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Turner-McGrievy GM, Wilcox S, Frongillo EA, Kim Y, Okpara N, Wilson M. Differences in dietary acceptability, restraint, disinhibition, and hunger among African American participants randomized to either a vegan or omnivorous soul food diet. Appetite 2024; 196:107280. [PMID: 38373534 PMCID: PMC10966697 DOI: 10.1016/j.appet.2024.107280] [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: 11/13/2023] [Revised: 01/08/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
The Nutritious Eating with Soul study was a 24-month, randomized behavioral nutrition intervention among African American adults. This present study, which is a secondary analysis of the NEW Soul study, examined changes in dietary acceptability, restraint, disinhibition, and hunger. Participants (n = 159; 79% female, 74% with ≥ college degree, mean age 48.4 y) were randomized to either a soul food vegan (n = 77) or soul food omnivorous (n = 82) diet and participated in a two-year behavioral nutrition intervention. Questionnaires assessing dietary acceptability (Food Acceptability Questionnaire; FAQ) and dietary restraint, disinhibition, and hunger (Three-Factor Eating Questionnaire; TFEQ) were completed at baseline, 3, 6, 12, and 24 months. Mixed models were specified with main effects (group and time) and interaction effects (group by time) to estimate mean differences in FAQ and TFEQ scores using intent-to-treat analysis. After adjusting for employment, education, food security status, sex, and age, there were no differences in any of the FAQ items, total FAQ score, dietary restraint, disinhibition, and hunger at any timepoint except for one item of the FAQ at 12 months. Participants in the vegan group reported a greater increase in satisfaction after eating a meal than the omnivorous group (mean difference 0.80 ± 0.32, 95% CI 0.18, 1.42; P = 0.01). This is one of the first studies to examine differences in dietary acceptability, hunger, and other eating factors among African American adults randomized to either a vegan or omnivorous soul food diet. The findings highlight that plant-based eating styles are equally acceptable to omnivorous eating patterns and have similar changes in hunger, restraint, and disinhibition. These results suggest that plant-based eating styles can be an acceptable dietary pattern to recommend for cardiovascular disease prevention and may result in greater post-meal satisfaction.
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Affiliation(s)
- Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA; Prevention Research Center, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA.
| | - Sara Wilcox
- Prevention Research Center, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA
| | - Yesil Kim
- Prevention Research Center, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
| | - Nkechi Okpara
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA; Department of Psychiatry and Human Behavior, The Miriam Hospital and Warren Alpert Medical School of Brown University, Box G-M1, Providence, RI, 02912, USA
| | - Mary Wilson
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC 29208, USA; Prevention Research Center, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
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2
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Kahleova H, Znayenko-Miller T, Smith K, Khambatta C, Barbaro R, Sutton M, Holtz DN, Sklar M, Pineda D, Holubkov R, Barnard ND. Effect of a Dietary Intervention on Insulin Requirements and Glycemic Control in Type 1 Diabetes: A 12-Week Randomized Clinical Trial. Clin Diabetes 2024; 42:419-427. [PMID: 39015168 PMCID: PMC11247033 DOI: 10.2337/cd23-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
This study compared the effects of a low-fat vegan diet to those of a portion-controlled diet in people with type 1 diabetes. Over 12 weeks, the average total daily dose of insulin decreased significantly and insulin sensitivity increased significantly in the vegan group, while no significant changes were observed in the group receiving the portion-controlled diet. Total and LDL cholesterol decreased in the vegan group, as did the ratio of blood urea nitrogen to creatinine. A1C decreased in both groups. These findings suggest that a low-fat vegan diet may yield improvements in insulin sensitivity, insulin requirements, glycemic control, and markers of cardiovascular and renal health compared with a portion-controlled diet in people with type 1 diabetes.
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Affiliation(s)
- Hana Kahleova
- Physicians Committee for Responsible Medicine, Washington, DC
| | | | - Karen Smith
- Physicians Committee for Responsible Medicine, Washington, DC
| | | | | | - Macy Sutton
- Physicians Committee for Responsible Medicine, Washington, DC
| | | | - Mark Sklar
- Private Practice, Endocrinology, Diabetes & Metabolism, Washington, DC
| | - Desiree Pineda
- Private Practice, Internal Medicine and Endocrinology, Washington, DC
| | | | - Neal D. Barnard
- Physicians Committee for Responsible Medicine, Washington, DC
- George Washington University School of Medicine & Health Sciences, Washington, DC
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3
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Campbell EK, Taillie L, Blanchard LM, Wixom N, Harrington DK, Peterson DR, Wittlin SD, Campbell TM. Post hoc analysis of food costs associated with Dietary Approaches to Stop Hypertension diet, whole food, plant-based diet, and typical baseline diet of individuals with insulin-treated type 2 diabetes mellitus in a nonrandomized crossover trial with meals provided. Am J Clin Nutr 2024; 119:769-778. [PMID: 38160802 DOI: 10.1016/j.ajcnut.2023.12.023] [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: 09/05/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Americans consume diets that fall short of dietary recommendations, and the cost of healthier diets is often cited as a barrier to dietary change. We conducted a nonrandomized crossover trial with meals provided utilizing 2 diets: Dietary Approaches to Stop Hypertension (DASH) and whole food, plant-based (WFPB), and thus had intake data from baseline and both intervention diets. OBJECTIVES Using actual diet records, describe food costs of baseline diets of individuals with type 2 diabetes (T2DM) as well as therapeutic DASH and WFPB diets. METHODS Three-day food records were collected and analyzed for each 7-d diet phase: baseline, DASH, and WFPB. Nutrient content was analyzed using the Nutrient Data System for Research and cost was determined using Fillet, an application to manage menu pricing. Food costs were calculated for each diet as consumed and adjusted to a standardized 1800 kcal/d. Ingredient-only costs of food away from home (FAFH) were approximated and analyzed. Costs were analyzed using linear mixed-effect models as a function of diet. RESULTS Fifteen subjects enrolled; 12 completed all dietary phases. The baseline, DASH, and WFPB diets, as consumed, cost $15.72/d (95% CI; $13.91, $17.53), $12.74/d ($11.23, $14.25), and $9.78/d ($7.97, $11.59), respectively. When adjusted to an 1800 kcal/d intake, the baseline, DASH, and WFPB diets cost $15.69/d ($13.87, $17.52), $14.92/d ($13.59, $16.26), and $11.96/d ($10.14, $13.78), respectively. When approximated ingredient-only costs of FAFH were analyzed, as consumed baseline [$11.01 ($9.53, $12.49)] and DASH diets [$11.81 ($10.44, $13.18)] had similar costs; WFPB diet [$8.83 ($7.35, $10.31)] cost the least. CONCLUSIONS In this short-term study with meals provided, the food costs of plant-predominant diets offering substantial metabolic health benefits were less than or similar to baseline food costs of adults with insulin-treated T2DM. Longer-term data without meal provision are needed for more generalizable results. This trial was registered at clinicaltrials.gov as NCT04048642.
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Affiliation(s)
- Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, NY, United States.
| | - Laurie Taillie
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| | - Lisa M Blanchard
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, NY, United States
| | - Donald K Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, NY, United States
| | - Derick R Peterson
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, NY, United States
| | - Steven D Wittlin
- Division of Endocrinology, University of Rochester Medical Center, NY, United States
| | - Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
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Milligan MN, Duemling K, Radovanovic N, Alkozah M, Riblet N. Impacts of nutrition counseling on depression and obesity: A scoping review. Obes Rev 2023; 24:e13594. [PMID: 37357149 DOI: 10.1111/obr.13594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 04/09/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023]
Abstract
This scoping review aims to evaluate the impact of nutrition counseling on mental health and wellbeing among people affected by obesity. Depression and obesity are major sources of morbidity and mortality worldwide. The prevalence of obesity is higher in patients with severe or suboptimally managed depression. Change in dietary quality prompted by nutrition counseling may pose a unique opportunity for intervention. Of the 1745 studies identified, 26 studies (total n = 6727) met inclusion criteria. Due to the heterogeneity of methods and outcome reporting, it was not possible to perform meta-analysis. Across all included studies, 34 different scales were used to quantify mental health/wellbeing. Eleven studies (42.3%) reported statistically significant findings between intervention and control groups. Only two of these studies assessed nutrition counseling independently rather than as part of a multidisciplinary intervention. Overall, many studies have examined the role of nutrition counseling on mental health/wellbeing in individuals affected by obesity. However, due to inconsistency in study methodologies and outcome measurement tools, it is challenging to draw robust or clinically meaningful conclusions about the effects of nutrition counseling on mental health in this population.
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Affiliation(s)
- Meredith N Milligan
- Leadership Preventive Medicine Residency, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
- Department of Family Medicine, Concord Hospital, Concord, New Hampshire, USA
| | - Kathleen Duemling
- Leadership Preventive Medicine Residency, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Natasa Radovanovic
- Leadership Preventive Medicine Residency, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
- Department of Endocrinology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Maria Alkozah
- Leadership Preventive Medicine Residency, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
- Department of Infectious Disease, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Natalie Riblet
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
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5
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Massar RE, McMacken M, Kwok L, Joshi S, Shah S, Boas R, Ortiz R, Correa L, Polito-Moller K, Albert SL. Patient-Reported Outcomes from a Pilot Plant-Based Lifestyle Medicine Program in a Safety-Net Setting. Nutrients 2023; 15:2857. [PMID: 37447186 DOI: 10.3390/nu15132857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Lifestyle medicine interventions that emphasize healthy behavior changes are growing in popularity in U.S. health systems. Safety-net healthcare settings that serve low-income and uninsured populations most at risk for lifestyle-related disease are ideal venues for lifestyle medicine interventions. Patient-reported outcomes are important indicators of the efficacy of lifestyle medicine interventions. Past research on patient-reported outcomes of lifestyle medicine interventions has occurred outside of traditional healthcare care settings. In this study, we aimed to assess patient-reported outcomes on nutrition knowledge, barriers to adopting a plant-based diet, food and beverage consumption, lifestyle behaviors, self-rated health, and quality-of-life of participants in a pilot plant-based lifestyle medicine program in an urban safety-net healthcare system. We surveyed participants at three time points (baseline, 3 months, 6 months) to measure change over time. After 6 months of participation in the program, nutrition knowledge increased by 7.2 percentage points, participants reported an average of 2.4 fewer barriers to adopting a plant-based diet, the score on a modified healthful plant-based diet index increased by 5.3 points, physical activity increased by 0.7 days per week while hours of media consumption declined by 0.7 h per day, and the percentage of participants who reported that their quality of sleep was "good" or "very good" increased by 12.2 percentage points. Our findings demonstrate that a lifestyle medicine intervention in a safety-net healthcare setting can achieve significant improvements in patient-reported outcomes. Key lessons for other lifestyle medicine interventions include using a multidisciplinary team; addressing all pillars of lifestyle medicine; and the ability for patients to improve knowledge, barriers, skills, and behaviors with adequate support.
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Affiliation(s)
- Rachel E Massar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Michelle McMacken
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Lorraine Kwok
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Shivam Joshi
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Division of Nephrology, Department of Medicine, Veterans Affairs, Orlando, FL 32827, USA
| | - Sapana Shah
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
| | - Rebecca Boas
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Robin Ortiz
- Departments of Pediatrics and Population Health, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY 10016, USA
| | - Lilian Correa
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Krisann Polito-Moller
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Stephanie L Albert
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
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Pano O, Rincón MG, Bullón-Vela V, Aguilera-Buenosvinos I, Diaz ZR, Minder B, Kopp-Heim D, Laine-Carmeli J, Martínez González M, Martinez J, Sayón-Orea C. Eating behaviors and health-related quality of life: A scoping review. Maturitas 2022; 165:58-71. [DOI: 10.1016/j.maturitas.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 10/31/2022]
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Nakazeko T, Shobako N, Hirano Y, Nakamura F, Honda K. Novel dietary intervention program “COMB meal program” approaching health and presenteeism: Two pilot studies. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Brouwer AR, D'Souza C, Singaraju S, Arango-Soler LA. Value attitude behaviour and social stigma in the adoption of veganism: An integrated model. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jakše B. Placing a Well-Designed Vegan Diet for Slovenes. Nutrients 2021; 13:4545. [PMID: 34960098 PMCID: PMC8706043 DOI: 10.3390/nu13124545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 02/06/2023] Open
Abstract
Interest in vegan diets has increased globally as well as in Slovenia. The quantity of new scientific data requires a thorough synthesis of new findings and considerations about the current reserved position of the vegan diet in Slovenia. There is frequently confusion about the benefits of vegetarian diets that are often uncritically passed on to vegan diets and vice versa. This narrative review aims to serve as a framework for a well-designed vegan diet. We present advice on how to maximize the benefits and minimize the risks associated with the vegan diet and lifestyle. We highlight the proper terminology, present the health effects of a vegan diet and emphasize the nutrients of concern. In addition, we provide guidance for implementing a well-designed vegan diet in daily life. We conducted a PubMed search, up to November 2021, for studies on key nutrients (proteins, vitamin B12, vitamin D, omega-3 long chain polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), calcium, iron, zinc, iodine and selenium) in vegan diets. Given the limited amount of scientific evidence, we focus primarily on the general adult population. A well-designed vegan diet that includes a wide variety of plant foods and supplementation of vitamin B12, vitamin D in the winter months and potentially EPA/DHA is safe and nutritionally adequate. It has the potential to maintain and/or to improve health. For physically active adult populations, athletes or individuals with fast-paced lifestyles, there is room for further appropriate supplementation of a conventional vegan diet according to individuals' health status, needs and goals without compromising their health. A healthy vegan lifestyle, as included in government guidelines for a healthy lifestyle, includes regular physical activity, avoidance of smoking, restriction of alcohol and appropriate sleep hygiene.
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Affiliation(s)
- Boštjan Jakše
- Department of Food Science, Biotechnical Faculty, University of Ljubljana, SI-1000 Ljubljana, Slovenia
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10
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Kahleova H, Berrien-Lopez R, Holtz D, Green A, Sheinberg R, Gujral H, Holubkov R, Barnard ND. Nutrition for Hospital Workers During a Crisis: Effect of a Plant-Based Dietary Intervention on Cardiometabolic Outcomes and Quality of Life in Healthcare Employees During the COVID-19 Pandemic. Am J Lifestyle Med 2021; 16:399-407. [PMID: 35698577 PMCID: PMC9184832 DOI: 10.1177/15598276211050339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The study tested the effects of a vegan diet on cardiometabolic outcomes and quality of
life among healthcare employees during the COVID-19 pandemic. Overweight hospital
employees were enrolled and randomly assigned (in a 1:1 ratio) to an intervention group,
which was asked to follow a low-fat vegan diet, or a control group, asked to make no diet
changes. However, due to COVID-19 disruptions, all participants remained on their usual
diets from March to June (12 weeks), creating a de facto control period, and all (n = 12)
started the vegan diet with online classes in June, which continued for 12 weeks. Nine
participants completed all final assessments. A crossover ANOVA was used for statistical
analysis of differences in cardiovascular health during the control period and during the
intervention. Despite the ongoing crisis, body weight decreased (treatment effect −5.7 kg
[95% CI −9.7 to −1.7]; P = .01); fasting plasma glucose decreased
(−11.4 mg/dL [95% CI −18.8 to −4.1]; P = .007); total and LDL-cholesterol
decreased (−30.7 mg/dL [95% CI −53.8 to −7.5]; P = .02; and −24.6 mg/dL
[−44.8 to −4.3]; P = .02, respectively); diastolic blood pressure
decreased (−8.5 mm Hg [95% CI −16.3 to −.7]; P = .03); and quality of
life increased (P = .005) during the intervention period, compared with
the control period. A vegan diet improved cardiometabolic outcomes and quality of life in
healthcare workers at the height of the COVID-19 pandemic.
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Affiliation(s)
- Hana Kahleova
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Rickisha Berrien-Lopez
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Danielle Holtz
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Amber Green
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Rosanne Sheinberg
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Harpreet Gujral
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Richard Holubkov
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
| | - Neal D. Barnard
- Physicians Committee for Responsible Medicine, Washington, DC, USA, (HK, DH, AG, NDB); Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, USA, (NDB); University of Maryland School of Medicine, Baltimore City, MD, USA, (RBL); Sibley Memorial Hospital, Washington, DC, USA, (HG, RS); School of Medicine, University of Utah, Salt Lake City, UT, USA, (RH)
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Quality of Life of Vegetarians during the COVID-19 Pandemic in Brazil. Nutrients 2021; 13:nu13082651. [PMID: 34444808 PMCID: PMC8398275 DOI: 10.3390/nu13082651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 01/07/2023] Open
Abstract
Health emergencies such as the COVID-19 pandemic can negatively impact quality of life (QoL) due to higher levels of stress, social isolation, and uncertainties. In this scenario, distinct population groups might react differently. Vegetarians, who follow a non-conventional dietary pattern, could be more vulnerable to the abrupt changes in normal life routine and economic instability. Therefore, this study aimed at evaluating if the current pandemic situation somehow affected vegetarians' QoL. A cross-sectional study was carried out in Brazil between 28 July and 14 September 2020 to evaluate the QoL in vegetarians during the pandemic period. Vegetarian adults replied to an online survey that included the VEGQOL and WHOQOL-BREF instruments to evaluate QoL and questions related to the COVID-19 pandemic. A total of 1282 individuals participated. Only 3.8% had tested positive for COVID-19, but 39.9% affirmed having a family member who tested positive for the disease. Almost half (46.3%) of the sample had an income drop due to the pandemic. Results of QoL scores in the different subcategories of vegetarians were similar to previously published data. Individuals who had already tested positive for COVID-19 had lower QoL scores than those who did not test positive, but only in the VEGQOL. QoL was lower for the participants who declared that Sars-Cov-2 had already infected a family member for almost all the parameters evaluated. On the other hand, an income drop affected QoL only partially. Studying how vegetarians are influenced by such conditions contributes to the generation of relevant data that can be used to support healthcare and public policies in the future.
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Quality of Life of Brazilian Vegetarians Measured by the WHOQOL-BREF: Influence of Type of Diet, Motivation and Sociodemographic Data. Nutrients 2021; 13:nu13082648. [PMID: 34444816 PMCID: PMC8400525 DOI: 10.3390/nu13082648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/18/2021] [Accepted: 07/27/2021] [Indexed: 01/26/2023] Open
Abstract
This study aimed to evaluate the general quality of life (QoL) of Brazilian vegetarians. A cross-sectional study was conducted with Brazilian vegetarian adults (18 years old and above). Individuals were recruited to participate in a nationwide online survey that comprised the WHOQOL-BREF as well as sociodemographic and characterization questions related to vegetarianism. The WHOQOL-BREF is composed of 24 items which are divided into four domains (domain 1: physical health; domain 2: psychological well-being; domain 3: social relationships; and domain 4: environment), plus two general items which were analyzed separately, totaling 26 items. The answers from the questionnaire were converted into scores with a 0-100 scale range, with separate analyses for each domain. Results were compared among groups based on the different characteristics of the vegetarian population. A total of 4375 individuals completed the survey. General average score results were 74.67 (domain 1), 66.71 (domain 2), 63.66 (domain 3) and 65.76 (domain 4). Vegans showed better scores when compared to the other vegetarians, except in domain four, where the statistical difference was observed only for semi-vegetarians (lower score). Individuals adopting a vegetarian diet for longer (>1 year) showed better results for domains one and two, with no difference for the other domains. Having close people also adopting a vegetarian diet positively influenced the results for all domains. On the other hand, it was not possible to distinguish any clear influence of the motivation for adopting a vegetarian diet on the scores' results. Adopting a vegetarian diet does not have detrimental effects on one's QoL. In fact, the more plant-based the diet, and the longer it was adopted, the better the results were.
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Bansal S, Connolly M, Harder T. Impact of a Whole-Foods, Plant-Based Nutrition Intervention on Patients Living with Chronic Disease in an Underserved Community. Am J Lifestyle Med 2021; 16:382-389. [DOI: 10.1177/15598276211018159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The current study evaluated the impact of a whole-foods, plant-based nutrition intervention on metabolic markers of patients with chronic disease in an underserved community setting. A retrospective analysis of metabolic biomarkers preintervention and postintervention was conducted on 31 patients with metabolic disease who attended an Eating for Life group visit series. Significant decreases were found for body mass index (BMI; −0.66 [−0.91 to −0.40] kg/m2), systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol (−20 [−29 to −10] mg/dL), low-density lipoprotein (LDL; −11.6 [−17.5 to −5.5] mg/dL), and high-density lipoprotein (HDL; −3.2 [−5.7 to −0.7] mg/dL, all Ps < .01). In participants with clinically abnormal preintervention data, the mean (95% CI) change significantly decreased for overweight (−0.45 [−0.85 to −0.05]) and obese (−0.76 [−1.13 to −0.39]) BMI, systolic blood pressure (−12 [−19 to −5] mm Hg), total cholesterol −22 [−40 to −4] mg/dL), and LDL (−15.6 [−23.8 to −7.4] mg/dL, all Ps ≤ .03). In conclusion, the Eating for Life model showed significant improvement in BMI, diastolic blood pressure, total cholesterol, and LDL in a federally qualified health center population. Group visits advocating for a whole-foods, plant-based diet may be effective in reducing chronic disease burden in underserved communities.
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Affiliation(s)
- Shipra Bansal
- A.T. Still University, School of Osteopathic Medicine in Arizona, Mesa, Arizona
- North Country HealthCare, Flagstaff, Arizona
| | - Meaghan Connolly
- A.T. Still University, School of Osteopathic Medicine in Arizona, Mesa, Arizona
- North Country HealthCare, Flagstaff, Arizona
| | - Tasha Harder
- A.T. Still University, School of Osteopathic Medicine in Arizona, Mesa, Arizona
- North Country HealthCare, Flagstaff, Arizona
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Treasure M, Thomas A, Ganocy S, Hong A, Krishnamurthi SS, Bajor DL, Berger NA, Meropol NJ. A pilot study of a low glycemic load diet in patients with stage I-III colorectal cancer. J Gastrointest Oncol 2021; 12:910-920. [PMID: 34295544 DOI: 10.21037/jgo-20-330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/28/2021] [Indexed: 01/05/2023] Open
Abstract
Background Consumption of a diet with high glycemic indices has been associated with inferior cancer-specific outcomes in patients with early-stage colorectal cancer, but there is limited prospective evidence that alterations in dietary habits improves cancer outcomes. This study aimed to determine the feasibility and acceptability of following a low glycemic load (GL) diet in patients with stage I-III colorectal cancer. Methods Patients with stage I-III colorectal cancer, who completed definitive therapy, and consumed an average daily GL >150 participated in a 12-week tailored face-to-face dietary intervention with a target GL. This study followed a 2-stage design, with 4 planned cohorts, each with an assigned GL target and dietary intervention intensity. The primary endpoint of feasibility was determined by participant compliance, defined as an individual following the assigned GL ≥75% of the time. Compliance was determined using 24-hour telephone recalls. A cohort was deemed feasible if at least 67% of participants were compliant. Secondary endpoints included acceptability of the diet, nutritional support resources necessary to follow the diet, and evaluation of the effect of the diet on physical measures and correlative laboratories. Results Only cohort 1 was required as the primary endpoint of feasibility was met (stringent GL target, low intensity dietary support). The majority of participants experienced a decrease in body mass index (BMI) and waist circumference, 29% experiencing meaningful weight loss (≥5%). The dietitian spent an average of 6.97 hours (SD 2.18) face-to-face time and 1.58 hours (SD 0.68) by phone with each participant. Significant decreases were seen in total cholesterol, very-low-density lipoprotein (VLDL) and triglycerides (all P<0.05). All participants liked the foods and were satisfied with the diet. All participants felt the in-person meetings were helpful, and 62% did not feel a virtual meeting (e.g., Skype, etc.) could replace in-person meetings. Conclusions Patients with stage I-III colorectal cancer can follow a low GL diet with a 12-week in-person dietary intervention. Significant changes in physical and laboratory measures suggest relevant biologic effects of the dietary intervention. This study establishes feasibility, and warrants a larger scale prospective intervention trial to evaluate the impact of a low GL diet on cancer outcomes.
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Affiliation(s)
- Michelle Treasure
- Department of Medicine, Division of Hematology and Oncology, Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland Clinic Learner College of Medicine, Cleveland, OH, USA
| | - Alicia Thomas
- Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Stephen Ganocy
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Augustine Hong
- Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Smitha S Krishnamurthi
- Department of Medicine, Division of Hematology and Oncology, Cleveland Clinic Foundation, Case Comprehensive Cancer Center, Cleveland Clinic Learner College of Medicine, Cleveland, OH, USA
| | - David L Bajor
- Department of Medicine, Division of Hematology and Oncology, University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nathan A Berger
- Department of Medicine, Division of Hematology and Oncology, University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Neal J Meropol
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Flatiron Health, Inc., New York, NY, USA
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15
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Hargreaves SM, Raposo A, Saraiva A, Zandonadi RP. Vegetarian Diet: An Overview through the Perspective of Quality of Life Domains. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4067. [PMID: 33921521 PMCID: PMC8069426 DOI: 10.3390/ijerph18084067] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 12/16/2022]
Abstract
Vegetarianism has gained more visibility in recent years. Despite the well-described effects of a vegetarian diet on health, its influence on the quality of life of the individuals who follow it still needs to be properly investigated. Quality of life relates to a subjective perception of well-being and functionality, and encompasses four main life domains: physical, psychological, social, and environmental. The adoption of a vegetarian diet, despite being a dietary pattern, could potentially influence and be influenced by all of these domains, either positively or negatively. This review aims to present an overview of the background, conceptualization, features, and potential effects of vegetarianism in all quality of life domains. The choice of adopting a vegetarian diet could have positive outcomes, such as better physical health, positive feelings related to the adoption of a morally correct attitude, an increased sense of belonging (to a vegetarian community), and lower environmental impact. Other factors, however, could have a negative impact on the quality of life of those choosing to abstain from meats or other animal products, especially when they go beyond one's control. These include the environment, the social/cultural group in which a person is inserted, gender-based differences, economic aspects, and a limited access to a wide variety of plant-based foods. It is important to understand all the effects of adopting a vegetarian diet-beyond its nutritional aspects. Not only do studies in this area provide more consistent data, but they may also contribute to mitigating all factors that might prevent individuals from adopting a vegetarian diet, or that may have a negative impact on the quality of life of those who already follow it.
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Affiliation(s)
- Shila Minari Hargreaves
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF 70910-900, Brazil;
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Ariana Saraiva
- Department of Animal Pathology and Production, Bromatology and Food Technology, Faculty of Veterinary, Universidad de Las Palmas de Gran Canaria, Trasmontaña s/n, 35413 Arucas, Spain;
| | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia, DF 70910-900, Brazil;
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Iguacel I, Huybrechts I, Moreno LA, Michels N. Vegetarianism and veganism compared with mental health and cognitive outcomes: a systematic review and meta-analysis. Nutr Rev 2021; 79:361-381. [PMID: 32483598 DOI: 10.1093/nutrit/nuaa030] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Vegetarian and vegan diets are increasing in popularity. Although they provide beneficial health effects, they may also lead to nutritional deficiencies. Cognitive impairment and mental health disorders have a high economic burden. OBJECTIVE A meta-analysis was conducted to examine the relationship between vegan or vegetarian diets and cognitive and mental health. DATA SOURCES PubMed, Scopus, ScienceDirect, and Proquest databases were examined from inception to July 2018. STUDY SELECTION Original observational or interventional human studies of vegan/vegetarian diets were selected independently by 2 authors. DATA EXTRACTION Raw means and standard deviations were used as continuous outcomes, while numbers of events were used as categorical outcomes. RESULTS Of 1249 publications identified, 13 were included, with 17 809 individuals in total. No significant association was found between diet and the continuous depression score, stress, well-being, or cognitive impairment. Vegans/vegetarians were at increased risk for depression (odds ratio = 2.142; 95%CI, 1.105-4.148) and had lower anxiety scores (mean difference = -0.847; 95%CI, -1.677 to -0.018). Heterogeneity was large, and thus subgroup analyses showed numerous differences. CONCLUSIONS Vegan or vegetarian diets were related to a higher risk of depression and lower anxiety scores, but no differences for other outcomes were found. Subgroup analyses of anxiety showed a higher risk of anxiety, mainly in participants under 26 years of age and in studies with a higher quality. More studies with better overall quality are needed to make clear positive or negative associations. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42018097204.
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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
- CIBERObn (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición), Zaragoza, Spain
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium; and the International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - 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; the Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- CIBERObn (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición) , Zaragoza, Spain
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Drewnowski A. Impact of nutrition interventions and dietary nutrient density on productivity in the workplace. Nutr Rev 2020; 78:215-224. [PMID: 31889196 DOI: 10.1093/nutrit/nuz088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The global spread of diet-related noncommunicable diseases represents a threat to public health and national economies alike. The elimination of poverty and the eradication of hunger, two key United Nations Sustainable Development Goals, cannot be accomplished without a well-nourished labor force. Easy access to low-cost diets that are energy dense but nutrient poor has resulted in hidden hunger, in which micronutrient deficiencies coexist with obesity or overweight. Workplace interventions in low- and middle-income countries have addressed nutrient adequacy and micronutrient deficiencies, often using fortified foods. Workplace interventions in high-income countries have largely focused on weight loss, smoking cessation, stress reduction, and physical activity. Even though improvement of productivity may have been the ultimate goal, relatively few interventions in high-income countries have explored the likely impact of improved dietary nutrient density on workplace performance. Given that optimal nutrition benefits both physical and mental health, interventions to improve diet quality ought to have a measurable impact on the productivity of the labor force. The present review examines the evidence linking workplace dietary interventions with workplace productivity measures.
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Affiliation(s)
- Adam Drewnowski
- A. Drewnowski is with the Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
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18
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Hargreaves SM, Nakano EY, Zandonadi RP. Brazilian Vegetarian Population-Influence of Type of Diet, Motivation and Sociodemographic Variables on Quality of Life Measured by Specific Tool (VEGQOL). Nutrients 2020; 12:E1406. [PMID: 32422862 PMCID: PMC7284834 DOI: 10.3390/nu12051406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022] Open
Abstract
The adoption of a vegetarian diet has been associated with positive health outcomes. However, few studies evaluate the effect of this eating pattern on quality of life. Moreover, no specific instrument for the vegetarian population to measure the quality of life is available worldwide. Therefore, this study aimed to elaborate and validate a specific questionnaire to measure the quality of life in vegetarians. The Specific Vegetarian Quality of Life Questionnaire (VEGQOL) was constructed based on other instruments and studies related to vegetarianism. The content and semantic validation were performed by a group of experts, followed by a pilot study to evaluate the questionnaire acceptability and reproducibility. Discriminant validation was tested using the WHOQOL as the gold standard measure (Pearson correlation ranging from 0.302 of the domain 3 to 0.392 of the domain 2). Afterward, a nationwide survey was conducted using VEGQOL. Content and semantic validation selected 19 of the initial 30 items. VEGQOL presented good reproducibility (Cohen's Kappa coefficient ranging from 0.361 to 0.730 and intraclass correlation coefficient of 0.820) and internal consistency (0.708), both adequate to evaluate the quality of life in vegetarians. The sample size (n = 5014 individuals, error of 3% at a level of significance of 5%) and distribution was representative of the Brazilian vegetarian population. In general, the quality of life of Brazilian vegetarians was considered satisfactory (VEGQOL cut off points 70-80). Among different types of vegetarians, the vegans showed better results with a VEGQOL mean value of 79.2 ± 10.7. Older individuals, the ones who adopted the diet for a longer time (VEGQOL mean value of 75.8 ± 12.7) and the ones who had other vegetarians in their social network (VEGQOL mean value of 74.6 ± 12.2) also had a better quality of life score. Individuals who adopted it for ethical or health reasons had a higher quality of life score. The questionnaire produced in this study is a useful tool for future research in this area. Results were better for vegans and for the ones who adopt the diet for ethical or health reasons.
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Affiliation(s)
- Shila Minari Hargreaves
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia DF 70910-900, Brazil;
| | | | - Renata Puppin Zandonadi
- Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Darcy Ribeiro, Asa Norte, Brasilia DF 70910-900, Brazil;
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Chester B, Babu JR, Greene MW, Geetha T. The effects of popular diets on type 2 diabetes management. Diabetes Metab Res Rev 2019; 35:e3188. [PMID: 31121637 DOI: 10.1002/dmrr.3188] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/09/2019] [Accepted: 05/17/2019] [Indexed: 12/23/2022]
Abstract
Type 2 diabetes can be managed with the use of diabetes self-management skills. Diet and exercise are essential segments of the lifestyle changes necessary for diabetes management. However, diet recommendations can be complicated in a world full of different diets. This review aims to evaluate the evidence on the effects of three popular diets geared towards diabetes management: low-carbohydrate and ketogenic diet, vegan diet, and the Mediterranean diet. While all three diets have been shown to assist in improving glycaemic control and weight loss, patient adherence, acceptability, and long-term manageability play essential roles in the efficacy of each diet.
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Affiliation(s)
- Brittannie Chester
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, Alabama
| | - Jeganathan Ramesh Babu
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, Alabama
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, Alabama
- Center for Neuroscience Initiative, Auburn University, Auburn, Alabama
| | - Michael W Greene
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, Alabama
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, Alabama
- Center for Neuroscience Initiative, Auburn University, Auburn, Alabama
| | - Thangiah Geetha
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, Alabama
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, Alabama
- Center for Neuroscience Initiative, Auburn University, Auburn, Alabama
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20
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Glenn AJ, Viguiliouk E, Seider M, Boucher BA, Khan TA, Blanco Mejia S, Jenkins DJA, Kahleová H, Rahelić D, Salas-Salvadó J, Kendall CWC, Sievenpiper JL. Relation of Vegetarian Dietary Patterns With Major Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Front Nutr 2019; 6:80. [PMID: 31263700 PMCID: PMC6585466 DOI: 10.3389/fnut.2019.00080] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 05/16/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Vegetarian dietary patterns are recommended for cardiovascular disease (CVD) prevention and management due to their favorable effects on cardiometabolic risk factors, however, the role of vegetarian dietary patterns in CVD incidence and mortality remains unclear. Objective: To update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we undertook a systematic review and meta-analysis of the association of vegetarian dietary patterns with major cardiovascular outcomes in prospective cohort studies that included individuals with and without diabetes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Methods: MEDLINE, EMBASE, and Cochrane databases were searched through September 6th, 2018. We included prospective cohort studies ≥1 year of follow-up including individuals with or without diabetes reporting the relation of vegetarian and non-vegetarian dietary patterns with at least one cardiovascular outcome. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). The pre-specified outcomes included CVD incidence and mortality (total CVD, coronary heart disease (CHD) and stroke). Risk ratios for associations were pooled using inverse variance random effects model and expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2-statistic). The overall certainty of the evidence was assessed using GRADE. Results: Seven prospective cohort studies (197,737 participants, 8,430 events) were included. A vegetarian dietary pattern was associated with reduced CHD mortality [RR, 0.78 (CI, 0.69, 0.88)] and incidence [0.72 (0.61, 0.85)] but were not associated with CVD mortality [0.92 (0.84, 1.02)] and stroke mortality [0.92 (0.77, 1.10)]. The overall certainty of the evidence was graded as “very low” for all outcomes, owing to downgrades for indirectness and imprecision. Conclusions: Very low-quality evidence indicates that vegetarian dietary patterns are associated with reductions in CHD mortality and incidence but not with CVD and stroke mortality in individuals with and without diabetes. More research, particularly in different populations, is needed to improve the certainty in our estimates. Clinical Trial Registration:Clinicaltrials.gov, identifier: NCT03610828.
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Affiliation(s)
- Andrea J Glenn
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Effie Viguiliouk
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Maxine Seider
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Tauseef A Khan
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hana Kahleová
- Physicians Committee for Responsible Medicine, Washington, DC, United States.,Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Dario Rahelić
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain.,Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Cyril W C Kendall
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
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21
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Mori K, Mori T, Nagata T, Nagata M, Iwasaki M, Sakai H, Kimura K, Shinzato N. Factors of occurrence and improvement methods of presenteeism attributed to diabetes: A systematic review. J Occup Health 2019; 61:36-53. [PMID: 30698334 PMCID: PMC6499359 DOI: 10.1002/1348-9585.12034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/11/2018] [Indexed: 01/22/2023] Open
Abstract
Objective A systematic review was performed to study factors of occurrence and improvement methods of presenteeism attributed to diabetes. Methods We set 2 clinical questions; (a) how comorbidities and complications of diabetes induce presenteeism and (b) what interventions or conditions effectively improve presenteeism. Then, we conducted a comprehensive search with MEDLINE/PubMed and Scopus databases and extracted those that met the clinical questions. Results Eighteen papers studied occurrence of presenteeism by comorbidities and complications of diabetes. Most studies were cross‐sectional and had a low quality of evidence. However, the associations of hypoglycemia, diabetic neuropathy, and mood disorders with presenteeism were relatively well studied. The papers that discussed effective interventions or conditions for improving presenteeism were very limited. Conclusions Our review suggests that presenteeism attributed to diabetes is mainly caused by hypoglycemia, diabetic neuropathy, and mood disorders. There are very limited evidences, but available information suggests that improving glycemic control, adjusting treatment regimen by evaluating the impact on work, providing psychological support, and developing suitable work accommodations may effectively reduce presenteeism.
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Affiliation(s)
- Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takahiro Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masako Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mahoko Iwasaki
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroki Sakai
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koki Kimura
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Natsumi Shinzato
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Littlejohn P, Cop I, Brown E, Afroze R, Davison KM. Comparison of Nutrigenomics Technology Interface Tools for Consumers and Health Professionals: Protocol for a Mixed-Methods Study. JMIR Res Protoc 2018; 7:e115. [PMID: 29891470 PMCID: PMC6018240 DOI: 10.2196/resprot.9846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/24/2018] [Accepted: 02/24/2018] [Indexed: 01/03/2023] Open
Abstract
Background Although nutrition interventions are a widely accepted resource for the prevention of long-term health conditions, current approaches have not adequately reduced chronic disease morbidity. Nutrigenomics has great potential; however, it is complicated to implement. There is a need for products based on nutrition-related gene test results that are easily understood, accessible, and used. Objective The primary objective of this study was to compare a nonpractitioner-assisted direct-to-consumer self-driven approach to nutrigenomics versus an integrated and personalized practitioner-led method. Methods This 4-month study used a mixed-methods design that included (1) a phase 1 randomized controlled trial that examined the effectiveness of a multifaceted, nutrition-based gene test (components assessed included major nutrients, food tolerances, food taste and preferences, and micronutrients) in changing health behaviors, followed by (2) a qualitative investigation that explored participants’ experiences. The study recruited 55 healthy males and females (aged 35-55 years) randomized as a 2:1 ratio where 36 received the intervention (gene test results plus integrated and personalized nutrition report) and 19 were assigned to the control group (gene test results report emailed). The primary outcomes of interest measures included changes in diet (nutrients, healthy eating index), changes in measures on General Self-efficacy and Health-Related Quality of Life scales, and anthropometrics (body mass index, waist-to-hip ratio) measured at baseline, post intervention (3 and 6 weeks), and the final visit (week 9 post intervention). Results Of the 478 individuals who expressed interest, 180 were invited (37.7%, 180/478) and completed the eligibility screening questionnaire; 73 of the 180 invited individuals (40.5%) were deemed eligible. Of the 73 individuals who were deemed to be eligible, 58 completed the baseline health questionnaire and food records (79%). Of these 58 individuals, 3 were excluded either because they did not complete all required data collection forms or were later found to be ineligible. The final sample (n=55) was mostly female (75%), married (85%), and those who had completed postsecondary education (62%). Conclusions This study will leverage quantitative and qualitative findings, which will guide the development of nutrigenomics-based products in electronic formats that are user-friendly for consumers and health professionals. Although the quantitative data have not been analyzed yet, the overwhelming interest in the study and the extremely high retention rate show that there is a great degree of interest in this field. Given this interest and the fact that nutrigenomics is an evolving science, a need for continued research exists to further the understanding of the role of genetic variation and its role and applications in nutrition practice. Trial Registration Clinicaltrials.gov NCT03310814; http://clinicaltrials.gov/ct2/show/NCT03310814 (Archived by WebCite at http://www.webcitation.org/6yGnU5deB) Registered Report Identifier RR1-10.2196/9846
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Affiliation(s)
- Paula Littlejohn
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada.,Health Science, Department of Biology, Kwantlen Polytechnic University, Surrey, BC, Canada
| | - Irene Cop
- Health Science, Department of Biology, Kwantlen Polytechnic University, Surrey, BC, Canada
| | - Erin Brown
- Health Science, Department of Biology, Kwantlen Polytechnic University, Surrey, BC, Canada.,Fraser Health Authority, Surrey, BC, Canada.,Vancouver Coastal Health, Vancouver, BC, Canada
| | - Rimi Afroze
- Health Science, Department of Biology, Kwantlen Polytechnic University, Surrey, BC, Canada
| | - Karen M Davison
- Health Science, Department of Biology, Kwantlen Polytechnic University, Surrey, BC, Canada.,Department of Psychology, University of Hawai`i at Mānoa, Honolulu, HI, United States
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Abstract
Cardiovascular (CV) disease (CVD) is the leading global cause of mortality, being responsible for 46% of non-communicable disease deaths. It has been estimated that about 85.6 million Americans are living with some form of CVD, which continues to rise. Healthy lifestyle choices may reduce the risk of myocardial infarction by >80%, with nutrition playing a key role. Vegetarian dietary patterns reduce CVD mortality and the risk of coronary heart disease (CHD) by 40%. Plant-based diets are the only dietary pattern to have shown reversal of CHD. Additionally, evidence suggests benefits of vegetarian dietary patterns in both the prevention and the treatment of heart failure and cerebrovascular disease. Plant-based diets are associated with lower blood pressure, lower blood lipids, and reduced platelet aggregation than non-vegetarian diets and are beneficial in weight management, reduce the risk of developing metabolic syndrome, and type 2 diabetes. They have also been shown an effective treatment method in diabetes management. Well planned vegetarian diets provide benefits in preventing and reversing atherosclerosis and in decreasing CVD risk factors and should be promoted through dietary guidelines and recommendations.
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Forestell CA, Nezlek JB. Vegetarianism, depression, and the five factor model of personality. Ecol Food Nutr 2018; 57:246-259. [DOI: 10.1080/03670244.2018.1455675] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Catherine A. Forestell
- Department of Psychological Sciences, The College of William & Mary, Williamsburg, VA, USA
| | - John B. Nezlek
- Department of Psychological Sciences, The College of William & Mary, Williamsburg, VA, USA
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Poznań, Poland
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van Wietmarschen HA, Wortelboer HM, van der Greef J. Grip on health: A complex systems approach to transform health care. J Eval Clin Pract 2018; 24:269-277. [PMID: 28032412 DOI: 10.1111/jep.12679] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 07/13/2016] [Accepted: 10/26/2016] [Indexed: 11/29/2022]
Abstract
This article addresses the urgent need for a transition in health care to deal with the increasing prevalence of chronic diseases and associated rapid rise of health care costs. Chronic diseases evolve and are predominantly related to lifestyle and environment. A shift is needed from a reductionist repair mode of thinking, toward a more integrated biopsychosocial way of thinking about health. The aim of this article is to discuss the opportunities that complexity science offer for transforming health care toward optimal treatment and prevention of chronic lifestyle diseases. Health and health care is discussed from a complexity science perspective. The benefits of concepts developed in the field of complexity science for stimulating transitions in health care are explored. Complexity science supports the elucidation of the essence of health processes. It provides a unique perspective on health with a focus on the relationships within networks of dynamically interacting factors and the emergence of health out of the organization of those relationships. Novel types of complexity science-based intervention strategies are being developed. The first application in practice is the integrated obesity treatment program currently piloted in the Netherlands, focusing on health awareness and healing relationships. Complexity science offers various theories and methods to capture the path toward unhealthy and healthy states, facilitating the development of a dynamic integrated biopsychosocial perspective on health. This perspective offers unique insights into health processes for patients and citizens. In addition, dynamic models driven by personal data provide simulations of health processes and the ability to detect transitions between health states. Such models are essential for aligning and reconnecting the many institutions and disciplines involved in the health care sector and evolve toward an integrated health care ecosystem.
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Affiliation(s)
- Herman A van Wietmarschen
- Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands
| | - Heleen M Wortelboer
- Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands
| | - Jan van der Greef
- Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands
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Toumpanakis A, Turnbull T, Alba-Barba I. Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: a systematic review. BMJ Open Diabetes Res Care 2018; 6:e000534. [PMID: 30487971 PMCID: PMC6235058 DOI: 10.1136/bmjdrc-2018-000534] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/28/2018] [Accepted: 07/08/2018] [Indexed: 02/06/2023] Open
Abstract
Diet interventions have suggested an association between plant-based diets and improvements in psychological well-being, quality of life and glycated hemoglobin (HbA1c) control in populations with diabetes. The aims of this review are to systematically analyze the available literature on plant-based diet interventions targeting diabetes in adults and to clearly define the benefits on well-being of such interventions. This is a systematic review of controlled trials. A computerized systematic literature search was conducted in the following electronic databases: Allied and Complementary Medicine, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, E-Journals, Excerpta Medica Database, MEDLINE, Health Management Information Consortium, PsycARTICLES, PsycINFO, PubMed, SocINDEX and Web of Science. The search strategy retrieved 1240 articles, of which 11 met the inclusion criteria (n=433; mean sample age 54.8 years). Plant-based diets were associated with significant improvement in emotional well-being, physical well-being, depression, quality of life, general health, HbA1c levels, weight, total cholesterol and low-density lipoprotein cholesterol, compared with several diabetic associations' official guidelines and other comparator diets. Plant-based diets can significantly improve psychological health, quality of life, HbA1c levels and weight and therefore the management of diabetes.
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Affiliation(s)
| | - Triece Turnbull
- Faculty of Health and Society, University of Northampton, Northampton, UK
| | - Isaura Alba-Barba
- Department of Cardiology, East Sussex NHS Healthcare Trust, Saint Leonards-on-Sea, UK
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Hibbeln JR, Northstone K, Evans J, Golding J. Vegetarian diets and depressive symptoms among men. J Affect Disord 2018; 225:13-17. [PMID: 28777971 DOI: 10.1016/j.jad.2017.07.051] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vegetarian diets are associate with cardiovascular and other health benefits, but little is known about mental health benefits or risks. AIMS To determine whether self-identification of vegetarian dietary habits is associated with significant depressive symptoms in men. METHOD Self-report data from 9668 adult male partners of pregnant women in the Avon Longitudinal Study of Parents and Children (ALSPAC) included identification as vegetarian or vegan, dietary frequency data and the Edinburgh Post Natal Depression Scale (EPDS). Continuous and binary outcomes were assessed using multiple linear and logistic regression taking account of potential confounding variables including: age, marital status, employment status, housing tenure, number of children in the household, religion, family history of depression previous childhood psychiatric contact, cigarette and alcohol consumption. RESULTS Vegetarians [n = 350 (3.6% of sample)], had higher depression scores on average than non-vegetarians (mean difference 0.96 points [95%CI + 0.53, + 1.40]) and a greater risk for EPDS scores above 10 (adjusted OR = 1.67 [95% CI: 1.14,2.44]) than non-vegetarians after adjustment for potential confounding factors. CONCLUSIONS Vegetarian men have more depressive symptoms after adjustment for socio-demographic factors. Nutritional deficiencies (e.g. in cobalamin or iron) are a possible explanation for these findings, however reverse causation cannot be ruled out.
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Affiliation(s)
- Joseph R Hibbeln
- Section on Nutritional Neurosciences, National Institute on Alcohol Abuse and Alcoholism, NIH, Rockville, MD, USA.
| | - Kate Northstone
- School of Social and Community Medicine, University of Bristol, UK
| | - Jonathan Evans
- School of Social and Community Medicine, University of Bristol, UK
| | - Jean Golding
- School of Social and Community Medicine, University of Bristol, UK
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Null G, Pennesi L. Diet and lifestyle intervention on chronic moderate to severe depression and anxiety and other chronic conditions. Complement Ther Clin Pract 2017; 29:189-193. [DOI: 10.1016/j.ctcp.2017.09.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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Kahleova H, Levin S, Barnard N. Cardio-Metabolic Benefits of Plant-Based Diets. Nutrients 2017; 9:nu9080848. [PMID: 28792455 PMCID: PMC5579641 DOI: 10.3390/nu9080848] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 07/30/2017] [Accepted: 08/03/2017] [Indexed: 12/26/2022] Open
Abstract
Cardio-metabolic disease, namely ischemic heart disease, stroke, obesity, and type 2 diabetes, represent substantial health and economic burdens. Almost one half of cardio-metabolic deaths in the U.S. might be prevented through proper nutrition. Plant-based (vegetarian and vegan) diets are an effective strategy for improving nutrient intake. At the same time, they are associated with decreased all-cause mortality and decreased risk of obesity, type 2 diabetes, and coronary heart disease. Evidence suggests that plant-based diets may reduce the risk of coronary heart disease events by an estimated 40% and the risk of cerebral vascular disease events by 29%. These diets also reduce the risk of developing metabolic syndrome and type 2 diabetes by about one half. Properly planned vegetarian diets are healthful, effective for weight and glycemic control, and provide metabolic and cardiovascular benefits, including reversing atherosclerosis and decreasing blood lipids and blood pressure. The use of plant-based diets as a means of prevention and treatment of cardio-metabolic disease should be promoted through dietary guidelines and recommendations.
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Affiliation(s)
- Hana Kahleova
- Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, N.W. Ste.400, Washington, DC 20016, USA.
| | - Susan Levin
- Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, N.W. Ste.400, Washington, DC 20016, USA.
| | - Neal Barnard
- Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, N.W. Ste.400, Washington, DC 20016, USA.
- George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA.
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Rosenfeld DL, Burrow AL. The unified model of vegetarian identity: A conceptual framework for understanding plant-based food choices. Appetite 2017; 112:78-95. [DOI: 10.1016/j.appet.2017.01.017] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 01/15/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
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Abstract
Despite its nutritional benefits, there is an increasing body of evidence to suggest that regular consumption of red meat may negatively impact health and disease risk, including the risk of most common chronic diseases. This chapter reviews the current evidence linking red and processed meat intakes with chronic disease, obesity and mortality risks and discusses possible mechanisms to explain these associations. Research on the health benefits of diets low in red meat, including vegetarian, vegan, Mediterranean and other plant-based diets, is also reviewed.
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Affiliation(s)
- Kate Marsh
- Northside Nutrition and Dietetics, Australia
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Wolever TMS, Chiasson JL, Josse RG, Leiter LA, Maheux P, Rabasa-Lhoret R, Rodger NW, Ryan EA. Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD). Can J Diabetes 2016; 41:164-176. [PMID: 27884550 DOI: 10.1016/j.jcjd.2016.08.223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 07/20/2016] [Accepted: 08/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes. METHODS Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index (HGI) diets; high-carbohydrate/low-glycemic-index (LGI) diets; or lower-carbohydrate/high-monounsaturated-fat (LC) diets for 1 year. We measured QOL at baseline and at study's end, and we measured symptoms and dietary satisfaction quarterly. RESULTS The HGI, LGI and LC diets contained, respectively, 47±1, 52±1 and 40±1% energy carbohydrate; 30±1, 27±1 and 40±1% fat with GI 64±0.4, 55±0.4 and 59±0.4. Significantly more participants reported increased flatulence on LGI than on LC and HGI diets at 3 months (41%, 19%, 14%; p<0.05), but not at 12 months (29%, 17%, 17%; ns). Abdominal distension was more severe (46% vs. 14%, 19%; p<0.05), and headache less severe (8% vs. 22%, 23%; p<0.05) on LGI than on both other diets. Increased appetite was more severe on LC (33%) than on HGI diets (14%, p<0.05). Joint/limb pains were less severe on LGI (16%) than HGI (28%) diets. LC elicited more severe gloomy thoughts (23%) than LGI (4%; p<0.05) but greater dietary-satisfaction (70%; p<0.05) than LGI (40%) and HGI (48%) diets. For all diets, glycated hemoglobin (A1C) levels increased less in those who gained less weight, had less increased appetite and were more satisfied with the enjoyment obtained from eating. CONCLUSIONS Each diet elicited increased severity of 1 or more symptoms than the other diets. Although overall dietary satisfaction was greater on the 40% carbohydrate diet than on the 50% carbohydrate diet, the LGI diet was no less satisfying than the HGI diet. Changes in appetite and dietary satisfaction may influence body weight and glycemic control, or vice-versa.
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Affiliation(s)
- Thomas M S Wolever
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Jean-Louis Chiasson
- Research Center (CHUM) Hôtel-Dieu de Montréal, University of Montréal, Montréal, Québec, Canada
| | - Robert G Josse
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Pierre Maheux
- Department of Medicine, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Rémi Rabasa-Lhoret
- IRCM (Institut de Recherches Cliniques de Montréal), Montréal, Québec, Canada
| | - N Wilson Rodger
- Department of Medicine, St. Joseph's Health Centre, Western University, London, Ontario, Canada
| | - Edmond A Ryan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Abstract
Despite its nutritional benefits, there is an increasing body of evidence to suggest that regular consumption of red meat may negatively impact health and disease risk, including the risk of most common chronic diseases. This chapter reviews the current evidence linking red and processed meat intakes with chronic disease, obesity and mortality risks and discusses possible mechanisms to explain these associations. Research on the health benefits of diets low in red meat, including vegetarian, vegan, Mediterranean and other plant-based diets, is also reviewed.
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Affiliation(s)
- Kate Marsh
- Northside Nutrition and Dietetics, Australia
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Barnard ND, Levin SM, Yokoyama Y. A Systematic Review and Meta-Analysis of Changes in Body Weight in Clinical Trials of Vegetarian Diets. J Acad Nutr Diet 2015; 115:954-69. [DOI: 10.1016/j.jand.2014.11.016] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 11/19/2014] [Indexed: 11/24/2022]
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Ruano-Rodríguez C, Serra-Majem L, Dubois D. Assessing the impact of dietary habits on health-related quality of life requires contextual measurement tools. Front Pharmacol 2015; 6:101. [PMID: 26005420 PMCID: PMC4424859 DOI: 10.3389/fphar.2015.00101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/23/2015] [Indexed: 12/11/2022] Open
Abstract
The increase of non-communicable diseases at all ages has fostered the general concern for sustaining population health worldwide. Unhealthy lifestyles and dietary habits impacting physical and psycho-social health are well known risk factors for developing life threatening diseases. Identifying the determinants of quality of life is an important task from a Public Health perspective. Consumer-Reported Outcome measures of health-related quality of life (HRQoL) are becoming increasingly necessary and relevant in the field of nutrition. However, quality of life questionnaires are seldom used in the nutrition field. We conducted a scientific literature search to find out the questionnaires used to determine the association between dietary habits and quality of life. A total of 13 studies were eligible for inclusion. Across these studies the short form-36, a generic (non-disease specific) HRQoL measurement instrument was the most widely used. However, generic measures may have limited content validity in the context of dietary habits interventions. We recommend additional contextual diet-specific HRQoL measures are also needed for evaluating the impact of diet habits on daily life functioning and well-being.
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Affiliation(s)
- Cristina Ruano-Rodríguez
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain ; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III , Madrid, Spain
| | - Lluis Serra-Majem
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain ; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III , Madrid, Spain
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Kahleova H, Pelikanova T. Vegetarian Diets in the Prevention and Treatment of Type 2 Diabetes. J Am Coll Nutr 2015; 34:448-58. [DOI: 10.1080/07315724.2014.976890] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Awareness and perception of plant-based diets for the treatment and management of type 2 diabetes in a community education clinic: a pilot study. J Nutr Metab 2015; 2015:236234. [PMID: 25802755 PMCID: PMC4329824 DOI: 10.1155/2015/236234] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/08/2015] [Indexed: 11/18/2022] Open
Abstract
Objective. To assess awareness, barriers, and promoters of plant-based diet use for management of type 2 diabetes (T2D) for the development of an appropriate educational program. Design. Cross-sectional study of patients and healthcare providers. Setting. Regional Diabetes Education Centre in ON, Canada. Participants. n = 98 patients attending the Diabetes Education Centre and n = 25 healthcare providers. Variables Measures. Patient questionnaires addressed demographics, health history, and eating patterns, as well as current knowledge, confidence levels, barriers to, promoters of, and interests in plant-based diets. Staff questionnaires addressed attitudes and current practice with respect to plant-based diets. Analysis. Mean values, frequency counts, and logistic regression (alpha = 0.05). Results. Few respondents (9%) currently followed a plant-based diet, but 66% indicated willingness to follow one for 3 weeks. Family eating preferences and meal planning skills were common barriers to diet change. 72% of healthcare providers reported knowledge of plant-based diets for diabetes management but low levels of practice. Conclusions and Implications. Patient awareness of the benefits of a plant-based diet for the management of diabetes remains suboptimal and may be influenced by perception of diabetes educators and clinicians. Given the reported willingness to try (but low current use of) plant-based diets, educational interventions targeting patient and provider level knowledge are warranted.
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Abstract
OBJECTIVE Studies investigating mood in vegetarian diets have yielded conflicting results, either demonstrating risk for mental disorders or mood protection. Our objective was to investigate mood, as well as factors that potentially impact mood in vegans (VG), vegetarians (VEG), and omnivores (OMN). METHODS We surveyed mood, diet, and lifestyle factors in a broad geographic online sample of adult VG (n = 283), VEG (n = 109), and OMN (n = 228) who were recruited via diet-related social networks. Mood was measured with the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS The sample was mostly female (78.5%), and age was inversely correlated with all DASS scores (p < 0.05). Mean DASS-A (anxiety) and DASS-S (stress) scores differed by group (F(2,616) = 4.73, p = 0.009, η(2) = 0.015, and F(2, 615) = 8.23, p < 0.001, η(2) = 0.026, respectively), with VG scores lower than OMN scores, indicating less mood disturbance. Analyses of covariance were conducted by gender, adjusting for age. Anxiety scores were different in males only (F(2,128) = 5.39, p = 0.006, η(p)(2) = 0.078) and lower anxiety in males was related to a vegan diet and daily fruit and vegetable intake. Mean stress scores were different in females only (F(2,476) = 3.82, p = 0.023, η(p)(2) = 0.016) and lower stress in females was related to a vegan diet and lower daily intake of sweets. DISCUSSION A strict plant-based diet does not appear to negatively impact mood, in fact, reduction of animal food intake may have mood benefits. The improved mood domains were not consistent with those found in other studies, which may be due to methodological differences.
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Agarwal U, Mishra S, Xu J, Levin S, Gonzales J, Barnard ND. A multicenter randomized controlled trial of a nutrition intervention program in a multiethnic adult population in the corporate setting reduces depression and anxiety and improves quality of life: the GEICO study. Am J Health Promot 2014; 29:245-54. [PMID: 24524383 DOI: 10.4278/ajhp.130218-quan-72] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine whether a plant-based nutrition program in a multicenter, corporate setting improves depression, anxiety, and productivity. DESIGN A quasi-experimental study examined the impact of diet on emotional well-being and productivity. SETTING The study was conducted in 10 corporate sites of a major U.S. insurance company. SUBJECTS There were 292 participants (79.8% women, 20.2% men), with body mass index ≥25 kg/m(2) and/or previous diagnosis of type 2 diabetes. INTERVENTION Either weekly instruction in following a vegan diet or no instruction was given for 18 weeks. MEASURES Depression and anxiety were measured using the Short Form-36 questionnaire. Work productivity was measured using the Work Productivity and Activity Impairment questionnaire. ANALYSIS Baseline characteristics were examined by t-test for continuous variables and χ(2) test for categorical variables. Analysis of covariance models were adjusted for baseline covariates. Paired t-tests were used to determine within-group changes and t-tests for between-group differences. RESULTS In an intention-to-treat analysis, improvements in impairment because of health (p < .001), overall work impairment because of health (p = .02), non-work-related activity impairment because of health (p < .001), depression (p = .02), anxiety (p = .04), fatigue (p < .001), emotional well-being (p = .01), daily functioning because of physical health (p = .01), and general health (p = 0.02) in the intervention group were significantly greater than in the control group. Results were similar for study completers. CONCLUSION A dietary intervention improves depression, anxiety, and productivity in a multicenter, corporate setting.
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A cost-effectiveness and return-on-investment analysis of a worksite vitality intervention among older hospital workers: results of a randomized controlled trial. J Occup Environ Med 2013; 55:337-46. [PMID: 23439274 DOI: 10.1097/jom.0b013e31827b738e] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To conduct a cost-effectiveness and return-on-investment analysis comparing a worksite vitality intervention with usual care. METHODS A total of 730 older hospital workers were randomized to the intervention or control group. The 6-month intervention consisted of yoga and aerobic exercising, coaching, and fruit. At baseline, and 6 and 12 months, general vitality, work-related vitality, and need for recovery were determined. Cost data were collected on a 3-monthly basis. The cost-effectiveness analysis was performed from the societal perspective and the return-on-investment analysis from the employer's perspective using bootstrapping techniques. RESULTS No significant differences in costs and effects were observed. Incremental cost-effectiveness ratios in terms of general vitality (range, 0 to 100), work-related vitality (range, 0 to 6), and need for recovery (range, 0 to 100) were, respectively, €280, €7506, and €258 per point improvement. Per euro invested, €2.21 was lost. CONCLUSIONS The intervention was neither cost-effective nor cost-saving.
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Mishra S, Xu J, Agarwal U, Gonzales J, Levin S, Barnard ND. A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: the GEICO study. Eur J Clin Nutr 2013; 67:718-24. [PMID: 23695207 PMCID: PMC3701293 DOI: 10.1038/ejcn.2013.92] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 03/29/2013] [Accepted: 04/04/2013] [Indexed: 12/31/2022]
Abstract
Background/objectives: To determine the effects of a low-fat plant-based diet program on anthropometric and biochemical measures in a multicenter corporate setting. Subjects/methods: Employees from 10 sites of a major US company with body mass index ⩾25 kg/m2 and/or previous diagnosis of type 2 diabetes were randomized to either follow a low-fat vegan diet, with weekly group support and work cafeteria options available, or make no diet changes for 18 weeks. Dietary intake, body weight, plasma lipid concentrations, blood pressure and glycated hemoglobin (HbA1C) were determined at baseline and 18 weeks. Results: Mean body weight fell 2.9 kg and 0.06 kg in the intervention and control groups, respectively (P<0.001). Total and low-density lipoprotein (LDL) cholesterol fell 8.0 and 8.1 mg/dl in the intervention group and 0.01 and 0.9 mg/dl in the control group (P<0.01). HbA1C fell 0.6 percentage point and 0.08 percentage point in the intervention and control group, respectively (P<0.01). Among study completers, mean changes in body weight were −4.3 kg and −0.08 kg in the intervention and control groups, respectively (P<0.001). Total and LDL cholesterol fell 13.7 and 13.0 mg/dl in the intervention group and 1.3 and 1.7 mg/dl in the control group (P<0.001). HbA1C levels decreased 0.7 percentage point and 0.1 percentage point in the intervention and control group, respectively (P<0.01). Conclusions: An 18-week dietary intervention using a low-fat plant-based diet in a corporate setting improves body weight, plasma lipids, and, in individuals with diabetes, glycemic control.
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Affiliation(s)
- S Mishra
- Clinical Research, Physicians Committee for Responsible Medicine, Washington, DC, USA.
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Kahleova H, Hrachovinova T, Hill M, Pelikanova T. Vegetarian diet in type 2 diabetes--improvement in quality of life, mood and eating behaviour. Diabet Med 2013; 30:127-9. [PMID: 23050853 DOI: 10.1111/dme.12032] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 09/12/2012] [Accepted: 10/05/2012] [Indexed: 11/29/2022]
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