Pattern analysis of vegan eating reveals healthy and unhealthy patterns within the vegan diet

Comparison of nutritional profile between plant-based meat analogues and real meat: A review focusing on ingredients, nutrient contents, bioavailability, and health impacts

In order to fully understand the nutritional heterogeneity of plant-based meat analogues and real meat, this review summarized their similarities and differences in terms of ingredients, nutrient contents, bioavailability and health impacts. Plant-based meat analogues have some similarities to real meat. However, plant-based meat analogues are lower in protein, cholesterol and VB12 but higher in dietary fiber, carbohydrates, sugar, salt and various food additives than real meat. Moreover, some nutrients in plant-based meat analogues, such as protein and iron, are less bioavailable. There is insufficient evidence that plant-based meat analogues are healthier, which may be related to the specific attributes of these products such as formulation and degree of processing. As things stand, it is necessary to provide comprehensive nutrition information on plant-based meat products so that consumers can make informed choices based on their nutritional needs.

Development of the VEGANScreener, a Tool for a Quick Diet Quality Assessment among Vegans in Europe

BACKGROUND

Plant-based diets are not inherently healthy. Similar to omnivorous diets, they may contain excessive amounts of sugar, sodium, and saturated fats, or lack diversity. Moreover, vegans might be at risk of inadequate intake of certain vitamins and minerals commonly found in foods that they avoid. We developed the VEGANScreener, a tool designed to assess the diet quality of vegans in Europe.

METHODS

Our approach combined best practices in developing diet quality metrics with scale development approaches and involved the following: (a) narrative literature synthesis, (b) evidence evaluation by an international panel of experts, and (c) translation of evidence into a diet screener. We employed a modified Delphi technique to gather opinions from an international expert panel.

RESULTS

Twenty-five experts in the fields of nutrition, epidemiology, preventive medicine, and diet assessment participated in the first round, and nineteen participated in the subsequent round. Initially, these experts provided feedback on a pool of 38 proposed items from the literature review. Consequently, 35 revised items, with 17 having multiple versions, were suggested for further consideration. In the second round, 29 items were retained, and any residual issues were addressed in the final consensus meeting. The ultimate screener draft encompassed 29 questions, with 17 focusing on foods and nutrients to promote, and 12 addressing foods and nutrients to limit. The screener contained 24 food-based and 5 nutrient-based questions.

CONCLUSIONS

We elucidated the development process of the VEGANScreener, a novel diet quality screener for vegans. Future endeavors involve contrasting the VEGANScreener against benchmark diet assessment methodologies and nutritional biomarkers and testing its acceptance. Once validated, this instrument holds potential for deployment as a self-assessment application for vegans and as a preliminary dietary screening and counseling tool in healthcare settings.

Theory of Food: Unravelling the Lifelong Impact of Childhood Dietary Habits on Adult Food Preferences across Different Diet Groups

The study investigates the behavioral manifestations of the "Theory of Food" (ToF), a novel theoretical framework centered on the early development of food perceptions. The ToF posits that childhood experiences with food shape cognitive networks influencing adult dietary choices. Stemming from the "Theory of Mind," the ToF hypothesizes that individuals construct an associative world of food images and representations mirroring the socio-cognitive world shaped by proper theory of mind development. The study, involving 249 healthy adults, employs the Cognitive Food Preference Questionnaire (CFPQ) and the Adult Food Preference Profile (AFPP) to explore the correlation between childhood and adult food preferences across diet groups (omnivores, vegetarians, and vegans). Results reveal robust correlations in omnivores, varied patterns in vegetarians, and mixed outcomes in vegans. Notably, omnivores show correlations in grains, fast food, dairy products, vegetables, meat, soft drinks, and snack consumption. Vegetarians exhibit correlations in grains, fast food, dairy products, vegetables, snacks, and, surprisingly, meat consumption. Vegans display correlations in grains, fast food, vegetables, and snacks. The study suggests that childhood dietary habits tend to influence adult food choices, offering insights for future research in the field of theory of food (ToF).

Development of a diet quality score and adherence to the Swiss dietary recommendations for vegans

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.

Experiences of Vegans with General Practitioners in the Austrian Health Care System: A Qualitative Study

This article explores the factors influencing the choice of general practitioners (GPs) and their role in the health care of vegans in Austria. The number of people identifying as vegan is on the rise, and GPs are increasingly confronted with vegan patients. A qualitative method was chosen for this study, and 14 semi-structured interviews with vegans were conducted between April 2022 and July 2022. Participants were recruited primarily through vegan social media groups. In their experiences with health care, vegans felt treated unequally or sometimes incorrectly. The experiences described highlight that participants felt that most GPs were biased against their veganism. Information exchange among vegans primarily takes place online and through publications of vegan associations, while GPs play a minor role in information provision. As the number of vegans grows, an appreciative way of communicating between GPs and vegan patients ought to be promoted. Voluntary interdisciplinary nutritional training, collaboration of the medical field with support organizations, provision of evidence-based information, and collaboration with dietitians and nutritionists could enrich the care of patients with a vegan diet.

The nutrient profile and cost of specialty dietary patterns: a hypothetical case study

OBJECTIVE

Ketogenic and vegan diets have become increasingly popular. The rising popularity of these dietary trends has been met in kind by the food industry producing a variety of specialty ultra-processed foods (UPF). Despite increasing popularity, the cost and nutrient profile of vegan and ketogenic diets (KD) that rely on UPF specialty products is poorly understood. We aimed to assess the cost and nutrient profile of vegan and KD that relied primarily on UPF and compare this to those that relied primarily on whole foods.

DESIGN

We designed and calculated the cost of four 1-d meal plans for a hypothetical weight-stable adult female. Two meal plans were created for the vegan-style and ketogenic-style diets, respectively, with one of each being predominantly whole food based and the other constituting primarily of UPF. Carbohydrates were limited to ≤50 g, protein was set at 15-20 % and fat ≥75 % for the ketogenic meal plans. Carbohydrates were set between 45 and 65 %, protein 15 and 25 % and fat 20 and 35 % for the vegan meal plans. FoodWorks dietary analysis software was used to assess data against the national Australian/New Zealand nutrient reference value for adult females and cost was calculated using Countdown online shopping (a local New Zealand supermarket).

SETTING

New Zealand.

PARTICIPANTS

None.

RESULTS

The whole food-based meal plans met a greater proportion of the macro and micronutrient thresholds and were less costly when compared with the specialty-based meal plans.

CONCLUSIONS

This study demonstrates that well-planned, predominantly whole food diets (regardless of dietary trend) are nutritionally superior and more cost-effective than those that rely on UPF.

Ultra-processing markers are more prevalent in plant-based meat products as compared to their meat-based counterparts in a German food market analysis

OBJECTIVE

To compare ultra-processing markers and nutrient composition in plant-based meat products (PBMP) with equivalent meat-based products (MBP).

DESIGN

A total of 282 PBMP and 149 MBP within 18 product categories were assessed. Based on the NOVA classification, 33 ultra-processing markers were identified and six ultra-processing bullet categories were defined, that is flavour, flavour enhancer, sweetener, colour, other cosmetic additives and non-culinary ingredients. The ingredient lists were analysed concerning these ultra-processing markers and ultra-processing bullet categories, as well as nutrient composition, for all PBMP and MBP. Differences between PBMP and MBP were assessed using chi-square and Mann-Whitney U tests, respectively.

SETTING

Cross-sectional analysis.

PARTICIPANTS

282 PBMP and 149 MBP.

RESULTS

The percentage of ultra-processed food (UPF) items was significantly higher in PBMP (88 %) as compared to MBP (52 %) (P < 0·0001). The proportion of UPF items was numerically higher in 15 out of 18 product categories with differences in six categories reaching statistical significance (P < 0·05). Flavour, flavour enhancer, colour, other cosmetic additives and non-culinary ingredients were significantly more prevalent in PBMP as compared to MBP (P < 0·0001). Concerning nutrient composition, median energy, total fat, saturated fat and protein content were significantly lower, whereas the amounts of carbohydrate, sugar, fibre and salt were significantly higher in PBMP (P < 0·05).

CONCLUSIONS

Ultra-processing markers are significantly more prevalent in PBMP as compared to MBP. Since UPF intake has been convincingly linked to metabolic and CVD, substituting MBP with PBMP might have negative net health effects.

Nutritional strategies to optimise musculoskeletal health for fall and fracture prevention: Looking beyond calcium, vitamin D and protein

Falls and osteoporotic fractures are a major public health problem, particularly among older adults. A third of individuals aged 65 years and over fall at least once each year, with up to 20 % of these resulting in serious injury, including fracture. In conjunction with regular exercise, the importance of diet for musculoskeletal health has largely focused upon calcium, vitamin D, and protein, particularly in the context of preventing falls and fractures. Whilst there is evidence for the benefits of these nutrients for musculoskeletal health, other aspects of the diet remain largely underexplored. For example, vegetables are rich sources of macro- and micronutrients that are essential for muscle function and bone health, which are key factors in the prevention of falls and fractures. Recent work has highlighted the importance of nutrients such as vegetable-derived nitrate and vitamin K1 in optimising muscle strength, physical function, and bone quality. In the context of dietary patterns, vegan/plant-based diets have recently gained popularity due to perceived health benefits, animal welfare, or to tackle climate change. The elimination and/or substitution of animal-based products for plant foods (without careful planning and/or expert dietary guidance) could, however, have long-term negative musculoskeletal consequences; a trend uncovered by recent evidence. Within the overarching theme of nutrition for fall and fracture prevention in older populations, the aim of this review is to (i) summarise the current evidence for calcium, vitamin D and protein; (ii) describe the importance of vegetables and selected nutrients, such as nitrate and vitamin K1, for muscle function and bone structural integrity; and (iii) highlight current evidence around different dietary patterns (e.g., plant-based, diet quality, data driven approaches) and their impact on musculoskeletal health.

Systematic review and meta-analysis of iodine nutrition in modern vegan and vegetarian diets

Vegan and vegetarian diets are widely supported and adopted, but individuals following such diets remain at greater risk of iodine deficiency. This systematic review and meta-analysis was conducted to assess the iodine intake and status in adults following a vegan or vegetarian diet in the modern day. A systematic review and quality assessment were conducted from October 2020 to December 2022 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidance. Studies were identified in Ovid MEDLINE, Web of Science, PubMed, and Scopus. Eleven articles were eligible for review containing 4421 adults (aged ≥ 18 years). Vegan groups had the lowest median urinary iodine concentration (mUIC) (12·2/l). None of the dietary groups had mUIC within the optimal range for iodine status (100-200 µg/l) (WHO). Vegan diets had the poorest iodine intake (17·3 µg/d) and were strongly associated with lower iodine intake (P = < 0·001) compared with omnivorous diets. Lower intake in vegan diets was influenced by sex (P = 0·007), the presence of voluntary or absence of Universal Salt Iodisation (USI) programmes (P = 0·01 & P = < 0·001), and living in a country with adequate iodine nutrition (P = < 0·001). Vegetarians and particularly vegans living in countries with no current USI programme continue to have increased risk of low iodine status, iodine deficiency and inadequate iodine intake. Further research into the usefulness of mandatory fortification of vegan appropriate foods is required.

Nutritional practices and experiences of people on vegan diet with healthcare system: a qualitative study

OBJECTIVES

The growing popularity of diets that restrict the consumption of animal-based foods is an important new challenge for the public healthcare system in Czechia. While the environmental and health-related benefits of plant-based diets are widely discussed in the media, people who follow these diets may lack professional support in terms of nutritional advice and even access to healthcare. The present study aims to map the nutritional practices and experiences with the healthcare system of people in Czechia who follow vegan diets.

METHODS

In a qualitative study we conducted semi-structured interviews with twenty-one self-reported adult vegans (14 women and 7 men; 18 with university education) who were on a vegan diet for at least a year. We were specifically interested in their motivation for why and how they became vegans; their everyday diet and eating routines; their use of health care and experiences with medical professionals; their nutritional knowledge and use of supplementation; and their perception of their health and embodiment.

RESULTS

The primary motivations for going vegan are ethical, environmental and health-related. Vegans see themselves and their diet as generally healthier, but for this to be true they must spend a considerable amount of time researching nutritional requirements and what dietary supplements they need. To this end, they tend to rely mainly on non-medical sources of information. Because of the lack of acceptance of veganism among primary-care physicians, vegans tend not to seek out medical advice or tell their doctor about their eating habits in order to avoid conflicts and negative experiences.

CONCLUSIONS

We identified a perceived lack of accessible educational materials and potentially limited access to primary healthcare recommendations for people who eliminate the consumption of animal-based foods. These findings deserve further research and public health risk-mitigation strategies.

The Association between Vegan Dietary Patterns and Physical Activity-A Cross-Sectional Online Survey

A balanced diet and sufficient physical activity (PA) are known to have positive health effects. The relationship between a vegan diet and PA levels is understudied. This cross-sectional online survey aimed to analyze whether different vegan dietary patterns differ in PA. In total, 516 vegan participants were included (June to August 2022). Different dietary patterns were compiled through principal component analysis, while group differences were calculated using independent tests, or chi-squared tests as well as logistic regression analyses. The population had an average age of 28.0 (SD: 7.7) years and had been living vegan for 2.6 (95% CI: 2.5-3.0) years. Two dietary patterns, the "convenience" and the "health-conscious" group, were identified. People with a convenience dietary pattern had significantly higher odds of sitting more (OR 1.10, 95% CI 1.04-1.18) and not achieving aerobic PA (OR 1.81, 95% CI 1.18-2.79) or strength training recommendations (OR 1.81, 95% CI 1.26-2.61) than people with a health-conscious dietary pattern. This study suggests the heterogeneity of vegan diets and that dietary patterns must be differentiated, as they also differ in the level of PA. Additional studies involving complete dietary assessment with a focus on ultraprocessed foods, blood metabolite analysis, and objective PA assessment are required.

Comparison of sensitivity to taste and astringency stimuli among vegans and omnivores

Taste perception plays a crucial role in determining food choices. It has been described in literature a relationship between diet composition and taste perception. Nowadays, with the rising concern in climate change and animal welfare, the number of people following a vegan diet is increasing to become a real trend. Research about differences in taste perception between vegan and omnivore is lacking. The aim of the study was to compare detection threshold for bitter, sour, umami and astringency stimuli (quinine monohydrochloride dihydrate, citric acid anhydrous, monosodium glutamate and tannic acid, respectively) participants following a vegan diet (n=24) and participants following an omnivore diet (n=30). Participants reported their consumption frequency for main food categories. The mean detection thresholds between the two groups narrowly missed significance with p-values of 0.07, 0.08, 0.06, for bitter, umami and astringency perception, respectively. No differences were found for sour taste (p-value=0.33). Further research is required to validate such findings and to understand the origin of the relationship between diet style and taste sensitivity.

Nutritional Assessment of Plant-Based Meat Alternatives: A Comparison of Nutritional Information of Plant-Based Meat Alternatives in Spanish Supermarkets

Since the classification of processed meat as carcinogenic by the International Agency for Research on Cancer (IARC) in 2015, an increase in consumption of plant-based meat alternatives (PBMAs) has been observed worldwide. This occurs in a context characterized by concern for health, animal welfare, and sustainability; however, evidence of their nutritional quality is still limited. Therefore, our objective was to evaluate the nutritional profile and processing degree of PBMAs available in Spain. In 2020, products from seven Spanish supermarkets were analyzed for their nutritional content and ingredients. Of the 148 products, the majority were low in sugars but moderate in carbohydrates, total and saturated fat, and high in salt. The main vegetable protein sources were soy (91/148) and wheat gluten (42/148). Comparatively, 43/148 contained animal protein, the most common being egg. Overall, PBMAs had a long list of ingredients and additives, and they were classified as ultra-processed foods (UPFs) according to the NOVA system. This study shows that the PBMAs available in Spanish supermarkets have a variable nutritional composition within and between categories. Further research is needed to determine if replacing meat with these UPFs could be a good alternative towards healthier and more sustainable dietary patterns.

Impact of Plant-Based Meat Alternatives on the Gut Microbiota of Consumers: A Real-World Study

Eating less meat is increasingly seen as a healthier, more ethical option. This is leading to growing numbers of flexitarian consumers looking for plant-based meat alternatives (PBMAs) to replace at least some of the animal meat they consume. Popular PBMA products amongst flexitarians, including plant-based mince, burgers, sausages and meatballs, are often perceived as low-quality, ultra-processed foods. However, we argue that the mere industrial processing of ingredients of plant origin does not make a PBMA product ultra-processed by default. To test our hypothesis, we conducted a randomised controlled trial to assess the changes to the gut microbiota of a group of 20 participants who replaced several meat-containing meals per week with meals cooked with PBMA products and compared these changes to those experienced by a size-matched control. Stool samples were subjected to 16S rRNA sequencing. The resulting raw data was analysed in a compositionality-aware manner, using a range of innovative bioinformatic methods. Noteworthy changes included an increase in butyrate metabolising potential-chiefly in the 4-aminobutyrate/succinate and glutarate pathways-and in the joint abundance of butyrate-producing taxa in the intervention group compared to control. We also observed a decrease in the Tenericutes phylum in the intervention group and an increase in the control group. Based on our findings, we concluded that the occasional replacement of animal meat with PBMA products seen in flexitarian dietary patterns can promote positive changes in the gut microbiome of consumers.