, for example. We concluded that protein patterns constitute strong elements in the background structure of the dietary intake and are associated with the nutrient profile that they convey.
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Affiliation(s)
- Erwan de Gavelle
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France.
| | | | - François Mariotti
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France.
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