Modifiable risk factors, oxidative stress markers, and SOD2 rs4880 SNP in coronary artery disease: an association study

BACKGROUND

Coronary artery disease (CAD) has been linked to single nucleotide polymorphism (SNP) in superoxide dismutase 2 (SOD 2) gene. Additionally, several modifiable risk factors are also known to influence the CAD risk.

AIM

To investigate the association between selected modifiable risk factors and oxidative stress markers with the SOD2 rs4880 SNP in CAD patients.

METHODS

A cohort of 150 angiographically confirmed CAD patients, and 100 control subjects in the same geographic area were enrolled. SOD levels and lipid peroxidation were assessed in the blood samples using standard protocols. The genotyping of the SOD2 gene was conducted through the PCR-sequencing method.

RESULTS

This study indicated that CAD patients with the rs4880 SNP having heterozygous AG and mutated homozygous GG genotypes have increased oxidative stress, decreased SOD activity, and a positive association with CAD risk (OR 2.85) in comparison with control individuals. The investigation among CAD patients was then carried out based on modifiable risk factors. The risk factors selected were clinical characteristics, physical habits, nutritional status, and body mass index. In all the cases, MDA levels showed a positive association, and SOD activity showed a negative association with the selected polymorphism.

CONCLUSIONS

The study suggests that the selected modifiable risk factors have an important role in the higher oxidative stress found in patients, which may lead to SOD2 polymorphism. It also suggests that the SOD2 locus can be identified as a marker gene for CAD susceptibility.

A Healthful Plant-Based Diet as an Alternative Dietary Approach in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease

Plant-based diets (PBDs) are gaining attention as a sustainable and health-conscious alternative for managing various chronic conditions, including metabolic dysfunction-associated steatotic liver disease (MASLD). In the absence of pharmacological treatments, exploring the potential of lifestyle modifications to improve biochemical and pathological outcomes becomes crucial. The adoption of PBDs has demonstrated beneficial effects such as weight control, increased metabolic health and improved coexisting diseases. Nonetheless, challenges persist, including adherence difficulties, ensuring nutritional adequacy, and addressing potential deficiencies. The aim of this review is to provide a comprehensive overview of the impact of PBDs on MASLD, emphasizing the need for tailored dietary interventions with professional support to optimize their effectiveness in preventing and treating metabolic diseases.

Intake of foods high in saturated fats, vegetarian dietary pattern, and sociodemographic characteristics associated with body weight in Peruvian university students

Background

The prevalence of obesity continues to increase among university students and the general population. Consumption of a diet high in saturated fats could be one of the risk factors.

Objective

The consumption of foods high in saturated fats, the vegetarian diet pattern, and sociodemographic characteristics associated with excess body weight (overweight/obesity) were evaluated in Peruvian university students.

Methods

A cross-sectional study was carried out selecting 5,608 Peruvian university students through no probabilistic convenience sampling. The survey was carried out during the months of February and April 2022. The Chi-square test and binary logistic regression analysis were used to evaluate the association between diet (saturated fats intake and dietary pattern) and sociodemographic factors with excess body weight in a cross-sectional analysis.

Results

It was observed that students who reported high consumption of foods high in saturated fats (ORB = 1.14) and those who had a non-vegetarian dietary pattern (ORB = 2.76) were found to be more likely to have excess body weight. On the contrary, students who reported adherence to the vegetarian diet pattern for more than 5 years were less likely to be overweight or obese (ORB = 0.84). Being ≥26 years of age (ORB = 3.28), living in urban areas (ORB = 1.68) and coastal areas of the country (ORB = 1.17), and enrolled in the engineering faculty (ORB = 1.19), were significantly associated with excess body weight.

Conclusion

The findings of the current study evidenced several factors associated with excess body weight in university students. Therefore, it is necessary to promote and implement healthy lifestyle programs, considering sociodemographic and dietary aspects such as age and dietary intake to control and prevent obesity in university students.

The impact of vegetarian diet on sperm quality, sex hormone levels and fertility: a systematic review and meta-analysis

BACKGROUND

An increasing number of people have adhered to a vegetarian diet for several years. Nowadays, the favourable effect of this dietary pattern on metabolic diseases is well established, but its impact on fertility and reproductive health as a serious health concern is not clear yet. Therefore, we aim to summarise existing evidence regarding the possible association between a vegetarian diet and fertility as measured by key indicators such as sperm quality and sex hormone levels.

METHODS

We systematically searched online databases, including PubMed, ISI, Scopus and Google Scholar, up to 1 December 2022 using relevant keywords. We included observational studies that compared semen quality, sex hormone levels and infertility in people who adhered to a vegetarian diet versus an omnivore diet. Heterogeneity between studies was assessed using I2 and Q tests. Standardised mean differences (SMD) using a random/fixed model were calculated to assess outcomes between vegetarians and omnivores in included articles.

RESULTS

Finally, out of 972 documents that were retrieved, 20 articles met our inclusion criteria, and 16 were eligible for quantitative synthesis. Results of meta-analyses showed that there were no significant differences between vegetarians and omnivores in terms of semen quality parameters, including total sperm count, total and progressive sperm motility, sperm morphology and sperm concentration. Seven studies on female sex hormone profiles were eligible for meta-analysis. The only significant difference was the lower level of plasma oestrone in vegetarians (pooled SMD: -0.56; 95% confidence interval [CI]: -1.08, -0.05; p-value = 0.03) compared to omnivores. Furthermore, our meta-analysis revealed significantly higher sex-hormone-binding globulin levels in vegetarian men than in omnivores (pooled SMD: 0.52; 95% CI: 0.18, 0.86; p-value = 0.002).

CONCLUSION

Despite the numerous health benefits of a vegetarian diet, our review suggested that there were no conclusive positive or negative associations between vegetarian diet and semen quality, sex hormone levels and infertility. Further studies are recommended to better understand vegetarian dietary pattern effect on infertility and reproductive health.

A systematic review of the definitions, narratives and paths forwards for a protein transition in high-income countries

The protein transition, aiming to rebalance protein intake between animal and alternative proteins, is gaining momentum in scientific and policy discussions on food system transformation. Here, using a systematic review approach, we identified 33 articles that address challenges in reducing the environmental impacts of protein production and consumption, providing healthy diets for a growing population and preventing adverse effects of industrial livestock production systems. We found unclear definitions of the protein transition, conflicting views on reduction or replacement of dietary protein and a lack of attention to systemic change by reducing protein to its macronutrient function. Three narratives were identified, namely, the consumer narrative focusing on consumption-based solutions targeting dietary changes; the techno-centred narrative developing new, more resource-efficient protein production systems; and the socio-technological narrative that intends to transition the agri-food system from an animal-dominated regime to an alternative protein regime. We conclude that solutions should consider factors such as scale, initiating actors and expected impact to support complementary protein transition approaches.

Popular Dietary Trends' Impact on Athletic Performance: A Critical Analysis Review

BACKGROUND

Nutrition fuels optimal performance for athletes. With increased research developments, numerous diets available, and publicity from professional athletes, a review of dietary patterns impact on athletic performance is warranted.

RESULTS

The Mediterranean diet is a low inflammatory diet linked to improved power and muscle endurance and body composition. Ketogenic diets are restrictive of carbohydrates and proteins. Though both show no decrements in weight loss, ketogenic diets, which is a more restrictive form of low-carbohydrate diets, can be more difficult to follow. High-protein and protein-paced versions of low-carbohydrate diets have also shown to benefit athletic performance. Plant-based diets have many variations. Vegans are at risk of micronutrient deficiencies and decreased leucine content, and therefore, decreased muscle protein synthesis. However, the literature has not shown decreases in performance compared to omnivores. Intermittent fasting has many different versions, which may not suit those with comorbidities or specific needs as well as lead to decreases in sprint speed and worsening time to exhaustion.

CONCLUSIONS

This paper critically evaluates the research on diets in relation to athletic performance and details some of the potential risks that should be monitored. No one diet is universally recommend for athletes; however, this article provides the information for athletes to analyze, in conjunction with medical professional counsel, their own diet and consider sustainable changes that can help achieve performance and body habitus goals.

Fad Diets: Facts and Fiction

The global prevalence of obesity is alarmingly high and is impacting both developed and underdeveloped countries, beyond the borders of ethnicity, sex, and age. On the other hand, the global interest in dieting has increased, and people are obsessed with certain fad diets, assuming them as a magic bullet for their long-term problems. A fad diet is a popular dietary pattern known to be a quick fix for obesity. These diets are quite appealing due to the proposed claims, but the lack of scientific evidence is a big question mark. Such diets are often marketed with specific claims that defy the basic principles of biochemistry and nutritional adequacy. These diets may have protective effects against obesity and certain chronic diseases like cardiovascular diseases, metabolic syndrome, and certain cancers. Limited evidence exists to support the proposed claims; rather certain studies suggest the negative health consequences of long-term adherence to such dietary patterns. Many fad diets have emerged in the previous few decades. This review article will explore the current evidence related to the health impacts of some most popular diets: Atkins diet, ketogenic diet, Paleolithic diet, Mediterranean diet, vegetarian diet, intermittent fasting and detox diet.

Functional Properties of Meat in Athletes' Performance and Recovery

Physical activity (PA) and sport play an essential role in promoting body development and maintaining optimal health status both in the short and long term. Despite the benefits, a long-lasting heavy training can promote several detrimental physiological changes, including transitory immune system malfunction, increased inflammation, and oxidative stress, which manifest as exercise-induced muscle damages (EIMDs). Meat and derived products represent a very good source of bioactive molecules such as proteins, lipids, amino acids, vitamins, and minerals. Bioactive molecules represent dietary compounds that can interact with one or more components of live tissue, resulting in a wide range of possible health consequences such as immune-modulating, antihypertensive, antimicrobial, and antioxidative activities. The health benefits of meat have been well established and have been extensively reviewed elsewhere, although a growing number of studies found a significant positive effect of meat molecules on exercise performance and recovery of muscle function. Based on the limited research, meat could be an effective post-exercise food that results in favorable muscle protein synthesis and metabolic performance.

Association Between Ideal Cardiovascular Health and Vegetarian Dietary Patterns Among Community-Dwelling Individuals

Background

Vegetarians have been shown to have better metabolic profiles than non-vegetarians, and vegetarianism has potential beneficial effects on cardiovascular disease. However, there is a lack of studies on vegetarians that examine both metabolic profiles and lifestyle habits, such as physical activity, smoking habits, and dietary patterns, which are equally important in the context of cardiovascular disease. We explored whether a vegetarian diet is associated with both metabolic traits and lifestyle habits by assessing cardiovascular health (CVH) metrics.

Methods

This was a cross-sectional study conducted in a Taiwanese population. Data collected between 2000 and 2016 were extracted from the MJ Health database. Participants aged 40 years and older without cardiovascular disease were included. CVH metrics included smoking habits, blood pressure, total cholesterol, serum glucose, body mass index, physical activity, and healthy diet score. Vegetarian participants were full-time vegetarians who did not consume meat or fish. All the data were assessed from self-report questionnaires, physical examinations, and blood analyses following standard protocol. Multiple logistic regression analysis was used to evaluate the association between vegetarianism and CVH metrics.

Results

Of 46,287 eligible participants, 1,896 (4.1%) were vegetarian. Overall, vegetarians had better CVH metrics (OR = 2.09, 95% CI = 1.84–2.37) but lower healthy diet scores (OR = 0.41, 95% CI = 0.33–0.51) after adjustment. No difference in physical activity (OR = 0.86, 95% CI = 0.73–1.02) was identified between vegetarians and non-vegetarians. Additionally, vegetarians had higher whole grain intake (OR = 2.76, 95% CI = 2.28–3.35) and lower sugar-sweetened beverage consumption (OR = 1.36, 95% CI = 1.18–1.58).

Conclusions

Our results suggested that vegetarians had better overall ideal CVH metrics but lower ideal healthy diet scores than non-vegetarians, which was likely due to the lack of fish consumption in this population group. When assessing CVH metrics and healthy diet scores for vegetarians, metrics and scores chosen should be suitable for use with vegetarian populations.

Total Meat Intake is Associated with Life Expectancy: A Cross-Sectional Data Analysis of 175 Contemporary Populations

Background

The association between a plant-based diet (vegetarianism) and extended life span is increasingly criticised since it may be based on the lack of representative data and insufficient removal of confounders such as lifestyles.

Aim

We examined the association between meat intake and life expectancy at a population level based on ecological data published by the United Nations agencies.

Methods

Population-specific data were obtained from 175 countries/territories. Scatter plots, bivariate, partial correlation and linear regression models were used with SPSS 25 to explore and compare the correlations between newborn life expectancy (e₍₀₎), life expectancy at 5 years of life (e₍₅₎) and intakes of meat, and carbohydrate crops, respectively. The established risk factors to life expectancy – caloric intake, urbanization, obesity and education levels – were included as the potential confounders.

Results

Worldwide, bivariate correlation analyses revealed that meat intake is positively correlated with life expectancies. This relationship remained significant when influences of caloric intake, urbanization, obesity, education and carbohydrate crops were statistically controlled. Stepwise linear regression selected meat intake, not carbohydrate crops, as one of the significant predictors of life expectancy. In contrast, carbohydrate crops showed weak and negative correlation with life expectancy.

Conclusion

If meat intake is not incorporated into nutrition science for predicting human life expectancy, results could prove inaccurate.

Influence of Different Cooking Methods on Fillet Steak Physicochemical Characteristics

Meat is a source of protein widely consumed by the population in many countries due mainly to the nutritional aspects, sensory characteristics, and cultural aspects. The meat cooking preparation can promote significant changes in the meat's chemical composition and physical characteristics. Such transformations can impact both the acceptance of the product and consumers' health. Due to the different thermal processes altering the physical-chemical characteristics of meat, the present study aimed to evaluate the physicochemical characteristics of fillet steak submitted to different cooking methods: pan-frying with and without oil and air fryer. We performed the analysis to evaluate the physicochemical characteristics considering moisture, lipid, protein, ash, sodium, and potassium content, cooking loss index and colorimetry in three degrees of doneness of the meat, rare, medium, and well done. The fillet steak prepared by pan-frying with oil lost higher moisture and weight than the other samples. The air fryer method presented the highest moisture content. There was a significant difference in lipid content in which the pan-frying with oil fillet steak showed the highest amount of lipids. The pan-frying with oil steak fillet also presented more changes in the colorimetric parameters evaluated compared to the other samples. The pan-frying with oil cooking method promoted more pronounced changes in the steak fillet, and the cooking air fryer, the changes in meat quality are less pronounced. Therefore, the air fryer can be considered a good alternative for cooking meat.

Exploring the Intersection Between Diet and Self-Identity: A Cross-Sectional Study With Australian Adults

OBJECTIVE

Diet-related self-identity, which includes components such as individuals' overall dietary pattern and food choice motivations, is a strong predictor of health behaviors. This study sought to assess the variation in dietary patterns reported by a sample of Australian adults and their associations with diet quality.

DESIGN

Cross-sectional survey.

PARTICIPANTS

Australian adults (n = 2,010) VARIABLES MEASURED: The main outcome measure was diet quality relative to the Australian Dietary Guidelines, measured by the Healthy Diet Score survey. Other outcomes captured included dietary patterns (eg, unrestricted, vegetarian, flexitarian, or ketogenic diets), diet-related self-identity constructs (centrality, prosocial motivation, personal motivation, and strictness), and sociodemographic characteristics (eg, age, sex, and education level).

ANALYSIS

Data were analyzed descriptively, and ordinary least squares regression was performed to identify significant predictors of diet quality.

RESULTS

Eighteen unique dietary patterns were reported. These were classified into 3 categories on the basis of the degree of restriction of core food groups. Diets based on restriction of animal protein were associated with the highest diet quality, including the highest consumption of fruits, vegetables, and whole grains, whereas restriction of other foods was associated with the poorest diet quality. Unrestricted diets reported the highest consumption of discretionary food (high in saturated fat, salt, or added sugar). Finally, the regression analysis found that diet quality was significantly predicted by dietary pattern and diet-related self-identity constructs (F[8, 1974] = 54.952; P < 0.0001; adjusted R² = 0.179).

CONCLUSIONS AND IMPLICATIONS

Dietary pattern and diet-related self-identity constructs are key determinants of diet quality. This has implications for future interventions, including that programs and messages could be tailored to ensure they align with the target population's self-identity and overall dietary patterns.

Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality

Objective

To summarize the association between vegetarian versus non-vegetarian diet on mortality due to ischemic heart disease, cerebrovascular disease, or all-cause mortality.

Methods

We searched PubMed, Cochrane databases, and ClinicalTrials.Gov from the inception of the databases to October 2019 with no language restriction. Randomized controlled trials or prospective observational studies comparing the association between vegetarian versus non-vegetarian diets among adults and reporting major adverse cardiovascular outcomes were selected. We used Paule-Mandel estimator for tau2 with Hartung-Knapp adjustment for random effects model to estimate risk ratio [RR] with 95% confidence interval [CI].The primary outcome of interest was all-cause mortality. The secondary outcome was ischemic heart disease mortality.

Results

Eight observational studies (n = 131,869) were included in the analysis. Over a weighted mean follow-up of 10.68 years, very low certainty of evidence concluded that a vegetarian diet compared with a non-vegetarian diet was associated with similar risk of all-cause (RR: 0.84, 95% CI: 0.65-1.07, I² : 97%) or cerebrovascular mortality (RR: 0.84, 95% CI: 0.63-1.14, I² : 90%), but was associated with a reduced risk of ischemic heart disease mortality (RR: 0.70, 95% CI: 0.55-0.89, I² : 82%).

Conclusion

A vegetarian diet, compared with a non-vegetarian diet, was associated with a reduced risk of ischemic heart disease mortality, whereas it had no effect on all-cause and cerebrovascular mortality. However, the results are to be considered with caution considering the low certainty of evidence. Despite recent studies supporting no restriction on animal protein intake gaining wide media attention and public traction, consideration for vegetarianism amongst those with risk factors for coronary artery disease should be contemplated.

Knowledge of Vegetarian and Nonvegetarian Peruvian Dietitians about Vegetarianism at Different Stages of Life

Background:

The vegetarian diet continues to gain recognition and popularity among people; however, few studies have considered the level of knowledge of professional dietitians about this dietary pattern.

Objective:

This study aimed to compare the level of knowledge of vegetarian and nonvegetarian Peruvian dietitians regarding vegetarianism at different life stages.

Methods:

A cross-sectional study was carried out. An online questionnaire based on the recommendations of the current dietary guidelines was administered to more than 400 registered dietitians. Of which, a total of 179 decided to participate in the study: 72 vegetarians and 107 nonvegetarians. The data were analyzed using the chi-square test, considering a significance level of 5%.

Results:

Women represented the largest proportion of the sample. The participants demonstrated a complete and exhaustive knowledge of the definition of vegetarian diets. Regarding the risks and benefits associated with vegetarianism, the largest proportion of those who got the correct answers were vegetarians. The percentage of correct answers selected for both groups regarding the critical nutrients were less than 50%. Only 17.6% identified the correct answer regarding the risk of eating disorders of vegetarianism.

Conclusions:

Dietitians did not demonstrate complete and comprehensive knowledge of the critical nutrients of vegetarianism and lack information on the risks of eating disorders from the vegetarian diet.

Comparison of diet quality of US adults based on primary motivation for following a vegetarian diet: A cross-sectional online study

Adults adopt a vegetarian diet for various motivations, but it is unknown their overall diet quality based on a primary motivation. The purpose of the study was to compare overall diet quality, nutrient intake and related food groups based on primary motivation for following a vegetarian diet. It was hypothesized that vegetarians who chose the diet for health-related motivations would have a higher diet quality based on the Healthy Eating Index (HEI)-2015 scores compared to those following the diet for other motivations. A cross-sectional study was conducted online in the United States. Participants (n = 511) completed an 18-item questionnaire and a 24-hour recall using the Automated Self-Administered 24-hour Dietary Recall (ASA24-2018) and were divided into one of three groups (Health, Animal, Other [family, religious beliefs, or environment]) based on their primary motivation for following a vegetarian diet. Total HEI-2015 scores were determined and Kruskal-Wallis ANOVA on Ranks with a Dunn's Method for all pairwise comparisons (p < 0.05) were conducted. Results showed that total HEI-2015 scores differed among groups (p = 0.022) with the Health group having a higher score than the Other group (70.2 [57.0, 79.1] versus 63.6 [52.2, 77.1], median 25th, 75th) but not the animal rights group (66.5 [55.1, 77.0]). Higher component scores for total protein foods, seafood and plant proteins and fatty acids contributed to the significant difference. Adults who were motivated by health to follow a vegetarian diet had a higher diet quality than those who cited Other as their primary motivation. As motivations may impact diet quality of vegetarians, it is necessary to account for them.

Vegetarian Diet: An Overview through the Perspective of Quality of Life Domains

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.

The association between plant-based diet indices and metabolic syndrome in Iranian older adults

BACKGROUND

We investigated the association between plant-based diets indices - an overall plant-based diet index; a healthful plant-based diet index; and an unhealthful plant-based diet index - and metabolic syndrome among Iranian older adults.

AIM

We aimed to examine the relationship between plant-based diet indices and metabolic syndrome.

METHODS

This cross-sectional study included 178 older adults (51 men and 127 women), with a mean age of 67.04 (60-83) who were referred to health centers in Tehran, Iran. Blood and urine samples were collected to measure serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides. We created an overall plant-based diet index, healthful plant-based diet index, and unhealthful plant-based diet index from semi-quantitative food-frequency questionnaire data. Anthropometric measures were done.

RESULTS

Our crude model results showed that triglycerides, systolic and diastolic blood pressure, fasting blood sugar, high-density lipoprotein cholesterol, and waist circumference did not significantly differ between tertiles of plant-based diet index and healthful plant-based diet index; also triglycerides, systolic and diastolic blood pressure, fasting blood sugar, and waist circumference did not significantly differ between tertiles of unhealthful plant-based diet index, but high-density lipoprotein cholesterol significantly differed between tertiles of unhealthful plant-based diet index. After adjusting for confounders the results remained non-significant for plant-based diet index but high-density lipoprotein cholesterol was significant for healthful and unhealthful plant-based diet indices. There was also no significant association between plant-based diet index (OR: 1.11; 95% CI: 0.53-2.33), healthful plant-based diet index (OR: 0.81; 95% CI: 0.39-1.68), and unhealthful plant-based diet index (OR: 0.81; 95% CI: 0.38-1.72) with metabolic syndrome, even after adjustment for confounders.

CONCLUSIONS

Our findings showed that plant-based diets are not significantly associated with risk of metabolic syndrome in older adults. To confirm the veracity of these findings, more studies should be conducted.

Nutrition as Treatment Modality in Heart Failure

PURPOSE OF REVIEW

This review aims to discuss recent evidence and controversies regarding nutrition as a treatment modality for heart failure (HF) patients.

RECENT FINDINGS

Adequate nutrition is known to promote health-related quality of life by addressing malnutrition and promoting optimal functioning among older adults and has an established role in the prevention of HF; however, evidence is limited on the effects of nutrition as a treatment modality in HF. While guidance of sodium restriction to address fluid overload is an ongoing debate among experts, evidence from case studies and small clinical trials suggest a positive impact of plant-based and Dietary Approaches to Stop Hypertension (DASH) dietary patterns on HF-related pathophysiology, quality of life, hospital admissions, and mortality. More clinical trials are needed to establish an evidence base to support dietary management strategies for patients with HF. Clinical and Translational Science Alliances (CTSAs) may provide infrastructure to overcome enrollment barriers.

Mean Differences of Total Cholesterol Levels among Vegetarians and Non-Vegetarians at Maha Vihara Maitreya Duta Palembang, Indonesia

Total cholesterol level is one of the risk factor of cardiovascular disease. The proportion rate of hypercholesterolemia in Indonesia remains high, numbering around one third of (35,9%) Indonesians. Hypercholesterolemia is a modifiable risk factor, one of early measures that can be taken to prevent hypercholesterolemia is nutritional intervention. A dietary pattern high in plant sources and lower fat consumption has been recommended by several health organisation for prevention of hypercholesterolemia. This study was intended to determine mean difference of cholesterol level between vegetarian and nonvegetarian in Maha Vihara Maitreya Duta Palembang. This was an observational analytical study with cross-sectional design. A total of 173 subjects at Maha Vihara Maitreya Duta Palembang was included which consist of 80 Vegetarian and 93 Nonvegetarian. Measurement of total cholesterol level was done using rapid diagnostic test (RDT) Autocheck® Multi Monitoring System and parametric Independent T Test was chosen as method of statistical analysis. p <0.001 indicates significant differences of total cholesterol level between vegetarian (172,51± 39,05 mg/dL ) and nonvegetarian (228,67±68,07 mg/dL) groups. The mean differences of total cholesterol of vegetarian group is 56,16 mg/dl lower than non vegetarian groups. A significant differences exist in total cholesterol level between vegetarian and non vegetarian group at Maha Vihara Maitreya Duta Palembang. Vegetarian groups has lower total cholesterol level compared to nonvegetarian.

Comparisons of conventional and novel anthropometric obesity indices to predict metabolic syndrome among vegetarians in Malaysia

Our study aimed to compare the ability of anthropometric obesity indices to predict MetS and to determine the sex-specific optimal cut-off values for MetS among Malaysian vegetarians. Body weight, height, waist circumference (WC), blood pressure (BP), fasting venous blood sample were collected from 273 vegetarians in Selangor and Kuala Lumpur, Malaysia. The abilities of body mass index (BMI), body fat percentage (BF%), waist to height ratio (WHtR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), and body roundness index (BRI) to identify MetS were tested using receiver operating characteristic (ROC) curve analyses. MetS was defined according to the Joint Interim Statement 2009. The ROC curve analyses show that BMI, BF%, WHtR, LAP and VAI were able to discriminate MetS in both sexes. LAP was a better predictor to predict MetS, followed by WHtR for male and female vegetarians. The suggested WHtR’s optimal cut-offs and LAP’s optimal cut-offs for MetS for male and female vegetarians were 0.541, 0.532, 41.435 and 21.743, respectively. In conclusion, LAP was a better predictor to predict MetS than other anthropometric obesity indices. However, WHtR could be an alternative obesity index in large epidemiology survey due to its convenient and cost-effective characteristics.

Gender Differences in Attitudes to Vegans/Vegetarians and Their Food Preferences, and Their Implications for Promoting Sustainable Dietary Patterns–A Systematic Review

Limiting meat consumption has recently become one of the key issues linked to public health and environmental sustainability. This is reflected in the strong emphasis on increasing promotion of plant-based nutritional styles, such as vegan and vegetarian diets. Vegan/vegetarian diets appeal to certain demographic groups more than to others. The most striking difference, however, is found between the sexes. Men and women differ in their preferences for plant products and in their attitudes to meat consumption. There are also differences between their motivations to start and/or follow a vegan/vegetarian diet. Major differences have also been observed in men’s and women’s attitudes towards people following plant-based diets. Vegetarian diets are generally considered to be less masculine than meat-based diets, and omnivores exhibit more prejudice against vegetarian men than women. This study follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) systematic literature review model. The Web of Science and PubMed databases were searched (up to January 2020) to identify studies, which analysed variables directly or indirectly related to inter-sex differences with regard to the vegan/vegetarian diet. After the screening process based on the relevance and quality criteria, 29 articles were included in the study. The purpose of this review is to raise awareness of these gender differences, not only as regards social perceptions, but also in terms of individual attitudes to vegetarian/vegan diets. Ignoring those differences hinders the promotion of plant-based diets and may explain the relatively meager success of previous efforts to promote sustainable nutritional styles.

Health-Related Quality of Life, Blood Pressure, and Biochemical and Anthropometric Profile in Vegetarians and Nonvegetarians

Several studies have been carried out which mainly focus on the analysis of the lipid profile in vegetarians and nonvegetarians. However, few studies have been undertaken in this population oriented to quality of life and health. This study aimed to compare health-related quality of life, blood pressure, and biochemical and anthropometric profile in vegetarians and nonvegetarians. The study included 149 participants out of an initial sample of 162: 62 vegetarians and 87 nonvegetarians. Health-related quality of life was assessed with the SF-12 Health Questionnaire version 2 and was related with the lipid profile, glucose, blood pressure, anthropometric measures, and sociodemographic characteristics. Vegetarians presented better Body Mass Index (BMI) and waist circumference (WC), as well as higher LDL levels. No significant differences in HDL and TG concentrations were found. Serum glucose concentrations were significantly lower among vegetarians. Nonvegetarian males had higher diastolic pressure levels. Vegetarian women had significantly higher levels of systolic pressure. As for the physical health and mental health components of quality of life, no significant differences were found in vegetarian and nonvegetarian women and men. In conclusion, vegetarians presented a better anthropometric profile, lower glycaemia, and higher LDL levels but no significant differences in health-related quality of life compared with nonvegetarians.

Brazilian vegetarians diet quality markers and comparison with the general population: A nationwide cross-sectional study

BACKGROUND

Vegetarianism is an increasingly common practice worldwide. Despite good evidence from other countries regarding vegetarians' diet quality, data from the Brazilian population is still scarce.

OBJECTIVE

To characterize the vegetarian Brazilian population and evaluate their diet quality compared to the general Brazilian population.

METHODS

We performed a nationwide cross-sectional study using an online self-administered questionnaire, previously validated for the Brazilian population, to evaluate diet quality markers of vegetarians. The invitation to participate in the survey was spread nationwide, aimed at vegetarian communities. Individuals who considered themselves vegetarians and were at least 18 years old were eligible to participate. The results on regular intake and intake adequacy were compared among vegetarians and between genders using the Pearson's chi-square test. The body mass index (BMI) were analyzed by the Analysis of Variance (ANOVA) followed by Tukey post-hoc test. The Kolmogorov-Smirnov test verified normality. All analyses considered bilateral hypotheses and a significance level of 5% (p <0.05).

RESULTS

Brazilian vegetarians presented better diet quality markers, such as higher regular weekly intake and adequate daily intake of fruits and vegetables, and lower regular intake of soft drinks when compared to the general Brazilian population. Vegetarians also presented a proportionally higher consumption of natural foods and lower consumption of processed foods. Among vegetarians, a higher proportion of vegans showed positive results regarding diet markers analysis, when compared to vegetarians, pesco-vegetarians, and semi-vegetarians.

CONCLUSIONS

Vegetarians showed better results of diet adequacy when compared to the general population in Brazil, and vegans fared better when compared with other vegetarians. Despite the good results found, a large proportion of the participants still did not achieve the fruits and vegetables daily intake, according to the World Health Organization recommendations.

Operational Differences in Plant-Based Diet Indices Affect the Ability to Detect Associations with Incident Hypertension in Middle-Aged US Adults

BACKGROUND

Several distinct plant-based diet indices (PDIs) have been developed to characterize adherence to plant-based diets.

OBJECTIVE

We contrasted 5 PDIs in a community-based cohort by assessing characteristics of the diet and evaluating whether these PDIs are associated with risk of incident hypertension.

METHODS

Using FFQ data from adults (45-64 y, n = 8041) without hypertension at baseline in the Atherosclerosis Risk in Communities (ARIC) Study, we scored participants' diets using the overall PDI (oPDI), healthy PDI (hPDI), less healthy (unhealthy) PDI (uPDI), provegetarian diet index, and PDI from the Rotterdam Study (PDI-Rotterdam). For the oPDI, provegetarian diet, and PDI-Rotterdam, higher intakes of all or selected plant foods received higher scores. For the hPDI, higher intakes of plant foods identified as healthful received higher scores. For the uPDI, higher intakes of less healthy plant foods received higher scores. All indices scored higher intakes of animal foods lower. We examined agreement between indices, and whether scores on these indices were associated with risk of hypertension using Cox proportional hazard models.

RESULTS

The PDIs were moderately-to-strongly correlated and largely ranked subjects consistently, except for the uPDI. Over a median follow-up of 13 y, 6044 incident hypertension cases occurred. When adjusted for sociodemographic characteristics, other dietary factors, and health behaviors, the highest compared with the lowest quintile for adherence to the oPDI, hPDI, and provegetarian diet was associated with a 12-16% lower risk of hypertension (all P-trend <0.05). Highest adherence to the uPDI was associated with a 13% higher risk of hypertension, when clinical factors were further adjusted for (P-trend = 0.03). No significant association was observed with the PDI-Rotterdam. The oPDI, hPDI, and provegetarian diet moderately improved the prediction of hypertension.

CONCLUSIONS

In middle-aged US adults, despite moderate agreement in ranking subjects across PDIs, operational differences can affect the ability to detect diet-disease associations, such as hypertension.

Plant-Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality in a General Population of Middle-Aged Adults

Background

Previous studies have documented the cardiometabolic health benefits of plant‐based diets; however, these studies were conducted in selected study populations that had narrow generalizability.

Methods and Results

We used data from a community‐based cohort of middle‐aged adults (n=12 168) in the ARIC (Atherosclerosis Risk in Communities) study who were followed up from 1987 through 2016. Participants’ diet was classified using 4 diet indexes. In the overall plant‐based diet index and provegetarian diet index, higher intakes of all or selected plant foods received higher scores; in the healthy plant‐based diet index, higher intakes of only the healthy plant foods received higher scores; in the less healthy plant‐based diet index, higher intakes of only the less healthy plant foods received higher scores. In all indexes, higher intakes of animal foods received lower scores. Results from Cox proportional hazards models showed that participants in the highest versus lowest quintile for adherence to overall plant‐based diet index or provegetarian diet had a 16%, 31% to 32%, and 18% to 25% lower risk of cardiovascular disease, cardiovascular disease mortality, and all‐cause mortality, respectively, after adjusting for important confounders (all P<0.05 for trend). Higher adherence to a healthy plant‐based diet index was associated with a 19% and 11% lower risk of cardiovascular disease mortality and all‐cause mortality, respectively, but not incident cardiovascular disease (P<0.05 for trend). No associations were observed between the less healthy plant‐based diet index and the outcomes.

Conclusions

Diets higher in plant foods and lower in animal foods were associated with a lower risk of cardiovascular morbidity and mortality in a general population.

Plant-Based Diets and Incident CKD and Kidney Function

BACKGROUND AND OBJECTIVES

The association between plant-based diets, incident CKD, and kidney function decline has not been examined in the general population. We prospectively investigated this relationship in a population-based study, and evaluated if risk varied by different types of plant-based diets.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

Analyses were conducted in a sample of 14,686 middle-aged adults enrolled in the Atherosclerosis Risk in Communities study. Diets were characterized using four plant-based diet indices. In the overall plant-based diet index, all plant foods were positively scored; in the healthy plant-based diet index, only healthful plant foods were positively scored; in the provegetarian diet, selected plant foods were positively scored. In the less healthy plant-based diet index, only less healthful plant foods were positively scored. All indices negatively scored animal foods. We used Cox proportional hazards models to study the association with incident CKD and linear mixed models to examine decline in eGFR, adjusting for confounders.

RESULTS

During a median follow-up of 24 years, 4343 incident CKD cases occurred. Higher adherence to a healthy plant-based diet (HR comparing quintile 5 versus quintile 1 [HRQ5 versus Q1], 0.86; 95% confidence interval [95% CI], 0.78 to 0.96; P for trend =0.001) and a provegetarian diet (HRQ5 versus Q1, 0.90; 95% CI, 0.82 to 0.99; P for trend =0.03) were associated with a lower risk of CKD, whereas higher adherence to a less healthy plant-based diet (HRQ5 versus Q1, 1.11; 95% CI, 1.01 to 1.21; P for trend =0.04) was associated with an elevated risk. Higher adherence to an overall plant-based diet and a healthy plant-based diet was associated with slower eGFR decline. The proportion of CKD attributable to lower adherence to healthy plant-based diets was 4.1% (95% CI, 0.6% to 8.3%).

CONCLUSIONS

Higher adherence to healthy plant-based diets and a vegetarian diet was associated with favorable kidney disease outcomes.

Healthy Plant-Based Diets Are Associated with Lower Risk of All-Cause Mortality in US Adults

Background

Plant-based diets, often referred to as vegetarian diets, are associated with health benefits. However, the association with mortality is less clear.

Objective

We investigated associations between plant-based diet indexes and all-cause and cardiovascular disease mortality in a nationally representative sample of US adults.

Methods

Analyses were based on 11,879 participants (20-80 y of age) from NHANES III (1988-1994) linked to data on all-cause and cardiovascular disease mortality through 2011. We constructed an overall plant-based diet index (PDI), which assigns positive scores for plant foods and negative scores for animal foods, on the basis of a food-frequency questionnaire administered at baseline. We also constructed a healthful PDI (hPDI), in which only healthy plant foods received positive scores, and a less-healthful (unhealthy) PDI (uPDI), in which only less-healthful plant foods received positive scores. Cox proportional hazards models were used to estimate the association between plant-based diet consumption in 1988-1994 and subsequent mortality. We tested for effect modification by sex.

Results

In the overall sample, PDI and uPDI were not associated with all-cause or cardiovascular disease mortality after controlling for demographic characteristics, socioeconomic factors, and health behaviors. However, among those with an hPDI score above the median, a 10-unit increase in hPDI was associated with a 5% lower risk in all-cause mortality in the overall study population (HR: 0.95; 95% CI: 0.91, 0.98) and among women (HR: 0.94; 95% CI: 0.88, 0.99), but not among men (HR: 0.95; 95% CI: 0.90, 1.01). There was no effect modification by sex (P-interaction > 0.10).

Conclusions

A nonlinear association between hPDI and all-cause mortality was observed. Healthy plant-based diet scores above the median were associated with a lower risk of all-cause mortality in US adults. Future research exploring the impact of quality of plant-based diets on long-term health outcomes is necessary.

In situ production of active vitamin B12 in cereal matrices using Propionibacterium freudenreichii

The in situ production of active vitamin B12 was investigated in aqueous cereal‐based matrices with three strains of food‐grade Propionibacterium freudenreichii. Matrices prepared from malted barley flour (33% w/v; BM), barley flour (6%; BF), and wheat aleurone (15%; AM) were fermented. The effect of cobalt and the lower ligand 5,6‐dimethylbenzimidazole (DMBI) or its natural precursors (riboflavin and nicotinamide) on active B12 production was evaluated. Active B12 production was confirmed by UHPLC–UV–MS analysis. A B12 content of 12–37 μg·kg⁻¹ was produced in BM; this content increased 10‐fold with cobalt and reached 940–1,480 μg·kg⁻¹ with both cobalt and DMBI. With riboflavin and nicotinamide, B12 production in cobalt‐supplemented BM increased to 712 μg·kg⁻¹. Approximately, 10 μg·kg⁻¹ was achieved in BF and AM and was increased to 80 μg·kg⁻¹ in BF and 260 μg·kg⁻¹ in AM with cobalt and DMBI. The UHPLC and microbiological assay (MBA) results agreed when both cobalt and DMBI or riboflavin and nicotinamide were supplemented. However, MBA gave ca. 20%–40% higher results in BM and AM supplemented with cobalt, indicating the presence of human inactive analogues, such as pseudovitamin B12. This study demonstrates that cereal products can be naturally fortified with active B12 to a nutritionally relevant level by fermenting with P. freudenreichii.

Vegan diets: practical advice for athletes and exercisers

With the growth of social media as a platform to share information, veganism is becoming more visible, and could be becoming more accepted in sports and in the health and fitness industry. However, to date, there appears to be a lack of literature that discusses how to manage vegan diets for athletic purposes. This article attempted to review literature in order to provide recommendations for how to construct a vegan diet for athletes and exercisers. While little data could be found in the sports nutrition literature specifically, it was revealed elsewhere that veganism creates challenges that need to be accounted for when designing a nutritious diet. This included the sufficiency of energy and protein; the adequacy of vitamin B12, iron, zinc, calcium, iodine and vitamin D; and the lack of the long-chain n-3 fatty acids EPA and DHA in most plant-based sources. However, via the strategic management of food and appropriate supplementation, it is the contention of this article that a nutritive vegan diet can be designed to achieve the dietary needs of most athletes satisfactorily. Further, it was suggested here that creatine and β-alanine supplementation might be of particular use to vegan athletes, owing to vegetarian diets promoting lower muscle creatine and lower muscle carnosine levels in consumers. Empirical research is needed to examine the effects of vegan diets in athletic populations however, especially if this movement grows in popularity, to ensure that the health and performance of athletic vegans is optimised in accordance with developments in sports nutrition knowledge.

Rice- or pork-based diets with similar calorie and content result in different rat gut microbiota

Rice is the most important food crop, and pork is the most widely eaten meat in the world. In this study, we compared the gut microbiota of the rats fed with rice or pork mixed diets, which have similar caloric contents. The physiological indices (body weights, hematology, serum chemistry, organ weights and histopathology) of two groups were all within the normal range. Two diets did not induce difference in the diversity of gut bacteria. However, Firmicutes were significantly higher in rice diet group, while Bacteroidetes were enriched in pork diet group. Butyrate and the bacteria enzymes β-glucuronidase, β-glucosidase and nitroreductase in the feces were all drastically higher in pork diet group. This study indicates that different diets with similar calorie and nutritional composition could change the community structure but not the diversity of rat fecal microbiota.

Gender differences in effectiveness of the Complete Health Improvement Program (CHIP) lifestyle intervention: an Australasian study

ISSUE ADDRESSED

Complete Health Improvement Program (CHIP) is a lifestyle modification program that promotes healthy diet, physical activity and stress management techniques. Among US CHIP participants, differences in gender responsiveness to improvements in chronic disease risk factors were demonstrated. This study examined gender differences in outcomes to the CHIP intervention in Australasia.

METHODS

Changes in body weight, blood pressure (BP), blood lipid profile and fasting plasma glucose (FPG) were assessed in 925 participants (34.3% men, mean age=56.0±12.5 years; 65.7% women, mean age=54.4±13.5 years) 30 days after program commencement.

RESULTS

Significant reductions (P<0.001) in all biometrics measured were found for men and women but were greater among men for total (TC) and low-density lipoprotein cholesterol (LDL), triglycerides (TG), FPG, body mass index (BMI) and TC/high-density lipoprotein cholesterol (HDL) ratio. Participants with highest baseline classifications of BMI, systolic BP, blood lipids and FPG showed greatest reductions in 30 days.

CONCLUSIONS

CHIP more effectively reduced chronic disease risk factors among men than women. All participants, but particularly men, entering the program with the greatest risk achieved the largest reductions. Possible physiological or behavioural factors include food preferences, making commitments and differential support modes. SO WHAT?: Developers of lifestyle intervention programs should consider gender differences in physiological and behavioural factors when planning interventions. In particular, developers should manage expectations of people entering lifestyle interventions to increase awareness that men tend to respond better than women. In addition, this is a call for further research to identify the underlying mechanisms responsible for the disproportionate responsiveness of males.

Gender differences in effectiveness of the Complete Health Improvement Program (CHIP)

OBJECTIVE

To determine the differential effect of gender on outcomes of the Complete Health Improvement Program, a chronic disease lifestyle intervention program.

DESIGN

Thirty-day cohort study.

SETTING

One hundred thirty-six venues around North America, 2006 to 2009.

PARTICIPANTS

A total of 5,046 participants (33.5% men, aged 57.9 ± 13.0 years; 66.5% women, aged 57.0 ± 12.9 years).

INTERVENTION

Diet, exercise, and stress management.

MAIN OUTCOME MEASURES

Body mass index, diastolic blood pressure, systolic blood pressure, lipids, and fasting plasma glucose (FPG).

ANALYSIS

The researchers used t test and McNemar chi-square test of proportions, at P < .05.

RESULTS

Reductions were significantly greater for women for high-density lipoprotein (9.1% vs 7.6%) but greater for men for low-density lipoprotein cholesterol (16.3% vs 11.5%), total cholesterol (TC) (13.2% vs 10.1%), triglycerides (11.4% vs 5.6%), FPG (8.2% vs 5.3%), body mass index (3.5% vs 3%), diastolic blood pressure (5.5% vs 5.1%), and TC/high-density lipoprotein (6.3% vs 1.4%) but not different for systolic blood pressure (6% vs 5%). The greatest reductions were in participants with the highest baseline TC, low-density lipoprotein, triglycerides, and FPG classifications.

CONCLUSIONS AND IMPLICATIONS

The Complete Health Improvement Program effectively reduced chronic disease risk factors among both genders, but particularly men, with the largest reductions occurring in individuals at greatest risk. Physiological or behavioral factor explanations, including differences in adiposity and hormones, dietary intake, commitment and social support, are explored. Researchers should consider addressing gender differences in food preferences and eliciting commitment and differential support modes in the development of lifestyle interventions such as the Complete Health Improvement Program.

Vegetarian nutrition: past, present, future

Early human food cultures were plant-based. Major religions such as Hinduism and Buddhism have recommended a vegetarian way of life since their conception. The recorded history of vegetarian nutrition started in the sixth century bc by followers of the Orphic mysteries. The Greek philosopher Pythagoras is considered the father of ethical vegetarianism. The Pythagorean way of life was followed by a number of important personalities and influenced vegetarian nutrition until the 19th century. In Europe, vegetarian nutrition more or less disappeared during the Middle Ages. In the Renaissance era and in the Age of Enlightenment, various personalities practiced vegetarianism. The first vegetarian society was started in England in 1847. The International Vegetarian Society was founded in 1908 and the first vegan society began in 1944. Prominent vegetarians during this time included Sylvester Graham, John Harvey Kellogg, and Maximilian Bircher-Benner. A paradigm shift occurred at the turn of the 21st century. The former prejudices that vegetarianism leads to malnutrition were replaced by scientific evidence showing that vegetarian nutrition reduces the risk of most contemporary diseases. Today, vegetarian nutrition has a growing international following and is increasingly accepted. The main reasons for this trend are health concerns and ethical, ecologic, and social issues. The future of vegetarian nutrition is promising because sustainable nutrition is crucial for the well-being of humankind. An increasing number of people do not want animals to suffer nor do they want climate change; they want to avoid preventable diseases and to secure a livable future for generations to come.

In defence of the vegan project

The vegan project is defined as the project that strives for radical legal reform to pass laws that would reserve the consumption of animal products to a very narrow range of situations, resulting in vegan diets being the default diets for the majority of human beings. Two objections that have been raised against such a project are described. The first is that such a project would jeopardise the nutritional adequacy of human diets. The second is that it would alienate human beings from nature. It is argued that neither undermines the vegan project.