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Eisenhauer A, Hastuti A, Heuser A, Kolevica A, Brandt B, Shroff R, Oehme J, Müller M. Calcium isotope composition in serum and urine for the assessment of bone mineral balance (BMB) - The Osteolabs post-market follow-up study. Bone 2024; 188:117210. [PMID: 39079608 DOI: 10.1016/j.bone.2024.117210] [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: 04/19/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 09/09/2024]
Abstract
To further explore the clinical applicability of the calcium (Ca) isotope marker (CIM), we determined the 44Ca/42Ca isotope ratio in blood serum and urine. This ratio is expressed in the conventional δ-notation (as defined in the text below) specifically as CIM-serum for serum and as CIM-urine for urine. Our study tested the hypothesis that CIM values can differentiate between positive and negative bone mineral balance (BMB) across a diverse clinical population considering variables such as age, gender, and diet. The threshold values (CIM-serum: -0.85 ± 0.06 ‰ and CIM-urine: 0.23 ± 0.06 ‰) established in the OsteoGeo study (NCT02967978, Eisenhauer et al., 2019) were evaluated in 2320 participants as part of a surveillance study referred to as Osteolabs study. The earlier study revealed women with osteoporosis had an average CIM-serum value of -0.91 ± 0.21 ‰ (N = 24) and a CIM-urine value of 0.18 ± 0.33 ‰ (N = 71) that are significantly below the threshold values (p = 0.02 for urine, one-sided Wilcoxon rank test, p < 0.001 for serum, one-sided Student's t-test). Diseases affecting BMB such as osteoporosis, acute and chronic kidney disease (CKD), hyperthyroidism, breast cancer, prostate cancer, and myeloma were associated with significantly lower average CIM values, falling below the equilibrium thresholds and indicating negative BMB. In contrast, patients receiving osteoprotective treatments such as denosumab, Romosozumab, bisphosphonates, or hormone replacement therapy for certain diseases, had CIM values above the equilibrium thresholds indicating a positive BMB. Additionally, Ca supplements taken by some of the patients ((N = 22 (serum), N = 49 (urine), median dose: 500 mg) showed a Ca isotope composition approximately 1 ‰ higher than that from a normal diet. Consequently, their CIM values need to be adjusted to account for the amount and duration of supplementation to be comparable to those with a normal diet. Participants taking vitamin D (237 women; 58 men) showed no significant difference from the average values of the study group. Counterintuitively, the possible impact of malnutrition on individual BMB was most pronounced in vegans, who exhibited the highest average CIM-urine values compared to patients on a normal diet (p < 0.001, N = 17). The results of this study were consistent with the registered OsteoGeo study (NCT02967978) and other earlier published Ca isotope-based studies on BMB. We confirm that the CIM threshold values determined in the OsteoGeo study are generally valid for this much larger and diverse surveillance study group covering a diverse population encompassing various medical conditions and therapies.
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Affiliation(s)
- A Eisenhauer
- GEOMAR, Helmholtz-Center for Ocean Research Kiel, Germany.
| | - A Hastuti
- GEOMAR, Helmholtz-Center for Ocean Research Kiel, Germany; Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - A Heuser
- GEOMAR, Helmholtz-Center for Ocean Research Kiel, Germany
| | - A Kolevica
- GEOMAR, Helmholtz-Center for Ocean Research Kiel, Germany
| | - B Brandt
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - R Shroff
- UCL Great Ormond Street Hospital, London, United Kingdom
| | - J Oehme
- Osteolabs GmbH, Kiel, Germany
| | - M Müller
- University Hospital Schleswig-Holstein, Kiel, Germany
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Tomczyk-Warunek A, Winiarska-Mieczan A, Blicharski T, Blicharski R, Kowal F, Pano IT, Tomaszewska E, Muszyński S. Consumption of Phytoestrogens Affects Bone Health by Regulating Estrogen Metabolism. J Nutr 2024; 154:2611-2627. [PMID: 38825042 DOI: 10.1016/j.tjnut.2024.05.026] [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: 01/11/2024] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/04/2024] Open
Abstract
Osteoporosis is a significant concern in bone health, and understanding its pathomechanism is crucial for developing effective prevention and treatment strategies. This article delves into the relationship between estrogen metabolism and bone mineralization, shedding light on how phytoestrogens can influence this intricate process. Estrogen, a hormone primarily associated with reproductive health, plays a pivotal role in maintaining bone density and structure. The article explores the positive effects of estrogen on bone mineralization, highlighting its importance in preventing conditions like osteoporosis. Phytoestrogens, naturally occurring compounds found in certain plant-based foods, are the focal point of the discussion. These compounds have the remarkable ability to mimic estrogen's actions in the body. The article investigates how phytoestrogens can modulate the activity of estrogen, thereby impacting bone health. Furthermore, the article explores the direct effects of phytoestrogens on bone mineralization and structure. By regulating estrogen metabolism, phytoestrogens can contribute to enhanced bone density and reduced risk of osteoporosis. Finally, the article emphasizes the role of plant-based diets as a source of phytoestrogens. By incorporating foods rich in phytoestrogens into one's diet, individuals may potentially bolster their bone health, adding a valuable dimension to the ongoing discourse on osteoporosis prevention. In conclusion, this article offers a comprehensive overview of 137 positions of literature on the intricate interplay between phytoestrogens, estrogen metabolism, and bone health, shedding light on their potential significance in preventing osteoporosis and promoting overall well-being.
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Affiliation(s)
- Agnieszka Tomczyk-Warunek
- Department of Rehabilitation and Physiotherapy, Laboratory of Locomotor Systems Research, Medical University of Lublin, Lublin, Poland
| | - Anna Winiarska-Mieczan
- Department of Bromatology and Nutrition Physiology, Institute of Animal Nutrition and Bromatology, University of Life Sciences in Lublin, Lublin, Poland.
| | - Tomasz Blicharski
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Rudolf Blicharski
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Filip Kowal
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Inés Torné Pano
- Department of Orthopedics and Rehabilitation, Medical University of Lublin, Lublin, Poland
| | - Ewa Tomaszewska
- Department of Animal Physiology, University of Life Sciences in Lublin, Lublin, Poland
| | - Siemowit Muszyński
- Department of Biophysics, University of Life Sciences in Lublin, Lublin, Poland
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Baroni L, Bonetto C, Rizzo G, Galchenko A, Guidi G, Visaggi P, Savarino E, Zavoli M, de Bortoli N. Nutrient Composition of Four Dietary Patterns in Italy: Results from an Online Survey (the INVITA Study). Foods 2024; 13:2103. [PMID: 38998609 PMCID: PMC11240948 DOI: 10.3390/foods13132103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024] Open
Abstract
Though Italy is a native land of Mediterranean diet, its adherence in the Italian population is low, witnessed by the high rates of overweight in its inhabitants. Vegetarian dietary patterns (i.e., lacto-ovo-vegetarian and vegan) are increasing in western countries, and also in Italy, where 9.5% of the population self-declared as vegetarian in 2023. Though the vegetarian diet has been associated with beneficial health effects, speculation on its alleged nutrient inadequacy exists. For this reason, we assessed the nutrient composition of the diet of 470 participants enrolled in an online survey (the INVITA study), who completed a weighted food questionnaire on three different days. Participants were divided into four dietary groups obtained according to their self-declared dietary intakes: 116 Meat Eaters (MEs), 49 Fish Eaters (FEs), 116 Lacto-Ovo-Vegetarians (LOVs), and 189 VegaNs (VNs). The mean intake of most of the main nutrients was similar among all groups and within the normal range expected for the Italian population, supporting the adequacy of diets within our Italian sample, especially the LOV and VN diet. Since the Mediterranean diet is a plant-based diet, some of its components still persist in the current Italian diet, representing a staple also for people adopting a vegetarian diet.
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Affiliation(s)
- Luciana Baroni
- Scientific Society for Vegetarian Nutrition-SSNV, 30171 Venice, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | | | - Alexey Galchenko
- Scientific Society for Vegetarian Nutrition-SSNV, 30171 Venice, Italy
- Earth Philosophical Society "Melodia Vitae", International, Toronto, CA, Canada
| | - Giada Guidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Pierfrancesco Visaggi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Edoardo Savarino
- Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35124 Padua, Italy
- Gastroenterology Unit, University Hospital of Padua, 35124 Padua, Italy
| | - Martina Zavoli
- Scientific Society for Vegetarian Nutrition-SSNV, 30171 Venice, Italy
| | - Nicola de Bortoli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
- NUTRAFOOD, Interdepartmental Center for Nutraceutical Research and Nutrition for Health, University of Pisa, 56126 Pisa, Italy
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Ambroszkiewicz J, Gajewska J, Szamotulska K, Rowicka G, Klemarczyk W, Strucińska M, Chełchowska M. Comparative Analysis of Myokines and Bone Metabolism Markers in Prepubertal Vegetarian and Omnivorous Children. Nutrients 2024; 16:2009. [PMID: 38999757 PMCID: PMC11243178 DOI: 10.3390/nu16132009] [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: 06/03/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
The role of bone and muscle as endocrine organs may be important contributing factors for children's growth and development. Myokines, secreted by muscle cells, play a role in regulating bone metabolism, either directly or indirectly. Conversely, markers of bone metabolism, reflecting the balance between bone formation and bone resorption, can also influence myokine secretion. This study investigated a panel of serum myokines and their relationships with bone metabolism markers in children following vegetarian and omnivorous diets. A cohort of sixty-eight healthy prepubertal children, comprising 44 vegetarians and 24 omnivores, participated in this study. Anthropometric measurements, dietary assessments, and biochemical analyses were conducted. To evaluate the serum concentrations of bone markers and myokines, an enzyme-linked immunosorbent assay (ELISA) was used. The studied children did not differ regarding their serum myokine levels, except for a higher concentration of decorin in the vegetarian group (p = 0.020). The vegetarians demonstrated distinct pattern of bone metabolism markers compared to the omnivores, with lower levels of N-terminal propeptide of type I procollagen (P1NP) (p = 0.001) and elevated levels of C-terminal telopeptide of type I collagen (CTX-I) (p = 0.018). Consequently, the P1NP/CTX-I ratio was significantly decreased in the vegetarians. The children following a vegetarian diet showed impaired bone metabolism with reduced bone formation and increased bone resorption. Higher levels of decorin, a myokine involved in collagen fibrillogenesis and essential for tissue structure and function, may suggest a potential compensatory mechanism contributing to maintaining bone homeostasis in vegetarians. The observed significant positive correlations between myostatin and bone metabolism markers, including P1NP and soluble receptor activator of nuclear factor kappa-B ligand (sRANKL), suggest an interplay between muscle and bone metabolism, potentially through the RANK/RANKL/OPG signaling pathway.
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Affiliation(s)
- Jadwiga Ambroszkiewicz
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland; (J.G.); (M.C.)
| | - Joanna Gajewska
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland; (J.G.); (M.C.)
| | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland;
| | - Grażyna Rowicka
- Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland; (G.R.); (W.K.); (M.S.)
| | - Witold Klemarczyk
- Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland; (G.R.); (W.K.); (M.S.)
| | - Małgorzata Strucińska
- Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland; (G.R.); (W.K.); (M.S.)
| | - Magdalena Chełchowska
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland; (J.G.); (M.C.)
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Galchenko A, Rizzo G, Sidorova E, Skliar E, Baroni L, Visaggi P, Guidi G, de Bortoli N. Bone mineral density parameters and related nutritional factors in vegans, lacto-ovo-vegetarians, and omnivores: a cross-sectional study. Front Nutr 2024; 11:1390773. [PMID: 38919395 PMCID: PMC11196821 DOI: 10.3389/fnut.2024.1390773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction The growing prevalence of vegetarianism determines the need for comprehensive study of the impact of these diets on health and particularly on bone metabolism. We hypothesized that significant dietary differences between vegans, lacto-ovo-vegetarians, and omnivores also cause significant differences in their nutrient status, which may affect bone health. Methods The study assessed dual-energy X-ray absorptiometry parameters in lumbar spine and femoral neck, average nutrient intake, serum nutrient concentrations, serum PTH levels, and urinary pH among 46 vegans, 38 lacto-ovo-vegetarians, and 44 omnivores. Results There were no differences in bone mineral density (BMD) between the groups. However, the parathyroid hormone (PTH) levels were still higher in vegans compared to omnivores, despite the same prevalence of hyperparathyroidism in all groups. These findings may probably be explained by the fact that each group had its own "strengths and weaknesses." Thus, vegans and, to a lesser extent, lacto-ovo-vegetarians consumed much more potassium, magnesium, copper, manganese, and vitamins B6, B9, and C. At the same time, the diet of omnivores contained more protein and vitamins D and B12. All the subjects consumed less vitamin D than recommended. More than half of vegans and omnivores had insufficiency or even deficiency of vitamin D in the blood. Low serum concentrations of manganese with its quite adequate intake are also noteworthy: its deficiency was observed in 57% of vegans, 79% of lacto-ovo-vegetarians, and 63% of omnivores. Discussion Currently, it is no longer possible to conclude that lacto-ovo-vegetarians have lower BMD than omnivores, as our research supported. Vegans in our study also did not demonstrate lower BMD values, only higher PTH blood concentrations, compared to omnivores, however, a large number of studies, including recent, show the opposite view. In this regard, further large-scale research is required. Vegans and lacto-ovo-vegetarians now have a variety of foods fortified with vitamins D and B12, as well as calcium. There is also a great diversity of ethically sourced dietary supplements. The found low concentrations of manganese require further investigation.
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Affiliation(s)
- Alexey Galchenko
- Scientific Society for Vegetarian Nutrition, Venice, Italy
- Earth Philosophical Society “Melodia Vitae”, International, Toronto, CA, Canada
| | | | | | - Elena Skliar
- Earth Philosophical Society “Melodia Vitae”, International, Toronto, CA, Canada
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, Venice, Italy
| | - Pierfrancesco Visaggi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giada Guidi
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Nicola de Bortoli
- Division of Gastroenterology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- NUTRAFOOD, Interdepartmental Center for Nutraceutical Research and Nutrition for Health, University of Pisa, Pisa, Italy
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Kraselnik A. Risk of Bone Fracture on Vegetarian and Vegan Diets. Curr Nutr Rep 2024; 13:331-339. [PMID: 38554239 DOI: 10.1007/s13668-024-00533-z] [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] [Accepted: 03/20/2024] [Indexed: 04/01/2024]
Abstract
PURPOSE OF REVIEW Bone fractures can have a devastating effect on health, especially in the elderly, undermining their independence for daily activities, and increasing the risk of comorbidities and mortality. Nutrition is a key factor in maintaining an optimal bone health across the lifespan. The number of people that choose to avoid meat or even all animal products is increasing globally, for a diversity of reasons. Properly planned vegetarian and vegan diets are widely recognized as a healthy dietary pattern, but the long-term impact of these diets on bone health and more specifically risk of bone fractures is less clear. Classic studies have observed a slightly lower bone mineral density in vegetarians but have many limitations, including inadequate adjusting for relevant confounding factors, and cross-sectional design. The aim of this review is to summarize and put into context the current evidence on the effect of vegetarian and vegan diets on bone health, with a focus on fracture risk. RECENT FINDINGS In recent years, results from many large prospective studies have emerged, which allowed us to assess the risk of incident bone fractures in vegetarians. In these studies, vegetarian and especially vegan diets were associated with an increased risk of bone fractures. In many recent prospective cohort studies, vegetarian and especially vegan diets were associated with an increased risk of bone fractures. At least part of this risk could be due to a lower body mass index and a lower intake of nutrients such as calcium, vitamin D, and protein. Some evidence suggests that combined vitamin D and calcium supplementation and other factors such as consumption of protein-rich foods may attenuate this risk. The eventual deleterious effect of vegetarian diets on bone health should be contextualized and balanced with its benefits, such as lower risk of cardiovascular disease and cancer.
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Affiliation(s)
- Ariel Kraselnik
- Sociedad Argentina de Medicina de Estilo de Vida (SAMEV), Av. Córdoba 3239, Ciudad Autónoma de Buenos Aires, Argentina.
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Ruxton CHS, Gordon S. Animal board invited review: The contribution of red meat to adult nutrition and health beyond protein. Animal 2024; 18:101103. [PMID: 38442540 DOI: 10.1016/j.animal.2024.101103] [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: 09/08/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
Red meat has been a critical part of human diets for millennia, providing a source of high-quality protein, micronutrients and essential fatty acids. However, as societies evolved and industrialisation reshaped our food systems, there has been a noticeable shift in meat-eating trends driven by concerns about the environmental impact of meat production and its potential risk to health. Yet, despite falling out of favour with some dietary experts and influencers, meat has an important role in a healthy diet and most adults still consume it. This article explores the nutritional value of red meat, authorised nutrition and health claims, how red meat fits into diet, providing the example of the United Kingdom (UK), and the health benefits and risks associated with both eating and avoiding red meat. Benefits of red meat include nutrient density and bioavailability while risks include colorectal cancer at high intakes of processed meats, based on observational studies. Benefits of meat-free diets include a lower risk of chronic diseases, based on observational studies, while risks include nutrient inadequacy, higher bone fracture risk and low protein quality. Hence, a wholesale shift to plant-based diets may not benefit adults who are vulnerable to sub-optimal nutrient intakes, such as women of child-bearing age and the elderly. More evidence from randomised controlled trials is recommended to fully understand the benefits and risks of both meat-containing and meat-free diets.
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Affiliation(s)
- C H S Ruxton
- Nutrition Communications, Cupar KY15 4HQ, United Kingdom.
| | - S Gordon
- NICHE, Ulster University, Coleraine BT52 1SA, United Kingdom
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García-Maldonado E, Gallego-Narbón A, Zapatera B, Alcorta A, Martínez-Suárez M, Vaquero MP. Bone Remodelling, Vitamin D Status, and Lifestyle Factors in Spanish Vegans, Lacto-Ovo Vegetarians, and Omnivores. Nutrients 2024; 16:448. [PMID: 38337732 PMCID: PMC10857037 DOI: 10.3390/nu16030448] [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: 12/12/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Sustainable healthy diets are promoted, and consequently vegetarian diets are currently increasing. However, scientific information on their effects on bone health is scarce. A cross-sectional study was performed in adults (66% women) classified into three groups: omnivores (n = 93), lacto-ovo vegetarians (n = 96), and vegans (n = 112). Nutrient intake, body composition, physical activity, vitamin D status (25-hydroxycholecalciferol, 25-OHD), parathormone (PTH), and bone formation (bone alkaline phosphatase, BAP) and resorption (N-telopeptides of type I collagen, NTx) markers were determined. Lacto-ovo vegetarians and especially vegans showed lower protein, fat, calcium, phosphorous, vitamin D, retinol, iodine, and zinc intakes, and higher carbohydrate, fibre, carotenes, magnesium, and vitamin K intakes compared to omnivores. Body composition was similar in the three groups that performed vigorous physical activity regularly. Body bone mass and muscle mass were positively correlated with BAP, and time performing physical activity with 25-OHD. The prevalence of vitamin D deficiency or insufficiency (25-OHD < 75 nmol/L) was 93.7% in the studied population, and vitamin D deficiency (25-OHD < 25 nmol/L) was significantly higher in vegans. Vegetarians of both groups had increased PTH and NTx with vegans showing significantly higher PTH and NTx than omnivores. Conclusion: Adult vegetarians, especially vegans, should reduce the risk of bone loss by appropriate diet planning and vitamin D supplementation.
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Affiliation(s)
- Elena García-Maldonado
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), C. José Antonio Novais 10, 28040 Madrid, Spain; (E.G.-M.); (A.G.-N.); (B.Z.); (A.A.); (M.M.-S.)
| | - Angélica Gallego-Narbón
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), C. José Antonio Novais 10, 28040 Madrid, Spain; (E.G.-M.); (A.G.-N.); (B.Z.); (A.A.); (M.M.-S.)
- Biology Department, Universidad Autónoma de Madrid, Darwin, 2, 28049 Madrid, Spain
| | - Belén Zapatera
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), C. José Antonio Novais 10, 28040 Madrid, Spain; (E.G.-M.); (A.G.-N.); (B.Z.); (A.A.); (M.M.-S.)
| | - Alexandra Alcorta
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), C. José Antonio Novais 10, 28040 Madrid, Spain; (E.G.-M.); (A.G.-N.); (B.Z.); (A.A.); (M.M.-S.)
| | - Miriam Martínez-Suárez
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), C. José Antonio Novais 10, 28040 Madrid, Spain; (E.G.-M.); (A.G.-N.); (B.Z.); (A.A.); (M.M.-S.)
| | - M. Pilar Vaquero
- Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), C. José Antonio Novais 10, 28040 Madrid, Spain; (E.G.-M.); (A.G.-N.); (B.Z.); (A.A.); (M.M.-S.)
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Ansari S, Abbasi B, Saneei P, Heidari Z, Saraf-Bank S. Higher lacto-vegetarian dietary score is associated with reduced risk of postmenopausal osteoporosis: A case-control study in a sample of Iranian postmenopausal women. Nutr Res 2023; 120:88-98. [PMID: 37950985 DOI: 10.1016/j.nutres.2023.08.003] [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: 04/24/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 11/13/2023]
Abstract
Osteoporosis is a systemic skeletal disease manifesting as weak and fragile bones. Dietary patterns have been described as an affecting constituent of bone metabolism. There is no consensus on the advantages or harms of vegetarian diets on bone health. This study aimed to design a lacto-vegetarian dietary score (LVDS) to evaluate the similarity of an individual's dietary pattern to the lacto-vegetarian dietary pattern and assess its association with postmenopausal osteoporosis (PMO). We hypothesized that individuals with greater LVDS will have a lower risk for PMO. In this hospital-based, case-control study, 220 cases (definitively diagnosed with osteoporosis) and 220 age-matched controls were registered. Usual dietary intakes were evaluated by a validated 147-item semiquantitative food frequency questionnaire. To design the LVDS, the energy-adjusted intakes of 12 food groups were categorized into quintiles, and positive or reverse points were assigned. To determine the association between the LVDS and PMO, binary logistic regression was used. Those in the top tertile of the LVDS had a lower chance of PMO compared with those in the bottom tertile (odds ratio, 0.11; 95% confidence interval, 0.06-0.22). An inverse relation was obtained between vegetables, fruits, legumes, nuts, dairy, soy protein, and egg consumption and PMO. Higher consumption of vegetable and animal oils significantly increased the risk of PMO. A dietary pattern similar to the lacto-vegetarian dietary pattern and concentrated on greater consumption of legumes, nuts, dairy, fruits, vegetables, and soy protein can be suggested as a protective method against PMO. Further, longitudinal studies are required to confirm these findings.
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Affiliation(s)
- Shakila Ansari
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Parvane Saneei
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sahar Saraf-Bank
- Nutrition and Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Je M, Kang K, Yoo JI, Kim Y. The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies. Nutrients 2023; 15:4386. [PMID: 37892460 PMCID: PMC10610213 DOI: 10.3390/nu15204386] [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: 09/05/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Osteoporosis is a health condition that involves weak bone mass and a deteriorated microstructure, which consequently lead to an increased risk of bone fractures with age. In elderly people, a fracture attributable to osteoporosis elevates mortality. The objective of this review was to examine the effects of macronutrients on bone mineral density (BMD), bone turnover markers (BTMs), and bone fracture in elderly people based on human studies. A systematic search was conducted in the PubMed®/MEDLINE® database. We included human studies published up to April 2023 that investigated the association between macronutrient intake and bone health outcomes. A total of 11 meta-analyses and 127 individual human studies were included after screening the records. Carbohydrate consumption seemed to have neutral effects on bone fracture in limited studies, but human studies on carbohydrates' effects on BMD or/and BTMs are needed. The human studies analyzed herein did not clearly show whether the intake of animal, vegetable, soy, or milk basic proteins has beneficial effects on bone health due to inconsistent results. Moreover, several individual human studies indicated an association between eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and osteocalcin. Further studies are required to draw a clear association between macronutrients and bone health in elderly people.
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Affiliation(s)
- Minkyung Je
- Department of Food and Nutrition, Gyeongsang National University, 501 Jinju-daero, Jinju 52828, Republic of Korea; (M.J.); (K.K.)
| | - Kyeonghoon Kang
- Department of Food and Nutrition, Gyeongsang National University, 501 Jinju-daero, Jinju 52828, Republic of Korea; (M.J.); (K.K.)
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, 27 Inhang-Ro, Incheon 22332, Republic of Korea;
| | - Yoona Kim
- Department of Food and Nutrition, Institute of Agriculture and Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju 52828, Republic of Korea
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11
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Wang T, Masedunskas A, Willett WC, Fontana L. Vegetarian and vegan diets: benefits and drawbacks. Eur Heart J 2023; 44:3423-3439. [PMID: 37450568 PMCID: PMC10516628 DOI: 10.1093/eurheartj/ehad436] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Plant-based diets have become increasingly popular thanks to their purported health benefits and more recently for their positive environmental impact. Prospective studies suggest that consuming vegetarian diets is associated with a reduced risk of developing cardiovascular disease (CVD), diabetes, hypertension, dementia, and cancer. Data from randomized clinical trials have confirmed a protective effect of vegetarian diets for the prevention of diabetes and reductions in weight, blood pressure, glycosylated haemoglobin and low-density lipoprotein cholesterol, but to date, no data are available for cardiovascular event rates and cognitive impairment, and there are very limited data for cancer. Moreover, not all plant-based foods are equally healthy. Unhealthy vegetarian diets poor in specific nutrients (vitamin B12, iron, zinc, and calcium) and/or rich in highly processed and refined foods increase morbidity and mortality. Further mechanistic studies are desirable to understand whether the advantages of healthy, minimally processed vegetarian diets represent an all-or-nothing phenomenon and whether consuming primarily plant-based diets containing small quantities of animal products (e.g. pesco-vegetarian or Mediterranean diets) has beneficial, detrimental, or neutral effects on cardiometabolic health outcomes. Further, mechanistic studies are warranted to enhance our understanding about healthy plant-based food patterns and the biological mechanisms linking dietary factors, CVD, and other metabolic diseases.
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Affiliation(s)
- Tian Wang
- Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Andrius Masedunskas
- Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Walter C Willett
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Luigi Fontana
- Charles Perkins Center, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Department of Clinical and Experimental Sciences, Brescia University, Brescia, Lombardy, Italy
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12
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West S, Monteyne AJ, van der Heijden I, Stephens FB, Wall BT. Nutritional Considerations for the Vegan Athlete. Adv Nutr 2023; 14:774-795. [PMID: 37127187 PMCID: PMC10334161 DOI: 10.1016/j.advnut.2023.04.012] [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: 02/22/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/03/2023] Open
Abstract
Accepting a continued rise in the prevalence of vegan-type diets in the general population is also likely to occur in athletic populations, it is of importance to assess the potential impact on athletic performance, adaptation, and recovery. Nutritional consideration for the athlete requires optimization of energy, macronutrient, and micronutrient intakes, and potentially the judicious selection of dietary supplements, all specified to meet the individual athlete's training and performance goals. The purpose of this review is to assess whether adopting a vegan diet is likely to impinge on such optimal nutrition and, where so, consider evidence based yet practical and pragmatic nutritional recommendations. Current evidence does not support that a vegan-type diet will enhance performance, adaptation, or recovery in athletes, but equally suggests that an athlete can follow a (more) vegan diet without detriment. A clear caveat, however, is that vegan diets consumed spontaneously may induce suboptimal intakes of key nutrients, most notably quantity and/or quality of dietary protein and specific micronutrients (eg, iron, calcium, vitamin B12, and vitamin D). As such, optimal vegan sports nutrition requires (more) careful consideration, evaluation, and planning. Individual/seasonal goals, training modalities, athlete type, and sensory/cultural/ethical preferences, among other factors, should all be considered when planning and adopting a vegan diet.
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Affiliation(s)
- Sam West
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Alistair J Monteyne
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Ino van der Heijden
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Francis B Stephens
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Benjamin T Wall
- Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom.
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13
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Isenmann E, Eggers L, Havers T, Schalla J, Lesch A, Geisler S. Change to a Plant-Based Diet Has No Effect on Strength Performance in Trained Persons in the First 8 Weeks-A 16-Week Controlled Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1856. [PMID: 36767221 PMCID: PMC9914713 DOI: 10.3390/ijerph20031856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Over the past few years, the number of people who have avoided animal products has been rising steadily. A plant-based diet is associated with a healthier lifestyle and has positive effects on various diseases. More and more healthy active people and performance-orientated athletes are giving up animal products for various reasons, such as for an improved performance or faster regeneration. However, the data in this context are limited. This study aimed to obtain initial findings on the influence of a diet change to veganism on the performance of strength-trained individuals. For this study, a total of 15 omnivorous individuals were recruited. They documented their dietary food intakes over 16 weeks. Every four weeks, the strength performance was tested via a leg press and bench press. In the first 8 weeks, the participants maintained their omnivorous diet, followed by 8 weeks of a vegan dietary phase. In total, 10 subjects participated successfully, and their data were part of the statistical analyses. There was no difference in the absolute and relative strength performance for the leg and bench press after changing to a vegan diet. For the total calorie intake and carbohydrates, only a small treatment effect, but no time effect, was observed. However, for the protein intake, a time and group effect were detected. In addition, the relative protein intake decreased significantly and was lower than the current recommendations for athletes. The results demonstrate that a change to a vegan diet has no beneficial nor negative effect on the strength performance when the total calorie intake and carbohydrate content are covered in the first 8 weeks.
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Affiliation(s)
- Eduard Isenmann
- Department of Fitness and Health, IST Hochschule of Applied Sciences Düsseldorf, 40233 Düsseldorf, Germany
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany
| | - Laura Eggers
- Department of Fitness and Health, IST Hochschule of Applied Sciences Düsseldorf, 40233 Düsseldorf, Germany
| | - Tim Havers
- Department of Fitness and Health, IST Hochschule of Applied Sciences Düsseldorf, 40233 Düsseldorf, Germany
| | - Jan Schalla
- Department of Fitness and Health, IST Hochschule of Applied Sciences Düsseldorf, 40233 Düsseldorf, Germany
| | - Alessio Lesch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany
| | - Stephan Geisler
- Department of Fitness and Health, IST Hochschule of Applied Sciences Düsseldorf, 40233 Düsseldorf, Germany
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14
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Ogilvie AR, McGuire BD, Meng L, Shapses SA. Fracture Risk in Vegetarians and Vegans: the Role of Diet and Metabolic Factors. Curr Osteoporos Rep 2022; 20:442-452. [PMID: 36129610 DOI: 10.1007/s11914-022-00754-7] [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] [Accepted: 08/22/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE OF REVIEW There is strong evidence that poor dietary intake of certain micro- and macro-nutrients can negatively affect bone health. It is unclear if diet is the primary culprit for poor bone health in the vegan population. RECENT FINDINGS Plant-based diets are gaining public interest since they may improve metabolic health. Studies that examine vegetarians and vegans together show a lower bone mineral density (BMD), but not always increased fracture risk compared to omnivores. However, vegans consistently have higher risk of fracture at multiple bone sites, especially at the hip. There is higher fracture risk in vegans which may be due to calcium and vitamin D intake, as well as amount of dietary protein and quality. Other nutrients (B vitamins, Se, Zn, Fe, iodine) or physiological factors (lower body mass index, microbiome, or endocrine profile) may also play a role but have not been examined and require further study.
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Affiliation(s)
- Anna R Ogilvie
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
- Institute of Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA
| | - Brandon D McGuire
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
- Institute of Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA
| | - Lingqiong Meng
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
- Institute of Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA
| | - Sue A Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA.
- Institute of Food, Nutrition, and Health, Rutgers University, New Brunswick, NJ, USA.
- Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
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15
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Dantas A, Orellana‐Palma P, Kumar D, Hernandez E, Prudencio ES. Block freeze concentration by centrifugation and vacuum increases the content of lactose‐free milk macronutrients. J Food Sci 2022; 87:5317-5329. [DOI: 10.1111/1750-3841.16383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 09/10/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Adriana Dantas
- Postgraduate Program in Food Engineering Federal University of Santa Catarina, Technology Center, Trindade Florianópolis, Santa Catarina Brazil
| | - Patricio Orellana‐Palma
- Department of Food Engineering Universidad de La Serena Av. Raúl Bitrán 1305 La Serena 1700000 Chile
| | - Dinesh Kumar
- School of Bioengineering & Food Technology Shoolini University of Biotechnology and Management Sciences Solan India
| | - Eduard Hernandez
- Department of Agri‐Food Engineering and Biotechnology Universitat Politécnica de Catalunya‐BarcelonaTech Barcelona Spain
| | - Elane Schwinden Prudencio
- Postgraduate Program in Food Engineering Federal University of Santa Catarina, Technology Center, Trindade Florianópolis, Santa Catarina Brazil
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16
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Zhang Y, Jelleschitz J, Grune T, Chen W, Zhao Y, Jia M, Wang Y, Liu Z, Höhn A. Methionine restriction - Association with redox homeostasis and implications on aging and diseases. Redox Biol 2022; 57:102464. [PMID: 36152485 PMCID: PMC9508608 DOI: 10.1016/j.redox.2022.102464] [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: 05/09/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 10/31/2022] Open
Abstract
Methionine is an essential amino acid, involved in the promotion of growth, immunity, and regulation of energy metabolism. Over the decades, research has long focused on the beneficial effects of methionine supplementation, while data on positive effects of methionine restriction (MR) were first published in 1993. MR is a low-methionine dietary intervention that has been reported to ameliorate aging and aging-related health concomitants and diseases, such as obesity, type 2 diabetes, and cognitive disorders. In addition, MR seems to be an approach to prolong lifespan which has been validated extensively in various animal models, such as Caenorhabditis elegans, Drosophila, yeast, and murine models. MR appears to be associated with a reduction in oxidative stress via so far mainly undiscovered mechanisms, and these changes in redox status appear to be one of the underlying mechanisms for lifespan extension and beneficial health effects. In the present review, the association of methionine metabolism pathways with redox homeostasis is described. In addition, the effects of MR on lifespan, age-related implications, comorbidities, and diseases are discussed.
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Affiliation(s)
- Yuyu Zhang
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Julia Jelleschitz
- German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, Department of Molecular Toxicology, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Tilman Grune
- German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, Department of Molecular Toxicology, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany; German Center for Diabetes Research (DZD), 85764, Muenchen-Neuherberg, Germany; NutriAct-Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany; German Center for Cardiovascular Research (DZHK), Berlin, Germany; Institute of Nutrition, University of Potsdam, Nuthetal, 14558, Germany
| | - Weixuan Chen
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Yihang Zhao
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Mengzhen Jia
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Yajie Wang
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China
| | - Zhigang Liu
- Laboratory of Functional Chemistry and Nutrition of Food, College of Food Science and Engineering, Northwest A&F University, Yangling, Shaanxi, 712100, China; German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, Department of Molecular Toxicology, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
| | - Annika Höhn
- German Institute of Human Nutrition (DIfE) Potsdam-Rehbruecke, Department of Molecular Toxicology, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany; German Center for Diabetes Research (DZD), 85764, Muenchen-Neuherberg, Germany.
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17
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Herpich C, Müller-Werdan U, Norman K. Role of plant-based diets in promoting health and longevity. Maturitas 2022; 165:47-51. [PMID: 35914402 DOI: 10.1016/j.maturitas.2022.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
Western-style obesity-promoting diets are associated with increased inflammation, higher disease incidence and mortality. In contrast, plant-based diets (PBDs), which incorporate large amounts of vegetables and fruit, legumes, whole grains and only a small amount of meat, are generally associated with better health and lower mortality. This narrative review summarizes the evidence on health and life span in adults adhering to PBDs and discusses the potentially longevity-promoting mechanism of PBDs as well as limitations due to nutrient deficiencies. Epidemiologic studies consistently report lower mortality rates in adults who adhering to PBDs when compared with people whose diet regularly includes meat. PBDs are associated with many health benefits, such as improved metabolic and inflammatory profile. In turn, the incidence of cardiovascular disease is lower in adults consuming PBDs, which contributes to their better health. The health-promoting effects of PBDs are still not entirely clear but most likely multifactorial and include modulation of the gut microbiome. The interest in possible longevity-promoting mechanisms of PBDs has increased in recent years, as many characteristics of PBDs such as protein restriction and restriction of certain amino acids are known to extend the life span. While there is ample evidence from animal studies, large-scale human studies, which also provide insight into the specific mechanisms of the effect of PBDs on longevity, are missing. However, due to the lower protein content of PBDs, there appears to be an age limit for the anticipated health effects, as adults over 65 require larger amounts of protein.
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Affiliation(s)
- Catrin Herpich
- University of Potsdam, Institute of Nutritional Science, 14558 Nuthetal, Germany; Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Geriatrics and Medical Gerontology, Berlin, Germany
| | - Ursula Müller-Werdan
- Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Geriatrics and Medical Gerontology, Berlin, Germany; Evangelisches Geriatriezentrum Berlin gGmbH, Berlin, Germany
| | - Kristina Norman
- University of Potsdam, Institute of Nutritional Science, 14558 Nuthetal, Germany; Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Geriatrics and Medical Gerontology, Berlin, Germany; German Institute for Human Nutrition Potsdam-Rehbrücke, Department of Nutrition and Gerontology, 14558 Nuthetal, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.
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18
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Dawczynski C, Weidauer T, Richert C, Schlattmann P, Dawczynski K, Kiehntopf M. Nutrient Intake and Nutrition Status in Vegetarians and Vegans in Comparison to Omnivores - the Nutritional Evaluation (NuEva) Study. Front Nutr 2022; 9:819106. [PMID: 35651513 PMCID: PMC9149309 DOI: 10.3389/fnut.2022.819106] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction In recent years, vegetarian and vegan diets became increasingly important as they are associated with beneficial health outcomes. Therefore, the NuEva study compares the impact of flexitarian, vegetarian, or vegan diets with omnivorous nutritional habits on nutrient intake and risk factors for non-communicable diseases. Methods A dietary protocol was kept over five days and blood and 24h urine samples were collected to examine the impact of dietary habits [omnivores, n = 65 (Median/Interquartile range: 33/17 yrs.), flexitarians, n = 70 (30/17 yrs.), ovo-lacto vegetarians, n = 65 (28/14 yrs.), vegans, n = 58 (25/10 yrs.)] on nutrient intake, nutrient concentrations in plasma, serum or 24h urine, body composition, and blood lipids. Results The increased exclusion of animal based foods in the diet (omnivores < flexitarians < vegetarians < vegans) is associated with a decreased intake of energy, saturated fat, cholesterol, disaccharides, and total sugar as well an increased intake of dietary fibers, beta carotene, vitamin E and K. The combined index of the B12 status (4cB12 score) in vegetarians (0.02/0.75) was lower compared to omnivores (0.34/0.58; p ≤ 0.05) and flexitarians (0.24/0.52; p ≤ 0.05). In omnivores vitamin A, vitamin E, ferritin, and the urinary excretion of selenium, iodine, and zinc were higher than in vegans (p ≤ 0.05). In contrast, vegans had the highest concentrations of biotin, folate, and vitamin C. Flexitarians, vegetarians, and vegans had a lower body weight, BMI, and body fat percentage in comparison to omnivores (p ≤ 0.05). In omnivores the concentrations on total cholesterol, total cholesterol/HDL cholesterol ratio, LDL cholesterol, LDL cholesterol/HDL cholesterol ratio, apolipoprotein B, and apolipoprotein B/ apolipoprotein A1 ratio were higher than in vegetarians and vegans (p ≤ 0.05). Conclusion The NuEva study confirms the position of the Academy of Nutrition and Dietetics that adequately planned vegetarian diets are healthy, nutritionally adequate, and may provide health benefits in the prevention and treatment of non-communicable diseases. Nevertheless, critical nutrients were identified for all groups studied. This highlights the need to develop individual nutritional concepts to ensure an adequate nutrient intake.
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Affiliation(s)
- Christine Dawczynski
- Junior Research Group Nutritional Concepts, Institute of Nutritional Sciences, Friedrich Schiller University, Jena, Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Leipzig, Germany
| | - Thomas Weidauer
- Junior Research Group Nutritional Concepts, Institute of Nutritional Sciences, Friedrich Schiller University, Jena, Germany.,Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Leipzig, Germany
| | - Cora Richert
- Institute of Clinical Chemistry and Laboratory Diagnostics, University Hospital, Jena, Germany
| | - Peter Schlattmann
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Leipzig, Germany.,Department of Medical Statistics, Informatics and Data Science, University Hospital, Jena, Germany
| | - Kristin Dawczynski
- Department for Pediatrics and Adolescent Medicine, Sophien- and Hufeland Hospital, Weimar, Germany
| | - Michael Kiehntopf
- Institute of Clinical Chemistry and Laboratory Diagnostics, University Hospital, Jena, Germany
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19
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Monti KS. Optimizing nutrition in plant-based diets. JAAPA 2022; 35:39-42. [DOI: 10.1097/01.jaa.0000823180.17959.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Ewy MW, Patel A, Abdelmagid MG, Mohamed Elfadil O, Bonnes SL, Salonen BR, Hurt RT, Mundi MS. Plant-Based Diet: Is It as Good as an Animal-Based Diet When It Comes to Protein? Curr Nutr Rep 2022; 11:337-346. [DOI: 10.1007/s13668-022-00401-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 12/12/2022]
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21
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Peng Y, Kyriakopoulou K, Keppler JK, Venema P, van der Goot AJ. Effect of calcium enrichment on the composition, conformation, and functional properties of soy protein. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2021.107191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Falchetti A, Cavati G, Valenti R, Mingiano C, Cosso R, Gennari L, Chiodini I, Merlotti D. The effects of vegetarian diets on bone health: A literature review. Front Endocrinol (Lausanne) 2022; 13:899375. [PMID: 35992115 PMCID: PMC9388819 DOI: 10.3389/fendo.2022.899375] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
In these recent years many people are adopting a vegetarian type diet due to the numerous positive health effects of this regimen such as the reduction of the incidence of many chronic disorders like diabetes, hypertension, obesity and cancer. However this diet is quite restrictive and so it could be possible to have a deficiency in some specific nutrients, increasing the risk of osteoporosis and fractures. Although there are conflicting results on the effects of the vegetarian diet on bone health and fracture incidence, it is always recommendable in vegetarian people to have an adequate intake of calcium and vitamin D, through an increased intake of supplements, natural and fortified foods, an adequate intake of protein, fruit, vegetables, as well as vitamin B12. The aim of this literature review is to revise the actual knowledge of the effect of some nutrients and vegetarian diets on bone health.
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Affiliation(s)
- Alberto Falchetti
- Experimental Research Laboratory on Bone Metabolism, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
| | - Guido Cavati
- Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Roberto Valenti
- Deparment of Surgery, Perioperative Medicine Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Christian Mingiano
- Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Roberta Cosso
- Unit of Functional and Osteoarticular Rehabilitation, San Giuseppe Hospital, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Piancavallo, Italy
| | - Luigi Gennari
- Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Iacopo Chiodini
- Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Daniela Merlotti
- Department of Medical Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- *Correspondence: Daniela Merlotti, ;
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Craig WJ, Mangels AR, Fresán U, Marsh K, Miles FL, Saunders AV, Haddad EH, Heskey CE, Johnston P, Larson-Meyer E, Orlich M. The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients 2021; 13:4144. [PMID: 34836399 PMCID: PMC8623061 DOI: 10.3390/nu13114144] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/13/2022] Open
Abstract
Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.
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Affiliation(s)
- Winston J. Craig
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | | | - Ujué Fresán
- eHealth Group, Instituto de Salud Global Barcelona (ISGlobal), 08036 Barcelona, Spain;
| | - Kate Marsh
- Private Practice, Chatswood, NSW 2067, Australia;
| | - Fayth L. Miles
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Angela V. Saunders
- Nutrition Insights, Sanitarium Health Food Company, Berkeley Vale, NSW 2261, Australia;
| | - Ella H. Haddad
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Celine E. Heskey
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Patricia Johnston
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Enette Larson-Meyer
- Human Nutrition, Foods, and Exercise Virginia Tech, Blacksburg, VA 24061, USA;
| | - Michael Orlich
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
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Galchenko A, Gapparova K, Sidorova E. The influence of vegetarian and vegan diets on the state of bone mineral density in humans. Crit Rev Food Sci Nutr 2021; 63:845-861. [PMID: 34723727 DOI: 10.1080/10408398.2021.1996330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
There are so many literatures about vegetarians being less prone to chronic, noninfectious diseases, which are, however, the main cause of the decline in quality of life and mortality in developed countries.However, according to various scientific sources, vegetarian and especially vegan diets often contain less saturated fats, protein, calcium, vitamins D and B12, or long-chain ω-3 PUFAs. One of the most common pathology associated with a predominantly plant diet is osteopenia and osteoporosis. An analysis of 13 studies has shown that vegetarians and vegans are at a higher risk of reducing of bone mineral density, thereby increasing the incidence of fractures.At the same time, plant-based diets are usually richer in many other micronutrients important for bone health: vitamins C and K, carotenoids, potassium, magnesium, manganese, copper, or silicon. Moreover, with the deepening of our knowledge about the role of nutrients in the body and the features of the nutritional status of the population, the quality of vegetarian and vegan diets also increases. They are less and less prone to micronutrient deficiencies. Recent studies show that BMD, as well as the risk of osteoporotic fractures, at least in vegetarians, equaled these indicators in omnivores.
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Affiliation(s)
- Alexey Galchenko
- Department of preventive diet therapy, Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation.,Department of Medical Elementology, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - K Gapparova
- Department of preventive diet therapy, Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - E Sidorova
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation
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25
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Devrim-Lanpir A, İlktaç HY, Wirnitzer K, Hill L, Rosemann T, Knechtle B. Vegan vs. omnivore diets paradox: A whole-metagenomic approach for defining metabolic networks during the race in ultra-marathoners- a before and after study design. PLoS One 2021; 16:e0255952. [PMID: 34555041 PMCID: PMC8459986 DOI: 10.1371/journal.pone.0255952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The effect of vegan diets on metabolic processes in the body is still controversial in ultra endurance athletes. The study aims to determine gut microbiome adaptation to extreme exercise according to vegan or omnivore diet consumed in ultra-marathoners. We also seek to evaluate long-term vegan diets' effects on redox homeostasis, and muscle fatigue, and assess energy availability. METHODS Seventy participants will be assigned to the study, including 35 vegan ultra-marathoners and 35 omnivores competing in the Sri-Chinmoy ultra marathon race. Research data will be collected from the participants at four steps (three visits to the research laboratory and the race day) throughout the study. At the first visit (seven days before the race), fecal samples, and anthropometric measurements will be collected. Body composition will be measured using DXA. Participants will be informed about keeping detailed food records and will be asked to record their diet data and activity logs during the entire study period. At second visit, maximum oxygen consumption will be measured on treadmill. On race day, blood samples will be collected immediately before, and 0. min, 2 hours, and 24 hours after the race. Body weight will be measured before and after the race. The blood and fecal samples will be stored at -80 C until analysis. Plasma malondialdehyde, reactive oxygen metabolites, total antioxidant capacity, Heatshockprotein-70, and serum Orosomucoid-1 will be analyzed in blood samples. Fecal samples will be analyzed with shotgun metagenomic analysis and interpreted using bioinformatics pipeline (HumanN2). Statistical tests will be analyzed using SPSS version 23.0 and R Software. DISCUSSION Study findings will determine the effects of the vegan diet on sports performance, revealing the multiple interactions between host and gut microbiome at the whole metagenomic level. Additionally, results will show the possible adaptation throughout the race by analyzing blood and fecal samples. Furthermore, by assessing energy availability and determining host-metabolite crosstalk for ultra-endurance athletes, possible nutritional deficiencies can be identified. Thus, advanced nutritional strategies can be developed based on metabolic needs. TRIAL REGISTRATION Current controlled trials, ISRCTN registry 69541705. Registered on 8 December 2019.
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Affiliation(s)
- Aslı Devrim-Lanpir
- Department of Nutrition and Dietetics, Faculty of Health Science, Istanbul Medeniyet University, Istanbul, Turkey
| | - Havvanur Yoldaş İlktaç
- Department of Nutrition and Dietetics, Faculty of Health Science, Istanbul Medeniyet University, Istanbul, Turkey
| | - Katharina Wirnitzer
- Department of Subject Didactics and Educational Research and Development, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Research Centre Medical Humanities, University of Innsbruck, Innsbruck, Austria
- Life and Health Science Cluster Tyrol, Subcluster Health/Medicine/Psychology, Tyrolean University Conference, Innsbruck, Austria
| | - Lee Hill
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
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26
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Rizzoli R, Biver E, Brennan-Speranza TC. Nutritional intake and bone health. Lancet Diabetes Endocrinol 2021; 9:606-621. [PMID: 34242583 DOI: 10.1016/s2213-8587(21)00119-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/12/2022]
Abstract
Osteoporotic or fragility fractures affect one in two women and one in five men who are older than 50. These events are associated with substantial morbidity, increased mortality, and an impaired quality of life. Recommended general measures for fragility fracture prevention include a balanced diet with an optimal protein and calcium intake and vitamin D sufficiency, together with regular weight-bearing physical exercise. In this narrative Review, we discuss the role of nutrients, foods, and dietary patterns in maintaining bone health. Much of this information comes from observational studies. Bone mineral density, microstructure-estimated bone strength, and trabecular and cortical microstructure are positively associated with total protein intake. Several studies indicate that fracture risk might be lower with a higher dietary protein intake, provided that the calcium supply is sufficient. Dairy products are a valuable source of these two nutrients. Hip fracture risk appears to be lower in consumers of dairy products, particularly fermented dairy products. Consuming less than five servings per day of fruit and vegetables is associated with a higher hip fracture risk. Adherence to a Mediterranean diet or to a prudent diet is associated with a lower fracture risk. These various nutrients and dietary patterns influence gut microbiota composition or function, or both. The conclusions of this Review emphasise the importance of a balanced diet including minerals, protein, and fruit and vegetables for bone health and in the prevention of fragility fractures.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Emmanuel Biver
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tara C Brennan-Speranza
- School of Medical Sciences and School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Pawlak R. Vitamin B12 status is a risk factor for bone fractures among vegans. Med Hypotheses 2021; 153:110625. [PMID: 34116377 DOI: 10.1016/j.mehy.2021.110625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/19/2021] [Accepted: 06/03/2021] [Indexed: 01/22/2023]
Abstract
Several studies consistently showed vegans having a higher risk of bone fractures compared to individuals from other diet groups. While researchers have focused on several factors as possible explanation of these findings, both dietary (e.g. calcium) and non-dietary (e.g. weight/BMI status), the widespread inadequate vitamin B12 (B12) status among vegans as a risk factor for bone fractures has not received adequate scrutiny. The detrimental impact of inadequate B12 status on bone tissue is both direct, via the impairment of the insulin-like growth hormone 1 and taurine synthesis, and indirect, induced through its hyperhomocysteinemic effect, via at least the following mechanisms: 1) reducing bone mineral content and density by accumulating in the extracellular matrix, 2) reducing osteoblasts and increasing osteoclasts function, 3) reducing blood flow to bone tissue, 4) inducing apoptosis via the reactive oxygen-species-mediated mitochondrial pathway, and 5) obstructing the formation of collagen cross-links, impeding lyslyl oxidase, and hampering insolubility of fibrils. Considering the widespread B12 deficiency prevalence among vegans, its role in bone fracture risk should not be overlooked.
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Affiliation(s)
- Roman Pawlak
- Department of Nutrition Science, East Carolina University, Greenville, NC 27858, United States.
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28
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Nutrient status and growth in vegan children. Nutr Res 2021; 91:13-25. [PMID: 34130207 DOI: 10.1016/j.nutres.2021.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/24/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022]
Abstract
Vegan diets have risen in popularity over the past 9 years. However, few studies have examined nutrient status and the effect of a vegan diet on the growth of children. This study analysed the existing literature on the health impact and growth impact of selected nutrients in vegan children. We assessed the intake of calories and protein, as well as the nutrients iron, calcium, vitamin D, cobalamin and folate. With a small percentage of outliers, vegan children showed normal growth and were less often obese. We found limited evidence that children on a vegan diet can obtain all the examined nutrients. Furthermore, as proper planning and supplementation by caregivers is needed, it is currently unknown how often vegan children follow well-planned diets. Deficiencies in cobalamin, calcium, and vitamin D seem to be the biggest risks associated with a poorly planned vegan diet. For a more definitive assessment, data on the intake and nutrient status of omega-3 fatty acids, zinc, iodine, and selenium in vegan children are needed. Future research should account for demographic shifts in those following a vegan diet, and should discriminate between vegan sub-populations that are open or closed towards scientific approaches, towards health in general, and toward supplementation. Studies should assess the modes and dosages of supplementation and the use of fortified foods or drinks, as well as adherence to the diet itself. Plant ferritin as a source of iron and endogenous cobalamin synthesis warrants further scientific inquiry. In summary, the current literature suggests that a well-planned vegan diet using supplementation is likely to provide the recommended amounts of critical nutrients to provide for normal progression of height and weight in children, and can be beneficial in some aspects. However, data on 5 critical nutrients are still missing, hampering a more definitive conclusion.
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29
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Lecerf JM. [Nutritional advices for postmenopausal woman. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:349-357. [PMID: 33753299 DOI: 10.1016/j.gofs.2021.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Menopause is a key period for health due to physiological changes, particularly of body composition (with decrease of lean mass and increase of fat mass) and of body fat distribution, leading to a higher risk for bone and muscular health and cardiometabolic health. Nutritional advices, associated to physical activity advices, may partially prevent these effects. The energy balance will be moderately negative if there is a weight gain, while the protein intake will be preserved and a regular physical activity will be increased. A Mediterranean style diet will be beneficial on cardiovascular health. Dairy products will be preserved, but restrictive and dietary exclusion will be avoided.
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Affiliation(s)
- J-M Lecerf
- Service de nutrition et activité physique, institut Pasteur de Lille, 1, rue du Professeur-Calmette, 59019 Lille cedex, France; Service de médecine interne, CHRU Lille, Lille, France.
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30
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Desmond MA, Sobiecki JG, Jaworski M, Płudowski P, Antoniewicz J, Shirley MK, Eaton S, Książyk J, Cortina-Borja M, De Stavola B, Fewtrell M, Wells JCK. Growth, body composition, and cardiovascular and nutritional risk of 5- to 10-y-old children consuming vegetarian, vegan, or omnivore diets. Am J Clin Nutr 2021; 113:1565-1577. [PMID: 33740036 PMCID: PMC8176147 DOI: 10.1093/ajcn/nqaa445] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Plant-based diets (PBDs) are increasingly recommended for human and planetary health. However, comprehensive evidence on the health effects of PBDs in children remains incomplete, particularly in vegans. OBJECTIVES To quantify differences in body composition, cardiovascular risk, and micronutrient status of vegetarian and vegan children relative to omnivores and to estimate prevalence of abnormal micronutrient and cholesterol status in each group. METHODS In a cross-sectional study, Polish children aged 5-10 y (63 vegetarian, 52 vegan, 72 matched omnivores) were assessed using anthropometry, deuterium dilution, DXA, and carotid ultrasound. Fasting blood samples, dietary intake, and accelerometry data were collected. RESULTS All results are reported relative to omnivores. Vegetarians had lower gluteofemoral adiposity but similar total fat and lean mass. Vegans had lower fat indices in all regions but similar lean mass. Both groups had lower bone mineral content (BMC). The difference for vegetarians attenuated after accounting for body size but remained in vegans (total body minus the head: -3.7%; 95% CI: -7.0, -0.4; lumbar spine: -5.6%; 95% CI: -10.6, -0.5). Vegetarians had lower total cholesterol, HDL, and serum B-12 and 25-hydroxyvitamin D [25(OH)D] without supplementation but higher glucose, VLDL, and triglycerides. Vegans were shorter and had lower total LDL (-24 mg/dL; 95% CI: -35.2, -12.9) and HDL (-12.2 mg/dL; 95% CI: -17.3, -7.1), high-sensitivity C-reactive protein, iron status, and serum B-12 (-217.6 pmol/L; 95% CI: -305.7, -129.5) and 25(OH)D without supplementation but higher homocysteine and mean corpuscular volume. Vitamin B-12 deficiency, iron-deficiency anemia, low ferritin, and low HDL were more prevalent in vegans, who also had the lowest prevalence of high LDL. Supplementation resolved low B-12 and 25(OH)D concentrations. CONCLUSIONS Vegan diets were associated with a healthier cardiovascular risk profile but also with increased risk of nutritional deficiencies and lower BMC and height. Vegetarians showed less pronounced nutritional deficiencies but, unexpectedly, a less favorable cardiometabolic risk profile. Further research may help maximize the benefits of PBDs in children.
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Affiliation(s)
- Małgorzata A Desmond
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK,Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland
| | - Jakub G Sobiecki
- Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland,MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Maciej Jaworski
- Department of Biochemistry, Radioimmunology, and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Paweł Płudowski
- Department of Biochemistry, Radioimmunology, and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Jolanta Antoniewicz
- Department of Nephrology, Kidney Transplantation, & Hypertension, The Children's Memorial Health Institute, Warsaw, Poland
| | - Meghan K Shirley
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Simon Eaton
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Janusz Książyk
- Department of Pediatrics, Nutrition, and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland
| | - Mario Cortina-Borja
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Bianca De Stavola
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Mary Fewtrell
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Shrestha A, Samuelsson LM, Sharma P, Day L, Cameron-Smith D, Milan AM. Comparing Response of Sheep and Cow Milk on Acute Digestive Comfort and Lactose Malabsorption: A Randomized Controlled Trial in Female Dairy Avoiders. Front Nutr 2021; 8:603816. [PMID: 33659266 PMCID: PMC7917135 DOI: 10.3389/fnut.2021.603816] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Sheep milk (SM) is a possible alternate dairy source for those who experience digestive symptoms with cow milk (CM). While both the milks contain lactose, one of the causes for self-reported intolerance to CM, the composition of SM and CM also differs across proteins and fats, which have been shown to impact digestive processes. Objective: To compare the acute digestive comfort and lactose malabsorption of SM to CM in female dairy avoiders. Method: In a double-blinded, randomized cross over trial, 30 dairy-avoiding females (aged 20-30 years) drank 650 mL of SM or CM (each reconstituted from spray dried powder) following an overnight fast, on two separate occasions at least 1 week apart. Blood samples were collected for glucose and insulin assessment, and single nucleotide polymorphisms of the lactase (LCT) gene (C/T13910 and G/A22018). Breath H2 and visual analog scale (VAS) digestive symptom scores were recorded at fasting and regular intervals over 4 h after ingestion. Results: Eighty percentage of study participants were lactase non-persistent (LNP; CC13910 and GG22018 genotype). Digestive symptoms, including abdominal cramps, distension, rumbling, bloating, belching, diarrhea, flatulence, vomiting, and nausea, were similar in response to SM and CM ingestion (milk × time, P > 0.05). Breath H2 was greater after CM than SM (72 ± 10 vs. 43 ± 6 ppm at 240 min, P < 0.001), which may be due to greater lactose content in CM (33 vs. 25 g). Accordingly, when corrected for the lactose content breath H2 did not differ between the two milks. The response remained similar when analyzed in the LNP subset alone (n = 20). Conclusions: Despite a higher energy and nutrient content, SM did not increase adverse digestive symptoms after ingestion, relative to CM, although there was a reduced breath H2 response, which could be attributed to the lower lactose content in SM. The tolerability of SM should be explored in populations without lactose intolerance for whom underlying trigger for intolerance is unknown.
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Affiliation(s)
- Aahana Shrestha
- The Liggins Institute, The University of Auckland, Auckland, New Zealand.,Riddet Institute, Palmerston North, New Zealand
| | | | - Pankaja Sharma
- The Liggins Institute, The University of Auckland, Auckland, New Zealand.,Riddet Institute, Palmerston North, New Zealand
| | - Li Day
- AgResearch Ltd., Te Ohu Rangahau Kai, Palmerston North, New Zealand
| | - David Cameron-Smith
- The Liggins Institute, The University of Auckland, Auckland, New Zealand.,Riddet Institute, Palmerston North, New Zealand.,Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Amber M Milan
- The Liggins Institute, The University of Auckland, Auckland, New Zealand.,AgResearch Ltd., Te Ohu Rangahau Kai, Palmerston North, New Zealand
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Weikert C, Trefflich I, Menzel J, Obeid R, Longree A, Dierkes J, Meyer K, Herter-Aeberli I, Mai K, Stangl GI, Müller SM, Schwerdtle T, Lampen A, Abraham K. Vitamin and Mineral Status in a Vegan Diet. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 117:575-582. [PMID: 33161940 DOI: 10.3238/arztebl.2020.0575] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 11/15/2019] [Accepted: 05/11/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND In Germany, public interest in a vegan diet is steadily growing. There are, however, no current data on the macro- and micronutrient status of vegans. METHODS In a cross-sectional study entitled "The Risks and Benefits of a Vegan Diet" (RBVD), we investigated the dietary intake, basic laboratory parameters, vitamin status, and trace-element status of 36 vegans and 36 persons on an omnivorous diet. Each group consisted of 18 men and 18 women aged 30-60. RESULTS Nearly all the vegans and one-third of the persons on a mixed diet had consumed supplements in the previous 4 weeks. Vegans and nonvegans had similar energy intake but differed in the intake of both macronutrients (e.g., dietary fiber) and micronutrients (e.g., vitamins B12, B2, D, E, and K, as well as folate, iodine, and iron). There were no intergroup differences in the biomarkers of vitamin B12, vitamin D, or iron status. The ferritin values and blood counts indicated iron deficiency in four vegans and three non-vegans. Measurements in 24-hour urine samples revealed lower calcium excretion and markedly lower iodine excretion in vegans compared to non-vegans; in one-third of the vegans, iodine excretion was lower than the WHO threshold value (<20 μg/L) for severe iodine deficiency. CONCLUSION Vitamin B12 status was similarly good in vegans and non-vegans, even though the vegans consumed very little dietary B12. This may be due to the high rate of supplementation. The findings imply a need to also assure adequate iodine intake in the population, especially among persons on a vegan diet.
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Affiliation(s)
- Cornelia Weikert
- German Federal Institute for Risk Assessment, Department of Food Safety, Berlin, Germany; Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg/Saar, Germany; Department of Clinical Medicine, Center for Nutrition, University of Bergen, Bergen, Norway; BEVITAL AS, Bergen, Norway; Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland; Medical Department of Endocrinology, Diabetes and Metabolic Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany; Clinical Research Unit, Berlin Institute of Health (BIH), Berlin, Germany; Charité-Center for Cardiovascular Research (CCR), Berlin, Germany; DZHK (German Center for Cardiovascular Research), Berlin site, Berlin, Germany; Institute of Agricultural and Nutritional Science, Martin Luther University Halle-Wittenberg, Halle, Germany; Department of Food Chemistry, Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; TraceAge DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena, Germany
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Abstract
In parallel with increased public awareness of the health and environmental benefits of consuming a plant-based diet, the numbers of people who identify as vegan has increased sharply. The question of whether vegetarian and vegan diets are appropriate for children is a longstanding and unresolved controversy. The more restrictive the diet and the younger the child, the greater the risk of nutritional deficiency. Nutrients of potential concern are protein quantity and quality, iron, zinc, selenium, calcium, riboflavin, vitamins A, D, B12 and essential fatty acids. Although intakes and status of some nutrients (e.g. vitamin D and iron) are low in many children, vegan children are particularly susceptible due to inadequate supply and/or excess dietary fibre as well as other components that limit bioavailability. Although position papers from North America state that well-planned vegetarian and vegan diets, supplemented appropriately, are suitable for all life stages, European statements include strong recommendations to parents that vegan diets should not be adopted by children without medical and dietetic supervision. Case histories of malnutrition and serious harm persist, including irreversible neurological damage due to vitamin B12 deficiency among un-supplemented children. The evidence available to evaluate the nutritional appropriateness of vegetarian diets for children is inadequate and dated. Although nutritionally adequate vegetarian diets are more easily achieved, successful provision of a complete vegan diet for a young child requires substantial commitment, expert guidance, planning, resources and supplementation.
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34
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Intake and adequacy of the vegan diet. A systematic review of the evidence. Clin Nutr 2020; 40:3503-3521. [PMID: 33341313 DOI: 10.1016/j.clnu.2020.11.035] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/15/2020] [Accepted: 11/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Vegan diets, where animal- and all their by-products are excluded from the diet, have gained popularity, especially in the last decade. However, the evaluation of this type of diet has not been well addressed in the scientific literature. This study aimed to investigate the adequacy of vegan diets in European populations and of their macro- and micronutrient intakes compared to World Health Organization recommendations. METHODS A systematic search in PubMed, Web of Science, IBSS, Cochrane library and Google Scholar was conducted and 48 studies (12 cohorts and 36 cross-sectional) were included. RESULTS Regarding macronutrients, vegan diets are lower in protein intake compared with all other diet types. Veganism is also associated with low intake of vitamins B2, Niacin (B3), B12, D, iodine, zinc, calcium, potassium, selenium. Vitamin B12 intake among vegans is significantly lower (0.24-0.49 μg, recommendations are 2.4 μg) and calcium intake in the majority of vegans was below recommendations (750 mg/d). No significant differences in fat intake were observed. Vegan diets are not related to deficiencies in vitamins A, B1, Β6, C, E, iron, phosphorus, magnesium, copper and folate and have a low glycemic load. CONCLUSIONS Following a vegan diet may result in deficiencies in micronutrients (vitamin B12, zinc, calcium and selenium) which should not be disregarded. However, low micro- and macronutrient intakes are not always associated with health impairments. Individuals who consume a vegan diet should be aware of the risk of potential dietary deficiencies.
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Tong TYN, Appleby PN, Armstrong MEG, Fensom GK, Knuppel A, Papier K, Perez-Cornago A, Travis RC, Key TJ. Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study. BMC Med 2020; 18:353. [PMID: 33222682 PMCID: PMC7682057 DOI: 10.1186/s12916-020-01815-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is limited prospective evidence on possible differences in fracture risks between vegetarians, vegans, and non-vegetarians. We aimed to study this in a prospective cohort with a large proportion of non-meat eaters. METHODS In EPIC-Oxford, dietary information was collected at baseline (1993-2001) and at follow-up (≈ 2010). Participants were categorised into four diet groups at both time points (with 29,380 meat eaters, 8037 fish eaters, 15,499 vegetarians, and 1982 vegans at baseline in analyses of total fractures). Outcomes were identified through linkage to hospital records or death certificates until mid-2016. Using multivariable Cox regression, we estimated the risks of total (n = 3941) and site-specific fractures (arm, n = 566; wrist, n = 889; hip, n = 945; leg, n = 366; ankle, n = 520; other main sites, i.e. clavicle, rib, and vertebra, n = 467) by diet group over an average of 17.6 years of follow-up. RESULTS Compared with meat eaters and after adjustment for socio-economic factors, lifestyle confounders, and body mass index (BMI), the risks of hip fracture were higher in fish eaters (hazard ratio 1.26; 95% CI 1.02-1.54), vegetarians (1.25; 1.04-1.50), and vegans (2.31; 1.66-3.22), equivalent to rate differences of 2.9 (0.6-5.7), 2.9 (0.9-5.2), and 14.9 (7.9-24.5) more cases for every 1000 people over 10 years, respectively. The vegans also had higher risks of total (1.43; 1.20-1.70), leg (2.05; 1.23-3.41), and other main site fractures (1.59; 1.02-2.50) than meat eaters. Overall, the significant associations appeared to be stronger without adjustment for BMI and were slightly attenuated but remained significant with additional adjustment for dietary calcium and/or total protein. No significant differences were observed in risks of wrist or ankle fractures by diet group with or without BMI adjustment, nor for arm fractures after BMI adjustment. CONCLUSIONS Non-meat eaters, especially vegans, had higher risks of either total or some site-specific fractures, particularly hip fractures. This is the first prospective study of diet group with both total and multiple specific fracture sites in vegetarians and vegans, and the findings suggest that bone health in vegans requires further research.
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Affiliation(s)
- Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Paul N Appleby
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Miranda E G Armstrong
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Georgina K Fensom
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Anika Knuppel
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
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Chuang TL, Lin CH, Wang YF. Effects of vegetarian diet on bone mineral density. Tzu Chi Med J 2020; 33:128-134. [PMID: 33912409 PMCID: PMC8059457 DOI: 10.4103/tcmj.tcmj_84_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/24/2020] [Accepted: 07/10/2020] [Indexed: 11/18/2022] Open
Abstract
Factors, such as hormonal changes in postmenopausal women, natural aging degeneration, race, gender, body size, lifestyle, physical activity, sunlight, dietary intake, medications, or other environmental issues, can affect the rate of bone formation or reabsorption, cause changes in bone mineral content, and influence the development of osteoporosis. Do vegetarian diets adversely affect bone mineral density (BMD)? Among postmenopausal Buddhists, long-term practitioners of vegan vegetarian were found to have a higher risk exceeding the lumbar fracture threshold and a lower level of hip BMD after controlling for other variables. However, results of several prospective longitudinal studies failed to show a harmful effect of vegetarianism on bone health. In the Taiwanese adult population, researchers also did not find that a vegetarian diet significantly affects age-related BMD decline. Due to the various levels of nutrients in the diet (such as protein, alkali, calcium, Vitamin K, and phytoestrogens) and major lifestyle factors (such as smoking and physical exercise), determining the impact of a vegetarian diet on bone health is very complex. Good-quality vegetarian food can provide a healthy foundation for building and maintaining healthy bones and preventing fractures.
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Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chun-Hung Lin
- Department of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
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Vegetarian and Vegan Weaning of the Infant: How Common and How Evidence-Based? A Population-Based Survey and Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134835. [PMID: 32635592 PMCID: PMC7370013 DOI: 10.3390/ijerph17134835] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022]
Abstract
Background: Vegetarian and vegan weaning have increasing popularity among parents and families. However, if not correctly managed, they may lead to wrong feeding regimens, causing severe nutritional deficiencies requiring specific nutritional support or even the need for hospitalization. Aim: To assess the prevalence of vegetarian and vegan weaning among Italian families and to provide an up-to-date narrative review of supporting evidence. Materials and methods: We investigated 360 Italian families using a 40-item questionnaire. The narrative review was conducted searching scientific databases for articles reporting on vegetarian and vegan weaning. Results: 8.6% of mothers follow an alternative feeding regimen and 9.2% of infants were weaned according to a vegetarian or vegan diet. The breastfeeding duration was longer in vegetarian/vegan infants (15.8 vs. 9.7 months; p < 0.0001). Almost half of parents (45.2%) claim that their pediatrician was unable to provide sufficient information and adequate indications regarding unconventional weaning and 77.4% of parents reported the pediatrician’s resistance towards alternative weaning methods. Nine studies were suitable for the review process. The vast majority of authors agree on the fact that vegetarian and vegan weaning may cause severe nutritional deficiencies, whose detrimental effects are particularly significant in the early stages of life. Discussion and conclusion: Our results show that alternative weaning methods are followed by a significant number of families; in half of the cases, the family pediatrician was not perceived as an appropriate guide in this delicate process. To date, consistent findings to support both the safety and feasibility of alternative weaning methods are still lacking. Since the risk of nutritional deficiencies in the early stages of life is high, pediatricians have a pivotal role in guiding parents and advising them on the most appropriate and complete diet regimen during childhood. Efforts should be made to enhance nutritional understanding among pediatricians as an unsupervised vegetarian or vegan diet can cause severe nutritional deficiencies with possible detrimental long-term effects.
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Muñoz-Garach A, García-Fontana B, Muñoz-Torres M. Nutrients and Dietary Patterns Related to Osteoporosis. Nutrients 2020; 12:nu12071986. [PMID: 32635394 PMCID: PMC7400143 DOI: 10.3390/nu12071986] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutritional factors on the development and progression of this disease can be significant and is not yet well established. Calcium intake and vitamin D status are considered to be essential for bone metabolism homeostasis. However, some recent studies have questioned the usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate intake of protein, vegetables and other nutrients is also of interest, and recommendations have been established by expert consensus and clinical practice guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the effects of the main dietary patterns on bone health. Although some dietary patterns seem to have beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility.
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Affiliation(s)
- Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de las Nieves Hospital, 18014 Granada, Spain
- Correspondence: (A.M.-G.); (M.M.-T.)
| | - Beatriz García-Fontana
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), 18014 Granada, Spain;
- CIBERFES, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Manuel Muñoz-Torres
- Instituto de Investigación Biosanitaria (Ibs.GRANADA), 18014 Granada, Spain;
- CIBERFES, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Unidad de Gestión Clínica Endocrinología y Nutrición, Hospital Universitario San Cecilio de Granada, 18016 Granada, Spain
- Department of Medicine, University of Granada, 18016 Granada, Spain
- Correspondence: (A.M.-G.); (M.M.-T.)
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Redecillas-Ferreiro S, Moráis-López A, Manuel Moreno-Villares J. Position paper on vegetarian diets in infants and children. Committee on Nutrition and Breastfeeding of the Spanish Paediatric Association. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.anpede.2019.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Dobersek U, Wy G, Adkins J, Altmeyer S, Krout K, Lavie CJ, Archer E. Meat and mental health: a systematic review of meat abstention and depression, anxiety, and related phenomena. Crit Rev Food Sci Nutr 2020; 61:622-635. [PMID: 32308009 DOI: 10.1080/10408398.2020.1741505] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: To examine the relation between the consumption or avoidance of meat and psychological health and well-being.Methods: A systematic search of online databases (PubMed, PsycINFO, CINAHL Plus, Medline, and Cochrane Library) was conducted for primary research examining psychological health in meat-consumers and meat-abstainers. Inclusion criteria were the provision of a clear distinction between meat-consumers and meat-abstainers, and data on factors related to psychological health. Studies examining meat consumption as a continuous or multi-level variable were excluded. Summary data were compiled, and qualitative analyses of methodologic rigor were conducted. The main outcome was the disparity in the prevalence of depression, anxiety, and related conditions in meat-consumers versus meat-abstainers. Secondary outcomes included mood and self-harm behaviors.Results: Eighteen studies met the inclusion/exclusion criteria; representing 160,257 participants (85,843 females and 73,232 males) with 149,559 meat-consumers and 8584 meat-abstainers (11 to 96 years) from multiple geographic regions. Analysis of methodologic rigor revealed that the studies ranged from low to severe risk of bias with high to very low confidence in results. Eleven of the 18 studies demonstrated that meat-abstention was associated with poorer psychological health, four studies were equivocal, and three showed that meat-abstainers had better outcomes. The most rigorous studies demonstrated that the prevalence or risk of depression and/or anxiety were significantly greater in participants who avoided meat consumption.Conclusion: Studies examining the relation between the consumption or avoidance of meat and psychological health varied substantially in methodologic rigor, validity of interpretation, and confidence in results. The majority of studies, and especially the higher quality studies, showed that those who avoided meat consumption had significantly higher rates or risk of depression, anxiety, and/or self-harm behaviors. There was mixed evidence for temporal relations, but study designs and a lack of rigor precluded inferences of causal relations. Our study does not support meat avoidance as a strategy to benefit psychological health.
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Affiliation(s)
- Urska Dobersek
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Gabrielle Wy
- Department of Criminology and Criminal Justice, University of Maryland, College Park, Maryland, USA
| | - Joshua Adkins
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Sydney Altmeyer
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Kaitlin Krout
- Department of Psychology, University of Southern Indiana, Evansville, Indiana, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
| | - Edward Archer
- Research and Development, EvolvingFX, Jupiter, Florida, USA
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Iguacel I, Miguel-Berges ML, Gómez-Bruton A, Moreno LA, Julián C. Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis. Nutr Rev 2020; 77:1-18. [PMID: 30376075 DOI: 10.1093/nutrit/nuy045] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Context The numbers of vegans and vegetarians have increased in the last decades. However, the impact of these diets on bone health is still under debate. Objective This systematic review and meta-analysis sought to study the impact of vegetarian and vegan diets on bone mineral density (BMD) and fracture risk. Data Sources A systematic search was conducted of PubMed, Scopus, and Science Direct, covering the period from the respective start date of each database to November 2017. Data Extraction Two investigators evaluated 275 studies against the inclusion criteria (original studies in humans, written in English or Spanish and including vegetarian or vegan diets and omnivorous diets as factors with BMD values for the whole body, lumbar spine, or femoral neck and/or the number of fractures as the outcome) and exclusion criteria (articles that did not include imaging or studies that included participants who had suffered a fracture before starting the vegetarian or vegan diet). The quality assessment tool for observational cohort and cross-sectional studies was used to assess the quality of the studies. Results Twenty studies including 37 134 participants met the inclusion criteria. Compared with omnivores, vegetarians and vegans had lower BMD at the femoral neck and lumbar spine and vegans also had higher fracture rates. Conclusions Vegetarian and vegan diets should be planned to avoid negative consequences on bone health. Systematic Review Registration PROSPERO registration no. CRD42017055508.
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Affiliation(s)
- Isabel Iguacel
- University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - María L Miguel-Berges
- University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - Alejandro Gómez-Bruton
- University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - Luis A Moreno
- University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - Cristina Julián
- University of Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
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Redecilla Ferreiro S, Moráis López A, Moreno Villares JM. [Position paper on vegetarian diets in infants and children. Committee on Nutrition and Breastfeeding of the Spanish Paediatric Association]. An Pediatr (Barc) 2019; 92:306.e1-306.e6. [PMID: 31866234 DOI: 10.1016/j.anpedi.2019.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 10/30/2019] [Indexed: 12/23/2022] Open
Abstract
In the last few years, there are an increased number of families following a vegetarian diet, including their children. In order to guarantee child heath, paediatricians need to know the characteristics of this diet and the main foods that are used. There are few data on the medium and long-term health outcomes when removing all animal foods from the child's diet, especially at younger ages. Nevertheless, new tools have recently become available to facilitate following a vegetarian diet and decreasing the risk of deficiencies. In this document, the group of foods commonly used in vegetarian diets are reviewed, as well as recommendations for each age group. It also mentions the need to use B12 supplements at all ages, as well as other nutrients (iodine, iron, vitaminD3, poly-unsaturated fatty acid n-3), when required. A vegetarian or a vegan diet, as in any other kind of diet, needs to be carefully designed. After reviewing current evidence, even though following a vegetarian diet at any age does not necessarily mean it is unsafe, it is advisable for infant and young children to follow an omnivorous diet or, at least, an ovo-lacto-vegetarian diet.
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Appleby PN, Key TJA. Letter: Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis. Nutr Rev 2019; 77:451. [PMID: 31222366 DOI: 10.1093/nutrit/nuz011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paul N Appleby
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Timothy J A Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
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Iguacel I, Miguel-Berges ML, Gómez-Bruton A, Moreno LA, Julian C. Authors’ Reply: Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis. Nutr Rev 2019; 77:452-453. [DOI: 10.1093/nutrit/nuz010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabel Iguacel
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - María L Miguel-Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - Alejandro Gómez-Bruton
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
| | - Cristina Julian
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Zaragoza, Spain
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Tanaka S, Ando K, Kobayashi K, Seki T, Hamada T, Machino M, Ota K, Morozumi M, Kanbara S, Ito S, Ishiguro N, Hasegawa Y, Imagama S. Reduction in body cell mass as a predictor of osteoporosis: A cross-sectional study. Mod Rheumatol 2019; 30:391-396. [DOI: 10.1080/14397595.2019.1589911] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Satoshi Tanaka
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyoshi Kobayashi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Taisuke Seki
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Hamada
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Machino
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kyotaro Ota
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masayoshi Morozumi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shunsuke Kanbara
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sadayuki Ito
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukiharu Hasegawa
- Department of Rehabilitation, Kansai University of Welfare Science, Osaka, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Lactose-Free Dairy Products: Market Developments, Production, Nutrition and Health Benefits. Nutrients 2019; 11:nu11030551. [PMID: 30841534 PMCID: PMC6471712 DOI: 10.3390/nu11030551] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/21/2019] [Accepted: 02/27/2019] [Indexed: 02/07/2023] Open
Abstract
Lactose-free dairy is able to provide the essential nutrients present in regular dairy products, like calcium and vitamins, to those that are not able to digest lactose. This product category currently has a wide and growing health appeal to consumers. In recent years, the quality and product variety in the lactose-free dairy segment has been increasing significantly, giving consumers more tempting products to decide from. As a result, lactose-free dairy is now the fastest growing market in the dairy industry. This review discusses the market developments and production possibilities and issues related to the wide variation of lactose-free dairy products that are currently available. Additionally, the health benefits that lactose-free dairy may offer compared to dairy avoidance are illustrated.
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Abstract
Food plays an essential role in normal cellular processes; however, certain foods may also trigger or worsen certain disease states. This article focuses particularly on the role of food in common gastrointestinal and liver diseases, and discusses the current evidence that either supports or debunks common dietary recommendations. Nutrition topics discussed include the use of artificial sweetener for weight loss, avoidance of all dairy products in the setting of lactose intolerance, dietary recommendations for diverticular disease, and dietary management in cirrhotic patients with hepatic encephalopathy.
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Affiliation(s)
- Michelle Pearlman
- Gastroenterology and Hepatology Fellow, Department of Internal Medicine, Division of Digestive and Liver Diseases, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390-9151, USA.
| | - Oviea Akpotaire
- Department of Internal Medicine, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390-9151, USA
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Redecillas S, Moráis A, Marques I, Moreno-Villares JM. WITHDRAWN: Recommendations on vegetarian diet in infants and children. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.anpede.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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