Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications

The proximate composition of vegetables enriched by incorporation of municipal solid waste into fertilizers and its impacts on environment and human health

The recent over production of municipal solid waste (MSW) poses a significant threat to both the ecosystem and human health. Utilizing MSW for agricultural purposes has emerged as a promising strategy to reduce solid waste disposal while simultaneously increasing soil fertility. To explore this potential solution further, an experiment was designed to assess the impact of varying concentrations of MSW (25%, 50%, and 75%) on the proximate composition of 15 different vegetable species. The experiment, conducted between 2018 and 2019, involved treating soil with different levels of solid waste and analyzing the proximate components, such as crude protein, dry matter, crude fiber, crude fat, and moisture content, in the 15 selected crops. The results indicate that the application of 25% MSW significantly increased the levels of crude protein, crude fiber, dry matter, and fat in Spinacia oleracea, Solanum tuberosum, Solanum melongena, and Abelmoschus esculentus. Conversely, the addition of 75% MSW notably elevated the moisture and ash content in Cucumis sativus. Correlation and scatter matrix analyses were conducted to elucidate the relationships between the protein, fiber, dry matter, ash, and fat contents. Principal component analysis and clustering confirmed the substantial impact of Treatment_1 (25% MSW) and Treatment_3 (75% MSW) on the proximate composition of the aforementioned vegetables, leading to their categorization into distinct groups. Our study highlights the efficacy of using 25% MSW to enhance the proximate composition and nutritional value of vegetables. Nonetheless, further research is warranted to investigate the mineral, antioxidant, vitamin, and heavy metal contents in the soil over an extended period of MSW application.

Dietary Intakes of Long-Chain Polyunsaturated Fatty Acids and Impulsivity: Comparing Non-Restricted, Vegetarian, and Vegan Diets

BACKGROUND

Research suggests a link between deficiencies in omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) and impulsivity among psychiatric populations. However, this association is less evident in non-clinical populations. As omega-3 LCPUFAs are predominantly sourced through fish consumption, non-fish dieters may be more vulnerable to higher impulsivity.

METHODS

This cross-sectional observational study explored the association between lower intakes of omega-3 LCPUFA food sources and higher self-reported measures of impulsivity among healthy adults consuming non-restricted, vegetarian, and vegan diets.

RESULTS

The results from the validated Food Frequency Questionnaire showed significantly lower estimated omega-3 LCPUFA intakes among vegans and vegetarians when compared with people consuming non-restricted diets. Furthermore, although all groups scored within the normal range of impulsivity measures, vegans scored comparatively higher. Vegans also scored significantly higher in impulsivity control relating to attention than those consuming non-restricted diets.

CONCLUSIONS

The significantly lower omega-3 LCPUFA dietary intakes in the vegan diets were associated with higher scores in the second-order attentional aspect of self-reported impulsiveness.

The knowledge, attitudes, and behaviours of pregnant women regarding seafood consumption during the antenatal period: a qualitative study

BACKGROUND

Maternal nutrition impacts fetal growth and development. The Food Standards Australia New Zealand (FSANZ) guidelines recommend pregnant women consume 2-3 servings (224-336 g) of fish/seafood per week to support intake of long chain omega 3 fatty acids, given adequate consumption supports numerous health benefits including reduced risk of preterm and early preterm birth. Evidence indicates that pregnant women purposely lower their fish/seafood intake, largely due to fears of methylmercury exposure. The aim of this study was to explore pregnant women's knowledge, attitudes, and behaviours regarding their fish/seafood consumption during the antenatal period.

METHODS

Semi-structured interviews were conducted between October 2018 and December 2020 among a purposive sample of 12 pregnant women from the Australian Capital Territory (ACT). The interviews were recorded, transcribed verbatim, and analysed using an interpretative phenomenological approach. Themes were developed on the women's lived experience related to fish/seafood knowledge, attitudes, and consumption behaviour.

RESULTS

The most prominent finding was widespread non-adherence to fish/seafood consumption guidelines. This was largely owing to a lack of proactive health promotion related to the health benefits of fish/seafood throughout pregnancy, including the health promoting roles of long chain omega 3 fatty acids for fetal growth and development. Three themes were identified: nutrition knowledge; sources of health promotion; and barriers and enablers to fish/seafood consumption.

CONCLUSIONS

To support adequate maternal consumption of fish/seafood throughout pregnancy, emphasis should be placed on the benefits of consuming this food group regularly. Additionally, pregnant women should receive education about the health promoting role of long chain omega 3 fatty acids. Dietitians are well placed to provide this information.

Vegetarian diets and diets which restrict animal-source foods during childhood in high-income countries

Increasing numbers of populations in the West are restricting their intake of meat and other animal products for reasons relating to health or ethics; in many countries, these restrictions are already common for cultural, religious, or socio-economic reasons. By following their parent's diet, children are exposed in parallel. This narrative review aims at assessing current data regarding vegetarian diets in children from birth to 18 years of age, which include, by increasing degree of restriction, flexitarian, lacto-ovo-vegetarian, lacto-vegetarian, pescatarian, vegan and macrobiotic diets. The 202 references include 45 studies in children. The more restrictive the diet and the younger the child, the greater the risk of nutritional deficiency. Of particular concern are vitamin B12, iron, zinc, calcium, n-3 long-chain polyunsaturated fatty acids, and protein and energy intake, especially in pregnant and nursing women, infants and young children. Providing an adequate lacto-ovo-vegetarian diet is relatively easy, whereas the maintenance of more restrictive diets may be challenging. The benefits and risks of vegetarian diets in adults are relatively well documented, but data for children are scarce. Vegan and macrobiotic diets should be discouraged in pregnant and lactating mothers as well as in young children, who, otherwise, should pay careful attention to ensuring nutritional adequacy, blood testing and appropriate supplementation. The health consequences of a chosen diet should be discussed with parents and adolescents to ensure the best possible adherence to advice and prescriptions. There is a need for well conducted studies in children but also for better knowledge of nutrition in healthcare professionals.Abbreviations: ALA: α-linolenic acid; ARA: arachidonic acid; ASF: animal source foods; BMC: bone mineral content; BMD: bone mineral density; DHA: docosahexaenoic acid; DRV: dietary reference value; EPA: eicosapentaenoic acid; FLD: flexitarian diet; LA: linoleic acid; LC-PUFA: long-chain polyunsaturated fatty acids; LOVD: lacto-ovo-vegetarian diet; LVD: lacto-vegetarian diet; MAD: macrobiotic diet; OMD: omnivorous diet; PSF: plant-source foods; SFA: saturated fatty acids; VGD: vegetarian diets; VND: vegan diet.

Functional metagenomic and metabolomics analysis of gut dysbiosis induced by hyperoxia

Background

Inhaled oxygen is the first-line therapeutic approach for maintaining tissue oxygenation in critically ill patients, but usually exposes patients to damaging hyperoxia. Hyperoxia adversely increases the oxygen tension in the gut lumen which harbors the trillions of microorganisms playing an important role in host metabolism and immunity. Nevertheless, the effects of hyperoxia on gut microbiome and metabolome remain unclear, and metagenomic and metabolomics analysis were performed in this mouse study.

Methods

C57BL/6 mice were randomly divided into a control (CON) group exposed to room air with fractional inspired oxygen (FiO2) of 21% and a hyperoxia (OXY) group exposed to FiO2 of 80% for 7 days, respectively. Fecal pellets were collected on day 7 and subjected to metagenomic sequencing. Another experiment with the same design was performed to explore the impact of hyperoxia on gut and serum metabolome. Fecal pellets and blood were collected and high-performance liquid chromatography with mass spectrometric analysis was carried out.

Results

At the phylum level, hyperoxia increased the ratio of Firmicutes/Bacteroidetes (p = 0.049). At the species level, hyperoxia reduced the abundance of Muribaculaceae bacterium Isolate-037 (p = 0.007), Isolate-114 (p = 0.010), and Isolate-043 (p = 0.011) etc. Linear discriminant analysis effect size (LEfSe) revealed that Muribaculaceae and Muribaculaceae bacterium Isolate-037, both belonging to Bacteroidetes, were the marker microbes of the CON group, while Firmicutes was the marker microbes of the OXY group. Metagenomic analysis using Kyoto Encyclopedia of Genes and Genomes (KEGG) and Carbohydrate-Active enZYmes (CAZy) revealed that hyperoxia provoked disturbances in carbohydrate and lipid metabolism. Fecal metabolomics analysis showed hyperoxia reduced 11-dehydro Thromboxane B2-d4 biosynthesis (p = 1.10 × 10-11). Hyperoxia blunted fecal linoleic acid metabolism (p = 0.008) and alpha-linolenic acid metabolism (p = 0.014). We showed that 1-docosanoyl-glycer-3-phosphate (p = 1.58 × 10-10) was the most significant differential serum metabolite inhibited by hyperoxia. In addition, hyperoxia suppressed serum hypoxia-inducible factor-1 (HIF-1, p = 0.007) and glucagon signaling pathways (p = 0.007).

Conclusion

Hyperoxia leads to gut dysbiosis by eliminating beneficial and oxygen strictly intolerant Muribaculaceae with genomic dysfunction of carbohydrate and lipid metabolism. In addition, hyperoxia suppresses unsaturated fatty acid metabolism in the gut and inhibits the HIF-1 and glucagon signaling pathways in the serum.

The Role of Hemp (Cannabis sativa L.) as a Functional Food in Vegetarian Nutrition

Recently, there has been a renewed interest in Cannabis sativa and its uses. The recreational use of inflorescences as a source of THC has led to the legal restriction of C. sativa cultivation to limit the detrimental effects of psychotropic substance abuse on health. However, this has also limited the cultivation of textile/industrial varieties with a low content of THC used for textile and nutritional purposes. While previously the bans had significantly penalized the cultivation of C. sativa, today many countries discriminate between recreational use (marijuana) and industrial and food use (hemp). The stalks of industrial hemp (low in psychotropic substances) have been used extensively for textile purposes while the seeds are nutritionally versatile. From hemp seeds, it is possible to obtain flours applicable in the bakery sector, oils rich in essential fatty acids, proteins with a high biological value and derivatives for fortification, supplementation and nutraceutical purposes. Hemp seed properties seem relevant for vegetarian diets, due to their high nutritional value and underestimated employment in the food sector. Hemp seed and their derivatives are a valuable source of protein, essential fatty acids and minerals that could provide additional benefit to vegetarian nutrition. This document aims to explore the information available in the literature about hemp seeds from a nutritional point of view, highlighting possible beneficial effects for humans with particular attention to vegetarian nutrition as a supplemental option for a well-planned diet.

Preliminary Estimation of Nutritional Quality of the Meat, Liver, and Fat of the Indigenous Yakutian Cattle Based on Their Fatty Acid Profiles

The Yakutian cattle is an indigenous Siberian cattle breed living in an extremely cold climate in some parts of Yakutia. There are only a few thousand animals of this breed, and the conservation of the Yakutian cattle is embedded in the international agenda. We studied the fatty acid profiles in the meat, liver, and fat of the Yakutian cattle (five individuals) of different ages and their main food resource-pasture plants. The fatty acid profile of the tissues of the Yakutian cattle differed from that of pasture plants: 16:0, 18:2n-6, and 18:3n-3 dominated in the pasture plants; 16:0, 18:0, 18:1n-9, 18:2n-6, 20:4n-6, 20:5n-3, and 22:5n-3 dominated in the meat and liver; and 16:0, 18:0, and 18:1n-9 dominated in the fat. The fatty acid composition of food products is related to the risk of developing cardiovascular disease (CVD). The meat and liver of the Yakutian cattle are health food products that contribute to decreasing the risk of developing CVD because of their rather high content of eicosapentaenoic and docosahexaenoic fatty acids, optimal n-6/n-3 and polyunsaturated fatty acids/saturated fatty acids ratios, low values of indexes of atherogenicity and thrombogenicity, and high values of hypocholesterolemic/hypercholesterolemic and health-promoting indexes. The results of the present study support the importance of preserving this valuable cattle breed. Actions should be taken to increase their population while retaining their contemporary housing and feeding conditions.

Valorization of Soybean Residue (Okara) by Supercritical Carbon Dioxide Extraction: Compositional, Physicochemical, and Functional Properties of Oil and Defatted Powder

In the context of food waste valorization, the purpose of this study is to demonstrate the complete valorization of soybean residue (okara) through supercritical carbon dioxide extraction (SCE). Okara oil (OKO) was separated from full-fat powder (FFP) using SCE with and without ethanol (EtOH) as a cosolvent. The kinetics of extraction, chemical composition, and physicochemical, functional, and health-promoting properties of OKO and defatted powder (DFP) were determined. The process yielded 18.5% oil after 450 min. The soluble dietary fiber and protein of the DFP increased significantly; its water and oil absorption capacities increased despite the decrease in swelling capacity corresponding to particle size reduction. The OKO was rich in linoleic and oleic acids, with a ratio of ω6-to-ω3 fatty acids = 9.53, and EtOH increased its phenolic content (0.45 mg GAE/g), aglycone content (239.6 μg/g), and antioxidant capacity (0.195 mg TE/g). The DFP paste showed gel-like consistency and shear-thinning flow behavior, whereas the OKO showed characteristic transition of the product and affected lubrication at contact zones. Both fractions showed potential as food ingredients based on their nutritional and functional properties, as well as the capability of modifying the microstructure of a model food system.

Chemical Characteristics and Thermal Oxidative Stability of Novel Cold-Pressed Oil Blends: GC, LF NMR, and DSC Studies

Plant oils contain a high content of unsaturated fatty acids. Studies of food products have revealed a considerable disproportion in the ratio of ω6 to ω3. This article presents information on the healthful qualities of eight new oil blends that contain a beneficial proportion of ω6 to ω3 fatty acids (5:1), as well as their degradation during heating at 170 and 200 °C. The fatty acid profile was analyzed by gas chromatography (GC), content of polar compounds and polymers of triacylglycerols by liquid chromatography (LC), water content was measured by the Karl Fischer method, and oxidative stability was measured by differential scanning calorimetry (DSC) and low-field nuclear magnetic resonance (LF NMR) methods. The results showed that during heating, the polar fraction content increased in samples heated at both analyzed temperatures compared to unheated oils. This was mainly due to the polymerization of triacylglycerols forming dimers. In some samples that were heated, particularly those heated to 200 °C, trimers were detected, however, even with the changes that were observed, the polar fraction content of the blends did not go beyond the limit. Despite the high content of unsaturated fatty acids, the analyzed blends of oils are characterized by high oxidative stability, confirmed by thermoanalytical and nuclear magnetic resonance methods. The high nutritional value as well as the oxidative stability of the developed oil blends allow them to be used in the production of food, in particular products that ensure an adequate supply of ω3 fatty acids.

Human Milk Composition and Nutritional Status of Omnivore Human Milk Donors Compared with Vegetarian/Vegan Lactating Mothers

Women of childbearing age in Western societies are increasingly adopting vegetarian diets. These women are sometimes rejected as milk donors, but little about the composition of their milk is known. The present study aimed to compare the intake, nutritional status, and nutritional composition of human milk from omnivore human milk donors (Donors) and vegetarian/vegan lactating mothers (Veg). Milk, blood, and urine samples from 92 Donors and 20 Veg were used to determine their fatty acid profiles, as well as vitamins and minerals. In a representative sample of both groups, we also determined the lipid class profile as a distribution of neutral and polar lipids, the molecular species of triacylglycerols, and the relative composition of phospholipids in their milk. A dietary assessment was conducted with a five-day dietary record (while considering the intake of supplements). We highlight the following results, expressed as the mean (SE), for the Veg vs. Donors: (1) Their docosahexaenoic acid (DHA) intake was 0.11 (0.03) vs. 0.38 (0.03) g/day; the plasma DHA was 0.37 (0.07) vs. 0.83 (0.06)%; and the milk DHA was 0.15 (0.04) vs. 0.33 (0.02)%. (2) Their milk B12 levels were 545.69 (20.49) vs. 482.89 (4.11) pM; 85% of the Veg reported taking B12 supplements (mean dose: 312.1 mcg/day); and the Veg group showed no differences with Donors in terms of total daily intake or plasma B12. (3) Their milk phosphatidylcholine levels were 26.88 (0.67) vs. 30.55 (1.10)%. (4) Their milk iodine levels were 126.42 (13.37) vs. 159.22 (5.13) mcg/L. In conclusion, the Vegs' milk was shown to be different from the Donors' milk, mainly due to its low DHA content, which is concerning. However, raising awareness and ensuring proper supplementation could bridge this gap, as has already been achieved for cobalamin.

The beneficial effects of omega-3 polyunsaturated fatty acids on controlling blood pressure: An umbrella meta-analysis

Several meta-analyses have revealed that n-3 PUFAs can lower blood pressure, but the findings are conflicting. In this regard, the present umbrella meta-analysis aimed was performed to clarify whether n-3 PUFAs have effects on blood pressure. PubMed, Scopus, Embase, Web of Science, and Google Scholar were used as international databases from inception to May 2022. To examine the effects of n-3 PUFA supplementation on blood pressure, a random-effects model was applied. The leave-one-out method was performed for the sensitivity analysis. The pooled estimate of 10 meta-analyses with 20 effect sizes revealed significant reductions in both systolic (ES = -1.19 mmHg; 95% CI: -1.76, -0.62, p < 0.001) and diastolic blood pressure (ES = -0.91 mmHg, 95% CI: -1.35, -0.47; p < 0.001) following n-3 PUFAs supplementation. In studies with a sample size of ≤ 400 participants and a mean age over 45, SBP and DBP were found to be substantially reduced. Overall, this umbrella meta-analysis indicates that n-3 PUFAs supplementation might play a role in improving DBP and SBP.

Vegan nutrition: a preliminary guide for health professionals

Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.

Physicochemical and Morphological Study of the Saccharomyces cerevisiae Cell-Based Microcapsules with Novel Cold-Pressed Oil Blends

Vegetable oils rich in polyunsaturated fatty acids are a valuable component of the human diet. Properly composed oil blends are characterized by a 5:1 ratio of ω6/ω3 fatty acids, which is favorable from a nutritional point of view. Unfortunately, their composition makes them difficult to use in food production, as they are susceptible to oxidation and are often characterized by a strong smell. Encapsulation in yeast cells is a possible solution to these problems. This paper is a report on the use of native and autolyzed yeast in the encapsulation of oils. The fatty acid profile, encapsulation efficiency, morphology of the capsules obtained, and thermal behavior were assessed. Fourier transform infrared analysis and low-field nuclear magnetic resonance relaxation time measurements were also performed. The process of yeast autolysis changed the structure of the yeast cell membranes and improved the loading capacity. Lower encapsulation yield was recorded for capsules made from native yeast; the autolysis process significantly increased the value of this parameter. It was observed that NY-based YBMCs are characterized by a high degree of aggregation, which may adversely affect their stability. The average size of the AY capsules for each of the three oil blends was two times smaller than the NY-based capsules. The encapsulation of oils in yeast cells, especially those subjected to the autolysis process, ensured better oxidative stability, as determined by DSC, compared to fresh blends of vegetable oils. From LF NMR analysis of the relaxation times, it was shown that the encapsulation process affects both spin-lattice T1 and spin-spin T2* relaxation times. The T1 time values of the YBMCs decreased relative to the yeast empty cells, and the T2* time was significantly extended. On the basis of the obtained results, it has been proven that highly unsaturated oils can be used as an ingredient in the preparation of functional food via protection through yeast cell encapsulation.

Nutrition Benefits and Considerations for Whole Foods Plant-Based Eating Patterns

Whole foods plant-based approaches to eating place an emphasis on the intake of fruits, vegetables, whole grains, and legumes and have many health benefits. While there are key nutrients and phytochemicals that can contribute to the purported health benefits, practitioners and patients should also be advised of key nutrients for which intake may be compromised when following this dietary pattern. With careful planning and utility of dietary supplements, individuals can achieve optimal intake of calcium, iron, vitamin D, omega 3 fatty acid-docosahexaenoic acid (DHA), and vitamin B12 and experience the health benefits of a dietary fiber and a host of phytochemicals. This article presents the health benefits of these food substances and approaches for overcoming nutrients of concern when following whole food plant-based eating patterns.

Nutritional Quality and Oxidative Stability during Thermal Processing of Cold-Pressed Oil Blends with 5:1 Ratio of ω6/ω3 Fatty Acids

The growing awareness of consumers means that new products are sought after, which, apart from meeting the basic demand for macronutrients and energy, will have a positive impact on our health. This article is a report on the characteristics of the new oil blends with a nutritious ω6/ω3 fatty acid ratio (5:1), as well as the heat treatment effect on the nutritional value and stability of the oils. Prepared oil blends were heated at 170 and 200 °C. The fatty acid composition and the changes in tocochromanols content during heating were analyzed, as well as the formation process of polar compounds and triacylglycerol polymers. During heating the highest loss of tocochromanols was characteristic of α-tocopherol and α-tocotrienol. The total content of tocopherols after heating was reduced to 1–6% of the original content in the unheated oil blends. The exception was the blend of oil with wheat germ oil, in which a high content of all tocopherols was observed in unheated and heated samples. The content of the polar fraction during heating increased on average 1.9 and 3.1 times in the samples heated at 170 and 200 °C, respectively, compared to the unheated oils. The level of the polar fraction was related to the high content of tocopherols or the presence of tocopherols and tocotrienols in the heated sample. The polymerization of triacylglycerols led mainly to the formation of triacylglycerol dimers. Trimers were observed in a small number of heated samples, especially those heated at 200 °C. Regardless of the changes in heated oils, none of the prepared blends exceeded the limit of the polar fraction content, maintaining the programmed ratio of ω6 to ω3 acids. The principal component analysis (PCA) used to define the clusters showed a large variety of unheated and heated samples. An outlier in all clusters was a blend of oil with wheat germ oil. In these samples, the degradation of tocopherols molecules and the increase of triacylglycerol polymers and the polar fraction content were the slowest.

Reduction in Serum LDL Cholesterol Using a Nutrient Compendium in Hyperlipidemic Adults Unable or Unwilling to Use Statin Therapy: A Double-Blind Randomized Crossover Clinical Trial

BACKGROUND

Many hyperlipidemic patients prescribed β-hydroxy-β-methylglutaryl coenzyme A reductase inhibitors (statins) are unable or unwilling to take them. A hedonically acceptable snack-based solution formulated from cholesterol-lowering food ingredients could represent a therapeutic alternative but has not been tested in this population.

OBJECTIVES

To evaluate the effect of snacks containing a compendium of functional bioactives on fasting LDL cholesterol in statin candidates unwilling to use or intolerant to ≥1 statin drug. Secondary outcomes included changes in circulating total cholesterol (TC), triglycerides, HDL cholesterol, fasting glucose, insulin, and high-sensitivity C-reactive protein concentrations, as well as effects of single-nucleotide polymorphisms (SNPs) on outcome.

METHODS

This multicenter, randomized, double-blind, free-living crossover study was composed of 2 regimented phases of 4 wk each, separated by a 4-wk washout. Eighteen men and 36 women, with a mean ± SD age of 49 ± 12 y and mean ± SD LDL cholesterol of 131 ± 32.1 mg/dL,  were instructed to ingest a variety of ready-to-eat snacks twice daily as a substitute for something they were consuming already. Other behavior changes were actively discouraged. Treatment products provided ≥5 g fiber, 1000 mg ω-3 (n-3) fatty acids, 1000 mg phytosterols, and 1800 μmol antioxidants per serving. Control products were calorie-matched like-items drawn from the general grocery marketplace. Serum lipids were measured at baseline and the end of each phase and compared using the ANOVA model. Compliance to study foods was confirmed by serum 18:3n-3 concentration assessment.

RESULTS

Comparing intervention phase endpoints, LDL cholesterol was reduced a mean ± SD of 8.80 ± 1.69% (P < 0.0001), and TC was reduced a mean ± SD of 5.08 ± 1.12% (P < 0.0001) by treatment foods compared with control foods, whereas effects on other analytes did not differ between treatments. SNPs were not significantly related to outcomes (P ≥ 0.230). Compliance with study foods was 95%.

CONCLUSIONS

Consumption of hedonically acceptable snacks containing a compendium of cholesterol-lowering bioactive compounds can rapidly and meaningfully reduce LDL cholesterol in adult patients unable or unwilling to take statin drugs. This trial was registered at clinicaltrials.gov as NCT02341924.

A review on bioactive phytochemicals and ethnopharmacological potential of purslane (Portulaca oleracea L.)

The Portulaca oleracea L. commonly known as purslane is distributed all over the world and easily grows in diverse soil and climatic conditions. It has been traditionally used as a nutritious and ethnomedicinal food across the globe. Various studies have shown that the plant is a rich source of various important phytochemicals such as flavonoids, alkaloids, terpenoids, proteins, carbohydrates, and vitamins such as A, C, E, and B, carotenoids and minerals such as phosphorus, calcium, magnesium and zinc. It is particularly very important because of the presence of a very high concentration of omega-3- fatty acids especially α-linolenic acid, gamma-linolenic acid and linoleic acid, which are not generally synthesized in terrestrial plants. Various parts of purslane are known for ethnomedicinal and pharmacological uses because of its anti-inflammatory, antidiabetic, skeletal muscle relaxant, antitumor, hepatoprotective, anticancer, antioxidant, anti-insomnia, analgesic, gastroprotective, neuroprotective, wound healing and antiseptic activities. Due to multiple benefits of purslane, it has become an important wonder crop and various scientists across the globe have shown much interest in it as a healthy food for the future. In this review, we provide an update on the phytochemical and nutritional composition of purslane, its usage as nutritional and an ethnomedicinal plant across the world. We further provide a detailed account on ethnopharmacological studies that have proved the ethnomedicinal properties of purslane.

The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals

Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.

Improvement of a Traditional Orphan Food Crop, Portulaca oleracea L. (Purslane) Using Genomics for Sustainable Food Security and Climate-Resilient Agriculture

Purslane (Portulaca oleracea L.) is a popular orphan crop used for its nutritional properties in various parts of the world. It is considered one of the richest terrestrial sources of omega-3 and omega-6-fatty acids (ω-3 and 6-FAs) suggesting its importance for human health. This ethnomedicinal plant is also an important part of traditional healing systems among the indigenous people. Many studies have indicated its tolerance against multiple stresses and found that it easily grows in a range of environmental gradients. It has also been considered one of the important biosaline crops for the future. Despite its huge nutritional, economic, and medicinal importance, it remains neglected to date. Most of the studies on purslane were focused on its ethnomedicinal, phytochemical, pharmacological, and stress-tolerance properties. Only a few studies have attempted genetic dissection of the traits governing these traits. Purslane being an important traditional food crop across the globe can be valorized for a sustainable food security in the future. Therefore, this review is an attempt to highlight the distribution, domestication, and cultivation of purslane and its importance as an important stress-tolerant food and a biosaline crop. Furthermore, identification of genes and their functions governing important traits and its potential for improvement using genomics tools for smart and biosaline agriculture has been discussed.

The Application of Lactobacillus reuteri CCM 8617 and Flaxseed Positively Improved the Health of Mice Challenged with Enterotoxigenic E. coli O149:F4

The aim of our study was to monitor the effects of dietary synbiotics on experimentally infected mice. Sixty mice were divided into the following three groups: negative control group C1, positive control group C2 (mice infected with enterotoxigenic Escherichia coli O149:F4_NAL), and experimental group LF (Lactobacillus reuteri CCM 8617_RIF + 10% flaxseed + E. coli O149:F4_NAL). Supplements were administered for 42 days. Microbiological, hematological, and biochemical analyses, electrophoretic analysis of lactate dehydrogenase (LDH) isoenzymes, and analysis of fatty acids using gas chromatography and isotachophoresis were performed. We recorded higher numbers of jejunal and ileal lactic acid bacteria, lower Enterobacteriaceae counts in the feces of the animals, and an increased production of organic acids in the synbiotic-fed group. The supplements applied favored n-3 polyunsaturated fatty acid (PUFA) metabolism and inhibited n-6 PUFA metabolism; thus, they influenced the n-6 to n-3 and eicosapentaenoic to arachidonic acid ratios. Additionally, the incorporation of n-3 PUFAs to the cell membrane decreased the activity of LDH, transaminases, and alkaline phosphatase. Results obtained in our study indicate the positive effect of continuous supplementation of combination of probiotic cheese enriched with L. reuteri CCM 8617_RIF and crushed flaxseed on composition of intestinal microflora and alleviation of the course of infection induced by pathogenic bacterium E. coli O149:F4_NAL.

Omega-3 PUFA profoundly affect neural, physiological, and behavioural competences - implications for systemic changes in trophic interactions

In recent decades, much conceptual thinking in trophic ecology has been guided by theories of nutrient limitation and the flow of elements, such as carbon and nitrogen, within and among ecosystems. More recently, ecologists have also turned their attention to examining the value of specific dietary nutrients, in particular polyunsaturated fatty acids (PUFA), among which the omega-3 PUFA, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play a central role as essential components of neuronal cell membranes in many organisms. This review focuses on a new neuro-ecological approach stemming from the biochemical (mechanistic) and physiological (functional) role of DHA in neuronal cell membranes, in particular in conjunction with G-protein coupled receptors (GPCRs). We link the co-evolution of these neurological functions to metabolic dependency on dietary omega-3 PUFA. We outline ways in which deficiencies in dietary DHA supply may affect, cognition, vision, and behaviour, and ultimately, the biological fitness of consumers. We then review emerging evidence that changes in access to dietary omega-3 PUFA may ultimately have profound impacts on trophic interactions leading to potential changes in community structure and ecosystem functioning that, in turn, may affect the supply of DHA within and across ecosystems, including the supply for human consumption.

Soybean oil lowers circulating cholesterol levels and coronary heart disease risk, and has no effect on markers of inflammation and oxidation

To reduce risk of coronary heart disease, replacement of saturated fats (SFAs) with polyunsaturated fats (PUFA) is recommended. Strong and concordant evidence supports this recommendation, but controversy remains. Some observational studies have reported no association between SFAs and coronary heart disease, likely because of failure to account for the macronutrient replacing SFAs, which determines the direction and strength of the observed associations. Controversy also persists about whether ω-6 (nω-6) PUFA or a high dietary ratio of nω-6 to ω-3 (nω-3) fatty acids leads to proinflammatory and pro-oxidative states. These issues are relevant to soybean oil, which is the leading edible oil consumed globally and in the United States. Soybean oil accounts for over 40% of the US intake of both essential fatty acids. We reviewed clinical and epidemiologic literature to determine the effects of soybean oil on cholesterol levels, inflammation, and oxidation. Clinical evidence indicates that soybean oil does not affect inflammatory biomarkers, nor does it increase oxidative stress. On the other hand, it has been demonstrated that when dietary SFAs are replaced with soybean oil, blood cholesterol levels are lowered. Regarding the nω-6:nω-3 dietary ratio, health agencies have consistently rejected the importance of this ratio, instead emphasizing the importance of consuming sufficient amounts of each type of fat. Thus, several lines of evidence indicate that soybean oil can positively contribute to overall health and reduction of risk of coronary heart disease.

Plasma Phospholipidomic Profile Differs between Children with Phenylketonuria and Healthy Children

Phenylketonuria (PKU) is a disease of the catabolism of phenylalanine (Phe), caused by an impaired function of the enzyme phenylalanine hydroxylase. Therapeutics is based on the restriction of Phe intake, which mostly requires a modification of the diet. Dietary restrictions can lead to imbalances in specific nutrients, including lipids. In the present study, the plasma phospholipidome of PKU and healthy children (CT) was analyzed by hydrophilic interaction liquid chromatography-tandem mass spectrometry and gas chromatography-mass spectrometry. Using this approach, 187 lipid species belonging to nine different phospholipid classes and three ceramides were identified. Principal component analysis of the lipid species data set showed a distinction between PKU and CT groups. Univariate analysis revealed that 146 species of phospholipids were significantly different between both groups. Lipid species showing significant variation included phosphatidylcholines, containing polyunsaturated fatty acids (PUFA), which were more abundant in PKU. The high level of PUFA-containing lipid species in children with PKU may be related to a diet supplemented with PUFA. This study was the first report comparing the plasma polar lipidome of PKU and healthy children, highlighting that the phospholipidome of PKU children is significantly altered compared to CT. However, further studies with larger cohorts are needed to clarify whether these changes are specific to phenylketonuric children.

Bioavailability and conversion of plant based sources of omega-3 fatty acids - a scoping review to update supplementation options for vegetarians and vegans

Omega-3 (n-3) fatty acids offer a plethora of health benefits with the majority of evidence showing beneficial effects from marine sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Emerging research examines the effects of n-3 dietary intakes on blood markers of vegetarians and vegans, but official guidance for plant based marine alternatives is yet to reach consensus. This scoping review provides an overview of trials investigating bioavailability of plant n-3 oils including EPA and DHA conversion. Searches of MEDLINE, PubMed, CINAHL and clinical trial registers identified randomized controlled trials from January 2010 to September 2020. The 'Omega-3 index' (EPA + DHA (O3I)), was used to compare n-3 status, metabolic conversion and bioavailability. Two reviewers independently screened articles and extracted data on outcomes. From 639 identified articles, screening and eligibility checks gave 13 articles. High dose flaxseed or echium seed oil supplements, provided no increases to O3I and some studies showed reductions. However, microalgal oil supplementation increased O3I levels for all studies. Findings indicate preliminary advice for vegetarians and vegans is regular consumption of preformed EPA and DHA supplements may help maintain optimal O3I. Further studies should establish optimum EPA and DHA ratios and dosages in vegetarian and vegan populations.

MicroRNA-193a-5p Regulates the Synthesis of Polyunsaturated Fatty Acids by Targeting Fatty Acid Desaturase 1 (FADS1) in Bovine Mammary Epithelial Cells

Cardiovascular diseases (CVDs) are seriously threatening to human life and health. Polyunsaturated fatty acids (PUFAs) are known for their role in preventing CVDs. It is beneficial to population health to promote the content of PUFAs in bovine milk. In recent years, limited research based on molecular mechanisms has focused on this field. The biological roles of numerous microRNAs (miRNAs) remain unknown. In this study, a promising and negatively correlated pair of the miRNA (miRNA-193a-5p) and a fatty acid desaturase 1 (FADS1) gene are identified and screened to explore whether they are potential factors of PUFAs’ synthesis in bovine milk. The targeted relationship between miRNA-193a-5p and FADS1 in bovine mammary epithelial cells (BMECs) is demonstrated by dual luciferase reporter assays. qRT-PCR and western blot assays indicate that both the expression of mRNA and the protein FADS1 show a negative correlation with miRNA-193a-5p expression in BMECs. Also, miR-193a-5p expression is positively correlated with the expression of genes associated with milk fatty acid metabolism, including ELOVL fatty acid elongase 6 (ELOVL6) and diacylglycerol O-acyltransferase 2 (DGAT2). The expression of fatty acid desaturase 2 (FADS2) is negatively correlated with miR-193a-5p expression in BMECs. The contents of triglycerides (TAG), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) have a significant positive correlation with the expression of FADS1 and a significant negative correlation with the expression of miR-193a-5p in BMECs. For the first time, this study confirms that miRNA-193a-5p regulates PUFAs metabolism in BMECs by targeting FADS1, indicating that miRNA-193a-5p and FADS1 are underlying factors that improve PUFAs content in bovine milk.

Dietary supplements in the management of varicocele-induced infertility: A review of potential mechanisms

Varicocele is a main cause of lower production of spermatozoon and infertility with multiple pathophysiological mechanisms. In the past decades, the use of dietary supplements has significantly increased due to both the modern lifestyle and the food shortages of the industrialised countries. The purpose of this review paper is to collect scientific evidences from basic and clinical studies which support the use of dietary supplements to define the clinical framework for patients with varicocele. In the present review, we used keywords such as dietary supplements, varicocele, male infertility, oxidative stress, DNA fragmentation, sperm parameters to find the proper articles. The standard search biomedical engines were used for seeking the papers. The use of dietary supplements such as minerals, vitamins and antioxidants has an essential role in the prevention and treatment of varicocele by increasing the levels of antioxidant enzymes (e.g. peroxidase, superoxide dismutase and catalase) and decreasing the levels of inflammatory markers (e.g. tumour necrosis factor-α, interleukin-6 and interleukin-1) in testis. According to the results, the dietary supplements may alleviate the spermatogenesis in varicocele patients through different mechanisms such as suppression of stress oxidative and inflammation in testicular tissue.

Children and adults should avoid consuming animal products to reduce risk for chronic disease: NO

Excessive attention to the animal versus plant binary food choice reflects society's moral views on eating right. To claim that avoidance of animal products is required to prevent chronic disease is not supported by evidence, makes little sense from an evolutionary perspective, and distracts policy makers from common-sense approaches to achieve adequate nutrition. Animal products provide highly bioavailable nutrients, some of which are not easily obtained from plants, and can play a key role in meeting the nutritional challenges of populations in both high- and low-income countries. This role goes beyond the need for protein and relates to vitamins, minerals, and numerous often-overlooked nutrients, such as long-chain fatty acids, taurine, and choline. Restrictive dietary prescriptions that exclude animal products complicate the quest for optimal nutrition by undermining dietary diversity and flexibility, and by introducing a dependency on fortification and supplementation. Thus, a vegan diet may put the general population at increased risk of poor nutrition, a problem of particular concern for those with special nutritional requirements.

Healthcare Cost Implications of Utilizing a Dietary Intervention to Lower LDL Cholesterol: Proof of Concept Actuarial Analysis and Recommendations

PURPOSE OF REVIEW

To determine if subsidizing the cost of a food-based intervention for managing hyperlipidemia could be cost-effective under commercial insurance and/or Medicare coverage scenarios.

RECENT FINDINGS

A large number of patients eligible for pharmaceutical treatment of hyperlipidemia either cannot or will not use lipid lowering drugs, leaving them at increased cardiovascular risk. Lipid levels can be modified by diet, but food has never enjoyed covered benefit status. We evaluated the financial implications of providing insurance coverage for a specifically formulated suite of food products previously documented to yield statistically significant lipid reductions, using multiple product uptake and lipid impact scenarios in both commercially covered and Medicare-covered populations. Even after controlling for multiple confounders, we noted positive payback on subsidizing the cost of lipid-lowering foods under all scenarios. Addressing a root cause of hyperlipidemia by directly encouraging dietary modification provides a cost-effective alternative for cholesterol management, especially for statin intolerant or statin unwilling patients.

Vegetarian and Vegan Weaning of the Infant: How Common and How Evidence-Based? A Population-Based Survey and Narrative Review

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.

[Are vegetarian diets nutritionally adequate? A revision of the scientific evidence]

Introduction

Vegetarian diets are booming and, although these diets have been linked to some health benefits, the low bioavailability of some micronutrients in plant foods may result in risk of nutritional deficiencies, which makes necessary adequate planning of these diets. In this regard, vitamin B12 deficiency in vegetarians has been evidenced and there is a consensus on the need of supplementation of this vitamin. Vitamin D deficiency may be more frequent than in omnivores, particularly during the winter, when skin synthesis is minimal. The low bioavailability of iron, zinc and selenium in vegetables can also affect nutritional status of vegetarians. Furthermore, vegetarian diets are usually deficient in polyunsaturated fatty acids of the omega-3 family, eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. On the other hand, these diets appear to provide adequate quantities of other vitamins, such as ascorbic acid, folic acid and the fat-soluble vitamins A and E. In this review, the characteristics of the intake of macro- and micronutrients of vegetarian diets and the diet and health relationships are presented. In addition, data on nutritional status of this population are also shown and suggestions on nutritional recommendations to prevent deficiencies are given. Finally, the possible clinical application of controlled interventions with vegetarian diets is presented.

Associations of a vegan diet with inflammatory biomarkers

Vegetarian or vegan nutrition might influence inflammatory processes, thereby reducing the risk of chronic diseases. As the vegan diet becomes more importance in modern societies, data from the “Risks and Benefits of a Vegan Diet”-study has been used to investigate the associations of veganism with a comprehensive spectrum of inflammatory biomarkers, compared to omnivores. This cross-sectional study comprises 36 vegans and 36 omnivores (18 men and 18 women each) aged 30–60 years. No significant differences in any of the investigated inflammatory biomarkers (high-sensitivity C-reactive protein (hsCRP), interleukin-18 (IL-18), interleukin-1 receptor antagonist (IL-1 RA), intercellular adhesion molecule-1 (ICAM-1), adiponectin, omentin-1 and resistin) were observed between vegans and omnivores. However, the duration of a vegan diet was positively correlated with resistin (Spearman r = 0.59), IL-18 concentrations (Spearman r = 0.44) and IL-1 RA (Spearman r = 0.34). Moreover, the present study supports BMI and waist circumference as important factors influencing the inflammatory state. Further research is needed to evaluate associations between a vegan diet and inflammatory biomarkers to provide more evidence about the inflammatory state as underlying mechanisms of a vegan diet to influence the risk of numerous chronic diseases.

Polyunsaturated fatty acids and DNA methylation in colorectal cancer

Colorectal cancer (CRC) has been designated a major global problem, especially due to its high prevalence in developed countries. CRC mostly occurs sporadically (75%-80%), and only 20%-25% of patients have a family history. Several processes are involved in the development of CRC such as a combination of genetic and epigenetic alterations. Epigenetic changes, including DNA methylation play a vital role in the progression of CRC. Complex interactions between susceptibility genes and environmental factors, such as a diet and sedentary lifestyle, lead to the development of CRC. Clinical and experimental studies have confirmed the beneficial effects of dietary polyunsaturated fatty acids (PUFAs) in preventing CRC. From a mechanistic viewpoint, it has been suggested that PUFAs are pleiotropic agents that alter chromatin remodeling, membrane structure and downstream cell signaling. Moreover, PUFAs can alter the epigenome via modulation of DNA methylation. In this review, we summarize recent investigations linking PUFAs and DNA methylation-associated CRC risk.

Docosahexaenoic acid,22:6n-3: Its roles in the structure and function of the brain

Docosahexaenoic acid,22:6n-3 (DHA) and its metabolites are vital for the structure and functional brain development of the fetus and infants, and also for maintenance of healthy brain function of adults. DHA is thought to be an essential nutrient required throughout the life cycle for the maintenance of overall brain health. The mode of actions of DHA and its derivatives at both cellular and molecular levels in the brain are emerging. DHA is the major prevalent fatty acid in the brain membrane. The brain maintains its fatty acid levels mainly via the uptake of plasma free fatty acids. Therefore, circulating plasma DHA is significantly related to cognitive abilities during ageing and is inversely associated with cognitive decline. The signaling pathways of DHA and its metabolites are involved in neurogenesis, antinociceptive effects, anti-apoptotic effect, synaptic plasticity, Ca²⁺ homeostasis in brain diseases, and the functioning of nigrostriatal activities. Mechanisms of action of DHA metabolites on various processes in the brain are not yet well known. Epidemiological studies support a link between low habitual intake of DHA and a higher risk of brain disorders. A diet characterized by higher intakes of foods containing high in n-3 fatty acids, and/or lower intake of n-6 fatty acids was strongly associated with a lower Alzheimer's Disease and other brain disorders. Supplementation of DHA improves some behaviors associated with attention deficit hyperactivity disorder, bipolar disorder, schizophrenia, and impulsive behavior, as well as cognition. Nevertheless, the outcomes of trials with DHA supplementation have been controversial. Many intervention studies with DHA have shown an apparent benefit in brain function. However, clinical trials are needed for definitive conclusions. Dietary deficiency of n-3 fatty acids during fetal development in utero and the postnatal state has detrimental effects on cognitive abilities. Further research in humans is required to assess a variety of clinical outcomes, including quality of life and mental status, by supplementation of DHA.

Alpha-Linolenic and Linoleic Fatty Acids in the Vegan Diet: Do They Require Dietary Reference Intake/Adequate Intake Special Consideration?

Good sources of the long-chain n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) include cold-water fish and seafood; however, vegan diets (VGNs) do not include animal-origin foods. Typically, US omnivores obtain enough dietary EPA and DHA, but unless VGNs consume algal n-3 supplements, they rely on endogenous production of long-chain fatty acids. VGN diets have several possible concerns: (1) VGNs have high intakes of linoleic acid (LA) as compared to omnivore/non-vegetarian diets. (2) High intakes of LA competitively interfere with the endogenous conversion of alpha-linolenic acid (ALA) to EPA and DHA. (3) High somatic levels of LA/low ALA indicate a decreased ALA conversion to EPA and DHA. (4) Some, not all VGNs meet the Dietary Reference Intake Adequate Intake (DRI-AI) for dietary ALA and (5) VGN diets are high in fiber, which possibly interferes with fat absorption. Consequently, health professionals and Registered Dietitians/Registered Dietitian Nutritionists working with VGNs need specific essential fatty acid diet guidelines. The purpose of this review was: (1) to suggest that VGNs have a DRI-AI Special Consideration requirement for ALA and LA based on VGN dietary and biochemical indicators of status and (2) to provide suggestions to ensure that VGNs receive adequate intakes of LA and ALA.

Long-chain Omega-3 Polyunsaturated Fatty Acids in Natural Ecosystems and the Human Diet: Assumptions and Challenges

Over the past three decades, studies of essential biomolecules, long-chain polyunsaturated fatty acids of the omega-3 family (LC-PUFAs), namely eicosapentaenoic acid (20:5n-3, EPA) and docosahexaenoic acid (22:6n-3, DHA), have made considerable progress, resulting in several important assumptions. However, new data, which continue to appear, challenge these assumptions. Based on the current literature, an attempt is made to reconsider the following assumptions: 1. There are algal classes of high and low nutritive quality. 2. EPA and DHA decrease with increasing eutrophication in aquatic ecosystems. 3. Animals need EPA and DHA. 4. Fish are the main food source of EPA and DHA for humans. 5. Culinary treatment decreases EPA and DHA in products. As demonstrated, some of the above assumptions need to be substantially specified and changed.

A cross-sectional study of fatty acids and brain-derived neurotrophic factor (BDNF) in human milk from lactating women following vegan, vegetarian, and omnivore diets

PURPOSE

Essential fatty acids are critical for brain growth and neurodevelopment in infancy. Maternal diet and supplement use have a significant impact on the fat composition of human milk. The objective of this study is to assess supplement utilization patterns and fatty acid and brain-derived neurotrophic factor (BDNF) concentrations in the breast milk of women following vegan, vegetarian, and omnivore diet patterns.

METHODS

This is a cross-sectional, observational study of 74 lactating women in the United States following a vegan (n = 26), vegetarian (n = 22), or omnivore (n = 26) diet pattern. A single breast milk sample was collected from each participant and assessed for fatty acids and BDNF.

RESULTS

Median unsaturated fatty acids in the breast milk of vegan, vegetarian, and omnivores, as a percentage of total fatty acids, was 66.0, 57.8, and 56.2%, respectively (p < 0.001). Total omega-3 percentages were 2.29% for vegans, 1.55% for vegetarians, and 1.46% for omnivores (p < 0.001). Docosahexaenoic acid percentages were not different by diet pattern, but over 80% of participants had milk concentrations below 0.30% of total fatty acids. Reports of omega-3 supplements use (10/74) and weekly seafood consumption (3/74) were limited. BDNF was not detectable in any samples.

CONCLUSIONS

Breast milk from vegans had significantly higher unsaturated fat and total omega-3 fats, and lower saturated fats, trans fats, and omega-6 to omega-3 ratios than their vegetarian and omnivore counterparts. Docosahexaenoic acid concentrations in breast milk were low regardless of maternal diet pattern, and were reflective of low seafood intake and supplement use.

Interaction of Dietary Linoleic Acid and α-Linolenic Acids with rs174547 in FADS1 Gene on Metabolic Syndrome Components among Vegetarians

Fatty acid desaturase 1 (FADS1) gene controls the fatty acid metabolism pathway in the human body. The lower intake of α-linolenic acid (ALA) than linoleic acid (LA) among vegetarians may disrupt the fatty acid metabolism and limit the conversion of ALA to anti-inflammatory products such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This cross-sectional study aimed to determine the interaction of rs174547 in FADS1 gene with LA and ALA on metabolic syndrome (MetS) components. A total of 200 Chinese and Indian vegetarians in Kuala Lumpur and Selangor, Malaysia participated in the present study. The data on socio-demographic characteristics, vegetarianism practices, dietary practices, anthropometric measurements, blood pressure (BP), and overnight venous fasting blood samples were collected from the vegetarians. The rs174547 in FADS1 gene was significantly associated with MetS and its components such as waist circumference (WC) and fasting blood glucose (FBG). Multiple logistic regression analyses revealed that vegetarians with TT genotype of rs174547 in FADS1 gene had higher odds for MetS, larger WC, higher BP, and a lower level of HDL-c. Two-way ANOVA analysis showed that LA interacts with rs174547 in FADS1 gene to affect HDL-c (p < 0.05) among vegetarians. The present findings suggest the need to develop dietary guidelines for vegetarians in Malaysia. Prospective studies are also needed to affirm the interaction between LA and rs174547 in FADS1 gene on HDL-c among Malaysian vegetarians.

Fatty Acid Profile and Cardiometabolic Markers in Relation with Diet Type and Omega-3 Supplementation in Spanish Vegetarians

Plant-based diets are becoming increasingly popular, and scientific information concerning the nutritional status in this population is needed. This study determined the fatty acid profile of Spanish lacto-ovo vegetarians (LO-vegetarians) and vegans. Participants were 104 healthy adults, LO-vegetarians (n = 49) and vegans (n = 55). Lifestyle habits and consumption of food and omega-3 supplements were estimated by questionnaires. BMI, blood pressure, and abdominal and body fat were determined. Serum was collected to analyze fatty acids, glucose, lipids, homocysteine, insulin, and leptin. Volunteers were classified according to serum omega-6 to omega-3 (n-6/n-3) ratio into three groups: n-6/n-3 < 10, n-6/n-3 ≥ 10 to 20, and n-6/n-3 > 20. Results showed low cardiovascular risk and high insulin sensitivity with negligible differences between diet types. Linoleic acid (C18:2n-6) was the major serum fatty acid, followed by oleic (C18:1n-9) and palmitic (C16:0) acids. In contrast, serum eicosapentaenoic acid (EPA, C20:5n-3) and docosahexaenoic acid (DHA, C22:6n-3) were (median, interquartile range) 0.27, 0.18% and 1.59, and 0.93%, respectively. Users of n-3 supplements (<10% of total vegetarians) had significantly higher EPA than non-users, while frequent consumption of flax-seeds was associated with increased α-linolenic acid (C18:3n-3). However, neither n-3 supplementation nor food consumption affected DHA levels in this vegetarian population.

Vegetarian-Based Dietary Patterns and their Relation with Inflammatory and Immune Biomarkers: A Systematic Review and Meta-Analysis

Dietary patterns with substantial proportions of energy from plant sources have been associated with favorable biomarkers of low-grade inflammation. Less is known of the relation between vegetarian-based dietary patterns and markers of inflammation and immune status. This systematic review and meta-analysis aimed to determine the relation between vegetarian-based dietary patterns and inflammatory and immune markers (C-reactive protein, tumour necrosis factor α, fibrinogen, natural killer cells, leukocytes, lymphocytes, thrombocytes, interleukins, and immunoglobulins). PubMed, Medline, and Cochrane scientific databases were searched to identify relevant studies. Random effects meta-analyses were conducted to assess the weighted mean differences (WMDs) for each outcome variable between vegetarian and non-vegetarian groups. Thirty observational and 10 intervention studies were included in the review. Pooled effects of vegetarian-based dietary patterns were associated with significantly lower concentrations of CRP (WMD: -0.61 mg/L; 95% CI: -0.91, -0.32 mg/L; P = 0.0001), fibrinogen (WMD: -0.22 g/L; 95% CI: -0.41, -0.04 mg/L; P = 0.02), and total leukocyte (WMD: -0.62 × 10(3)/μL; 95% CI -1.13 × 10(3), -0.10 × 10(3)/μL; P = 0.02) compared with those following non-vegetarian dietary patterns in observational studies. Insufficient data were identified for a meta-analysis of intervention studies. This study provides evidence that vegetarian-based dietary patterns are associated with lowered serum C-reactive protein, fibrinogen, and total leukocyte concentrations. Future research should focus on large-scale intervention trials, contrasting differences in inflammation and immune status and function between vegetarian and non-vegetarian-based populations.

The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring

Vegetarian and vegan diets have increased worldwide in the last decades, according to the knowledge that they might prevent coronary heart disease, cancer, and type 2 diabetes. Althought plant-based diets are at risk of nutritional deficiencies such as proteins, iron, vitamin D, calcium, iodine, omega-3, and vitamin B12, the available evidence shows that well planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients. A review of the scientific literature in this field was performed, focusing specifically on observational studies in humans, in order to investigate protective effects elicited by maternal diets enriched in plant-derived foods and possible unfavorable outcomes related to micronutrients deficiencies and their impact on fetal development. A design of pregestational nutrition intervention is required in order to avoid maternal undernutrition and consequent impaired fetal growth.

Dietary Intake of Polyunsaturated Fatty Acids and Pain in Spite of Inflammatory Control Among Methotrexate-Treated Early Rheumatoid Arthritis Patients

Objective

To investigate potential associations between dietary intake of polyunsaturated fatty acids (FAs) and pain patterns in early rheumatoid arthritis (RA) patients after 3 months of methotrexate (MTX) treatment.

Methods

We included 591 early RA patients with MTX monotherapy from a population‐based prospective case–control study, the Epidemiological Investigation of Rheumatoid Arthritis. Dietary data on polyunsaturated FAs (food frequency questionnaires) were linked with data on unacceptable pain (visual analog scale [VAS] >40 mm), noninflammatory/refractory pain (VAS >40 mm and C‐reactive protein [CRP] level <10 mg/liter), and inflammatory pain (VAS >40 mm and CRP level >10 mg/liter) after 3 months. Statistical analysis included logistic regression.

Results

After 3 months of MTX treatment, 125 patients (21.2%) had unacceptable pain, of which 92 patients had refractory pain, and 33 patients had inflammatory pain. Omega‐3 FA intake was inversely associated with unacceptable pain and refractory pain (odds ratio [OR] 0.57 [95% confidence interval (95% CI) 0.35–0.95] and OR 0.47 [95% CI 0.26–0.84], respectively). The omega‐6:omega‐3 FA ratio, but not omega‐6 FA alone, was directly associated with unacceptable pain and refractory pain (OR 1.70 [95% CI 1.03–2.82] and OR 2.33 [95% CI 1.28–4.24], respectively). Furthermore, polyunsaturated FAs were not associated with either inflammatory pain or CRP level and erythrocyte sedimentation rate at followup. Omega‐3 FA supplementation was not associated with any pain patterns.

Conclusion

Omega‐3 FA was inversely associated with, and the omega‐6:omega‐3 FA ratio was directly associated with, unacceptable and refractory pain, but not with inflammatory pain or systemic inflammation. The inverse association between omega‐3 FA and refractory pain may have a role in pain suppression in RA.

Vegan Nutrition for Mothers and Children: Practical Tools for Healthcare Providers

As the number of subjects choosing vegan diets increases, healthcare providers must be prepared to give the best advice to vegan patients during all stages of life. A completely plant-based diet is suitable during pregnancy, lactation, infancy, and childhood, provided that it is well-planned. Balanced vegan diets meet energy requirements on a wide variety of plant foods and pay attention to some nutrients that may be critical, such as protein, fiber, omega-3 fatty acids, iron, zinc, iodine, calcium, vitamin D, and vitamin B12. This paper contains recommendations made by a panel of experts from the Scientific Society for Vegetarian Nutrition (SSNV) after examining the available literature concerning vegan diets during pregnancy, breastfeeding, infancy, and childhood. All healthcare professionals should follow an approach based on the available evidence in regard to the issue of vegan diets, as failing to do so may compromise the nutritional status of vegan patients in these delicate periods of life.

The Role of Omega-3 Fatty Acids in the Setting of Coronary Artery Disease and COPD: A Review

Chronic obstructive pulmonary disease (COPD) is a growing healthcare concern and will represent the third leading cause of death worldwide within the next decade. COPD is the result of a complex interaction between environmental factors, especially cigarette smoking, air pollution, and genetic preconditions, which result in persistent inflammation of the airways. There is growing evidence that the chronic inflammatory state, measurable by increased levels of circulating cytokines, chemokines, and acute phase proteins, may not be confined to the lungs. Cardiovascular disease (CVD) and especially coronary artery disease (CAD) are common comorbidities of COPD, and low-grade systemic inflammation plays a decisive role in its pathogenesis. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) exert multiple functions in humans and are crucially involved in limiting and resolving inflammatory processes. n-3 PUFAs have been intensively studied for their ability to improve morbidity and mortality in patients with CVD and CAD. This review aims to summarize the current knowledge on the effects of n-3 PUFA on inflammation and its impact on CAD in COPD from a clinical perspective.