Vegans report less stress and anxiety than omnivores

Is trauma associated with plant-based diet choice?

Examinations of links between plant-based diets (e.g., vegetarian and vegan diets) and indices of physical and mental health have received increased attention in the scientific literature in recent years. However, there has been little to no published research examining predictors of plant-based diet choice. Researchers have suggested that plant-based diets could be linked to trauma for a variety of reasons, including the idea that trauma can increase the risk for mental illnesses, and plant-based diets may be adopted to self-medicate mental illness and promote recovery. The current study examined the link between trauma across the lifespan and experiences of intimate partner violence (IPV) with adherence to a plant-based diet. Participants were a nationally representative United States sample of 1665 individuals who completed self-report questionnaires. Consistent with hypotheses, bivariate correlations indicated that all measures of trauma were associated with an increased likelihood of being plant-based. Findings from a logistic regression analysis indicated those with a history of IPV were 2.31 times more likely to be plant-based, and those with any experience of trauma more broadly were 1.09 times more likely to be plant-based. These results suggest the importance of considering the role of trauma and victimization when examining links between plant-based diet and other outcomes and point to a number of possible avenues for additional investigation to better understand these associations.

Plant-based eating pattern and psychological symptoms: a cross-sectional survey among patients with migraine

OBJECTIVES

The present study evaluated the association between plant-based diet index (PDI) and psychological symptoms, including depressive symptoms, stress, and anxiety among Iranian women diagnosed with migraine headaches.

METHODS

A cross-sectional study was conducted on 262 patients with migraine (aged 20-50 years; body mass index, 18.5-30 kg/m²). Three versions of the PDI were calculated: overall PDI, healthy PDI (hPDI), and unhealthy PDI (uPDI) based on dietary data collected via a 168-item food frequency questionnaire (FFQ). Psychological symptoms, including depressive symptoms, anxiety, and stress, were assessed using the Depression, Anxiety, Stress Scale-21 (DASS-21) questionnaire.

RESULTS

After adjustment for potential confounders, patients in the highest tertile of the PDI showed a lower risk of depressive symptoms [odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.22, 0.77]. Furthermore, inverse associations were evident between the PDI score and the risk of stress (OR = 0.46, 95% CI: 0.24, 0.85).

DISCUSSION

Higher adherence to a plant-based eating pattern is associated with a reduced risk of psychological symptoms. However, future longitudinal studies and clinical trials should replicate our observations and delineate the underlying mechanisms driving these associations.

Nutritional Modulation of the Gut-Brain Axis: A Comprehensive Review of Dietary Interventions in Depression and Anxiety Management

Mental health is an increasing topic of focus since more than 500 million people in the world suffer from depression and anxiety. In this multifactorial disorder, parameters such as inflammation, the state of the microbiota and, therefore, the patient's nutrition are receiving more attention. In addition, food products are the source of many essential ingredients involved in the regulation of mental processes, including amino acids, neurotransmitters, vitamins, and others. For this reason, this narrative review was carried out with the aim of analyzing the role of nutrition in depression and anxiety disorders. To reach the review aim, a critical review was conducted utilizing both primary sources, such as scientific publications and secondary sources, such as bibliographic indexes, web pages, and databases. The search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase, and CinAhl. The results show a direct relationship between what we eat and the state of our nervous system. The gut-brain axis is a complex system in which the intestinal microbiota communicates directly with our nervous system and provides it with neurotransmitters for its proper functioning. An imbalance in our microbiota due to poor nutrition will cause an inflammatory response that, if sustained over time and together with other factors, can lead to disorders such as anxiety and depression. Changes in the functions of the microbiota-gut-brain axis have been linked to several mental disorders. It is believed that the modulation of the microbiome composition may be an effective strategy for a new treatment of these disorders. Modifications in nutritional behaviors and the use of ergogenic components are presented as important non-pharmacological interventions in anxiety and depression prevention and treatment. It is desirable that the choice of nutritional and probiotic treatment in individual patients be based on the results of appropriate biochemical and microbiological tests.

Religious Involvement, Vegetarian Diet, and Mental Well-Being Among Seventh-day Adventists in Peru

Mental well-being is conditioned by several factors, including religious involvement and diet. However, this evidence does not exist among members of the Seventh-day Adventist Church (SDA) in Latin America, particularly Peru. This study evaluated the association between religious involvement and vegetarian diet with mental well-being in members of the SDA Church in Peru. In this cross-sectional study, the sample included 767 participants, aged 18 to 59 years. A face-to-face and online survey was administered that included information on the dietary regimen and sociodemographic characteristics. Religious involvement and mental well-being were measured using the 12-item version of the General Health Questionnaire (GHQ-12) and the Duke University Religion Index (DUREL), respectively. A multivariate analysis was conducted to investigate the factors associated with mental well-being. Being female (β = 1.80, p < 0.001), coming from the highland region (β = 1.98, p < 0.001), having a basic educational degree (β = 1.85, p < 0.001), a higher level of religious involvement (β = 0.34, p < 0.001), and being vegetarian (β = 1.21, p < 0.001) were associated with greater mental well-being. This evidence highlights the implication of religious participation and a vegetarian diet in mental health, not only among SDA church members but also in a broader context. However, it should be recognized that direct transfer of church-based health promotion interventions and strategies to the general population can present challenges; therefore, it is suggested that these strategies should be adapted and adjusted to consider differences in the community context.

Impact of vegetarianism on cognition and neuropsychological status among urban community-dwelling adults in Telangana, South India: a cross-sectional study

PURPOSE

The potential benefits of vegetarian diets in reducing cognitive impairment have garnered attention due to existing mixed results; hence, our study aims to examine the impact of vegetarianism on cognitive function and neuropsychological status among urban community-dwelling adults from Telangana.

METHODS

The dietary patterns were self-reported and dietary data collected using a Food Frequency Questionnaire while cognitive function was assessed using Mini-Mental State Examination (MMSE) and depression, anxiety, and stress (DASS-21) questionnaire for psychological measures. Adults (N = 304) aged 40 years and above, who followed either a vegetarian or non-vegetarian diet for at least 6 months prior to data collection, scored MMSE ≥ 19 indicating mild cognitive impairment, and were recruited using convenience sampling.

RESULTS

Among the participants, vegetarians (n = 155) exhibited significantly better mood states compared to non-vegetarians (n = 149), as indicated by lower scores on the DASS subscales for depression (10.0 ± 0.06 vs. 17.0 ± 0.07, p =  < 0.001), anxiety (4.0 ± 0.05 vs. 6.0 ± 0.07, p = 0.005), and stress (8.0 ± 0.02 vs. 10.0 ± 0.05, p = 0.007). Vegetarians also demonstrated superior cognitive functioning compared to non-vegetarians, as indicated by higher MMSE scores (26.0 ± 0.04 vs. 24.0 ± 0.03, p =  < 0.001). MMSE scores were inversely correlated with depression, anxiety, and stress for vegetarians (ρ = - 0.371, p = 0.000; ρ = - 0.027, p = 0.734; and ρ = - 0.105, p = 0.914), respectively. Similar to the vegetarians group, MMSE scores were negatively correlated with depression (ρ = - 0.059), but the correlation is not significant.

CONCLUSION

Vegetarianism exerted a positive influence on the cognitive and neuropsychological status of the investigated population. Nevertheless, additional research is required to comprehend the underlying mechanisms that elucidate the long-term effects of vegetarianism and plant-based nutritional interventions on brain health.

Depression, Anxiety, Emotional Eating, and Body Mass Index among Self-Reported Vegetarians and Non-Vegetarians: A Cross-Sectional Study in Peruvian Adults

Background: Vegetarianism is commonly associated with various health benefits. However, the association between this dietary regimen and aspects of mental health remains ambiguous. This study compared the symptoms of depression and anxiety, emotional eating (EmE), and body mass index (BMI) in Peruvian vegetarian and non-vegetarian adults. Methods: A cross-sectional study was conducted on 768 Peruvian adults, of whom 284 (37%) were vegetarians and 484 (63%) were non-vegetarians. The Depression Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2), and an EmE questionnaire were applied; additionally, the BMI was calculated. Simple and multiple linear regression and Poisson regression models with robust variance were used to evaluate the association between depression, anxiety, EmE, and BMI with dietary patterns. Results: The vegetarians (Adjusted Prevalence Ratio [PR] = 0.24, 95% CI 0.16-0.31; p < 0.001) reported more depressive symptoms than the non-vegetarians. This trend persisted for anxiety, with an adjusted PR of 0.17 (95% CI: 0.01-0.29; p = 0.012). However, the vegetarians (adjusted PR = -0.38, 95% CI: -0.61--0.14; p < 0.001) reported lower EmE scores compared to the non-vegetarians. Likewise, the vegetarians had a lower mean BMI than the non-vegetarians (B = -0.16, 95% CI: -0.21--0.08; p < 0.001). Conclusions: Vegetarian diets are associated with increased symptoms of depression and anxiety, as well as lower EmE and BMI scores. Further longitudinal studies are needed to elucidate these associations and determine causality and the underlying mechanisms involved.

Diet quality and anxiety: a critical overview with focus on the gut microbiome

Anxiety disorders disproportionally affect females and are frequently comorbid with eating disorders. With the emerging field of nutritional psychiatry, focus has been put on the impact of diet quality in anxiety pathophysiology and gut microbiome underlying mechanisms. While the relationship between diet and anxiety is bidirectional, improving dietary habits could better facilitate the actions of pharmacological and psychological therapies, or prevent their use. A better understanding of how gut bacteria mediate and moderate such relationship could further contribute to develop personalized programs and inform probiotics and prebiotics manufacturing. To date, studies that look simultaneously at diet, the gut microbiome, and anxiety are missing as only pairwise relationships among them have been investigated. Therefore, this study aims at summarizing and integrating the existing knowledge on the dietary effects on anxiety with focus on gut microbiome. Findings on the effects of diet on anxiety are critically summarized and reinterpreted in relation to findings on (i) the effects of diet on the gut microbiome composition, and (ii) the associations between the abundance of certain gut bacteria and anxiety. This novel interpretation suggests a theoretical model where the relationship between diet and anxiety is mediated and/or modulated by the gut microbiome through multiple mechanisms. In parallel, this study critically evaluates methodologies employed in the nutritional field to investigate the effects of diet on anxiety highlighting a lack of systematic operationalization and assessment strategies. Therefore, it ultimately proposes a novel evidence-based approach that can enhance studies validity, reliability, systematicity, and translation to clinical and community settings.

The mediating effect of health behaviors on the association between job strain and mental health outcome: a national survey of police officers

Police officers often face emotionally challenging interpersonal situations and numerous studies have demonstrated that policing is a stressful occupation. A study revealed a significant positive correlation between emotional demands among police officers and emotional dissonance, as well as burnout. Health-promoting behaviors can contribute to better overall health outcomes and reduce the risk of developing health problems, but there is limited research evaluating the association of job strain and health behaviors with mental health outcomes in police officers. The objective of this study was to assess the job strain associated with mental health mediated by health behaviors in Taiwanese police officers. This was a cross-sectional quantitative study conducted in Oct 2016. A total of 41,871 police officers (response rate was 79.7%) participated questionnaire that consisted of demographic information, job characteristics, health behaviors, and mental component summary (MCS) scores of the Short-Form Health Survey. Independent t-tests and one-way analysis of variance (One-way ANOVA) were conducted to assess the differences in mean MCS scores across various demographics, health behavior, and job characteristics. Multivariate regression analyses were used to assess the relationship between job strain and health behaviors with mental health outcomes. MCS scores were associated with job characteristics and health behaviors among police officers except for gender. After adjusting for covariates, multivariate analysis indicated that police officers with high job demands and high job strain index exhibited poor MCS scores. Job strain was significantly associated with MCS mediated by health behaviors (consumption of fruits and vegetables, and physical activity) in Taiwanese police officers. Since regular physical activity and increased vegetable and fruit consumption might alleviate the effects of job strain on mental health status, it is recommended that institutional policies be established to promote health-enhancing behaviors among police officers.

Motivations matter: moral and health-related motives indirectly relate to differential psychological health indicators among vegetarians

Due to rising popularity of vegetarianism in recent years, research interest has surged in examining the relationship between vegetarianism and psychological health. However, given inconsistent findings in prior research, the answer to whether practicing vegetarianism is associated with better or worse psychological health is still elusive. The present investigation aimed to demonstrate that vegetarians are not homogeneous in terms of psychological experiences, such that it is crucial to consider the motives behind vegetarians' dietary choice when examining their psychological health. In a survey study with 266 vegetarians and 104 omnivores, it was shown that health vegetarians displayed higher levels of disordered eating as compared to moral vegetarians and omnivores. Mediation analyses further revealed that, among vegetarians, health motivation was positively correlated with disordered eating tendencies, indirectly linking it with poorer psychological health; moral motivation was positively correlated with prosocial behavior, which in turn predicted better psychological health. These findings have implications for understanding the psychological health of vegetarians with different dietary motives and for developing interventions to promote their psychological health.

Association of plant-based dietary patterns with depression and anxiety symptoms in Chinese older adults: A nationwide study

BACKGROUND

The associations of plant-based dietary patterns with depression and anxiety symptoms among older adults have not been extensively studied. Therefore, the purpose of this study was to examine these associations in Chinese older adults.

METHODS

Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was employed in the present study. The simplified food frequency questionnaire was used to assess the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). The Center for Epidemiologic Studies Depression Scale-10 (CES-D-10) was used to evaluate depression symptoms, and the Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess anxiety symptoms. This study employed logistic regression and linear regression to examine the associations between plant-based dietary patterns and symptoms of depression and anxiety.

RESULTS

This study included 11,971 older adults, with a mean age of 83.23 ± 11.10 years. The results indicated that PDI and hPDI were negative associated with depression symptoms (adjusted β -0.09, 95 % CI -0.11, -0.07) (adjusted β -0.09, 95 % CI -0.11, -0.07) and anxiety symptoms (adjusted β -0.03, 95 % CI -0.04, -0.02) (adjusted β -0.04, 95 % CI -0.05, -0.02), while uPDI was positive associated with depression symptoms (adjusted β 0.09, 95 % CI 0.07, 0.11) and anxiety symptoms (adjusted β 0.04, 95 % CI 0.03, 0.05).

CONCLUSIONS

The findings from this study have the potential to promote healthy dietary patterns in older adults, and may have implications for the prevention and management of depression and anxiety in this population.

Dietary eating patterns, dairy consumption, and anxiety: A systematic literature review

BACKGROUND

Nutrition affects both physical and mental health but evidence is mixed regarding potential associations between anxiety and diet, particularly dairy consumption. We conducted a systematic literature review (SLR) of dairy consumption and/or various dietary patterns and risk of anxiety.

METHODS

Literature searches were conducted in PubMed and Embase. All study designs except case reports, small case series, and SLRs were considered for inclusion. Reference lists of previously published SLRs were reviewed for any relevant additional studies. Studies of populations without dairy sensitivities exploring the association between dietary patterns and/or dairy consumption and anxiety published through May 2022 were identified using predefined eligibility criteria. Study quality was determined using the Academy of Nutrition and Dietetics Quality Criteria Checklist.

RESULTS

For this SLR, 132 studies were included; 80 were cross-sectional. Studies examined different dietary patterns (e.g., Mediterranean, gluten-free) and anxiety using various anxiety scales, with 19 studies specifically reporting on whole dairy consumption and anxiety. Dairy consumption was significantly associated with a lower risk of anxiety in 7 studies, while the remaining 12 studies showed no significant associations. Evidence was mixed for the association between various dietary patterns and anxiety, but more studies observed a lower risk of anxiety with greater adherence to "healthy" diets (e.g., Mediterranean, diet quality score, vegetarian/vegan) than a higher risk. Notable heterogeneity in study populations, time periods, geographical locations, dietary assessment methods, and anxiety scales was observed.

CONCLUSIONS

The results of this SLR suggest a potential link between diet including diary consumption and anxiety, but future studies, especially with longitudinal designs that measure diet and anxiety at several timepoints and comprehensively adjust for confounders, are needed to fully understand the relationship between diet and anxiety.

Diet and odor hedonic ratings: comparative study between vegetarians, flexitarians, and omnivores

OBJECTIVES

Odor hedonic perception is well known to exhibit great variability and to depend on several parameters, i.e. stimulus, context, and subject characteristics. As hedonic perception (pleasant/unpleasant character) of food odors is considered one of the most prominent dimensions in eating behavior, the question of hedonic variability in this context arises. Thus, the aim of the present study was to compare odor hedonic ratings in three populations with regard to diet (i.e. omnivore, vegetarian, and flexitarian diets).

METHODS

Four categories of odors were compared: meat, vegetable, other food, and non-food odors.

RESULTS

The results showed that vegetarian and flexitarian individuals rated meat odors as more unpleasant than omnivores, while no significant difference was found for other categories of odors.

DISCUSSION

The question of whether the diet influences the hedonic perception or/and inversely is discussed, regarding several aspects of food consumption such as eating disorders, food education, … and could further serve to manage eating behaviors.

PRACTICAL APPLICATIONS

This study evidenced that vegetarians and flexitarians specifically rated meat odors as being more unpleasant than those of omnivores. Because of the growing number of vegetarians and flexitarians in the general population, it could be suggested to take into account the odor hedonic perception (especially regarding food odors) in studies related to diets. Besides, the present results could further serve research in several aspects of food consumption such as eating disorders (anorexia, bulimia … etc.) or food education as well as the management of eating behaviors, especially in an elderly population.

Veganism and body weight: An N of 1 self-experiment

The causal effect that veganism has on body weight has not been scientifically examined. An N of 1 self-experiment was conducted in which blinded body weight and additional behavioural and psychological measures were assessed during two phases of vegan vs. non-vegan lifestyle adherence. In study phase 1, body weight change was -0.8 kg over 1 month of veganism (vs. +0.5 kg non-vegan month). In study phase 2, weight change was -1.2 kg over two veganism months (vs. +1.6 kg non-vegan months). Behavioural and psychological measures were similar during vegan vs. non-vegan periods. Veganism appeared to reduce body weight in this N of 1 self-experiment.

Changes in anxiety and depression levels and meat intake following recognition of low genetic risk for high body mass index, triglycerides, and lipoproteins: A randomized controlled trial

BACKGROUND

Psychological status affects dietary intake, and recognizing genetic information can lead to behavior changes by influencing psychological factors such as anxiety or depression.

OBJECTIVES

In this study, we examined the effects of disclosing genetic information on anxiety or depression levels and the association between these psychological factors and dietary intake.

METHODS

A total of 100 healthy adults were randomly assigned to an intervention group (n = 65) informed about their genetic test results regarding body mass index and lipid profiles (triglyceride and cholesterol concentrations) and a not-informed control group (CON, n = 35). Based on polygenic risk scores, participants in the intervention group were subclassified into an intervention-low risk (ILR, n = 32) and an intervention-high risk (IHR, n = 33) group. Nutrient and food intakes were assessed via a 3-day dietary record at baseline and at 3 and 6 months. Depression and anxiety levels were measured using PHQ-9 and GAD-7 questionnaires, and the relative levels of blood metabolites were measure using GC-MS/MS analysis.

RESULTS

Noticeable changes in dietary intake as well as psychological factors were observed in male subjects, with those perceiving their genetic risks as low (ILR) showing a significant increase in protein intake at 3 months compared to baseline (ILR: 3.9 ± 1.4, p<0.05). Meat intake also increased significantly in males in the ILR group at 3 months, but not in the IHR and CON groups (ILR: 49.4 ± 30.8, IHR: -52.2 ± 25.4, CON: -5.3 ± 30.3 g/d). ILR group showed a significant decrease in anxiety levels at 3 months, and their anxiety scores showed a negative association with meat intake (standardized β = -0.321, p<0.05). The meat intake at 3 months was associated with the relative levels of arginine and ornithine (standardized β = 0.452, p<0.05 and standardized β = 0.474, p<0.05, respectively).

CONCLUSIONS

Taken together, anxiety levels were decreased in male subjects who perceived their genetic risk to be low, and the decrease in anxiety levels was associated with an increase in meat intake. This suggests that recognizing genetic information may affect psychological factors and dietary intake.

The relationship between a plant-based diet and mental health: Evidence from a cross-sectional multicentric community trial (LIPOKAP study)

BACKGROUND

Dietary patterns emphasizing plant foods might be neuroprotective and exert health benefits on mental health. However, there is a paucity of evidence on the association between a plant-based dietary index and mental health measures.

OBJECTIVE

This study sought to examine the association between plant-based dietary indices, depression and anxiety in a large multicentric sample of Iranian adults.

METHODS

This cross-sectional study was performed in a sample of 2,033 participants. A validated food frequency questionnaire was used to evaluate dietary intakes of participants. Three versions of PDI including an overall PDI, a healthy PDI (hPDI), and an unhealthy PDI (uPDI) were created. The presence of anxiety and depression was examined via a validated Iranian version of the Hospital Anxiety and Depression Scale (HADS).

RESULTS

PDI and hPDI were not associated to depression and anxiety after adjustment for potential covariates (age, sex, energy, marital status, physical activity level and smoking). However, in the crude model, the highest consumption of uPDI approximately doubled the risk of depression (OR= 2.07, 95% CI: 1.49, 2.87; P<0.0001) and increased the risk of anxiety by almost 50% (OR= 1.56, 95% CI: 1.14, 2.14; P= 0.001). Adjustment for potential confounders just slightly changed the associations (OR for depression in the fourth quartile= 1.96; 95% CI: 1.34, 2.85, and OR for anxiety in the fourth quartile= 1.53; 95% CI: 1.07, 2.19).

CONCLUSIONS

An unhealthy plant-based dietary index is associated with a higher risk of depression and anxiety, while plant-based dietary index and healthy plant-based dietary index were not associated to depression and anxiety.

Vegetarians have an indirect positive effect on sleep quality through depression condition

This study aimed to assess the association between a vegetarian diet and sleep quality among Chinese healthy adults and explore potential contributing factors. A cross-sectional study was conducted with 280 vegetarians and 280 age- and sex-matched omnivores from Shanghai, China. The Pittsburgh Sleep Quality Index (PSQI) and the Central Depression Scale (CES-D) were used to assess sleep and depression condition, respectively. A validated semi-quantitative food frequency questionnaires (SQFFQ) was employed to assess dietary intakes, and body composition was measured with InBody720. Multi-linear regression and logistic regression analysis were performed for the data analysis. The sleep quality was significantly better in the vegetarians than in the omnivores (PSQI score: 2.80 ± 2.02 vs. 3.27 ± 1.90, p = 0.005). The proportion of vegetarians who reported self-satisfied sleep was also higher than that of the omnivores (84.6% vs. 76.1%, p = 0.011). However, after adjusted for the depression condition (CES-D scores), the difference in sleep quality between vegetarians and omnivores became insignificant (p = 0.053). Compared to omnivores, vegetarians had lower depression scores (CES-D: 9.37 ± 6.24 vs. 10.94 ± 7.00, p = 0.006). After controlling for confounding factors, there was positive association between depression condition and sleep quality (β = 0.106, 95%CI: 0.083 to 0.129, p < 0.001). Similarly, participants with better CES-D score had a lower risk of sleep disorders after controlling for the same confounding factors (OR = 1.109, 95%CI: 1.072 to 1.147, p < 0.001). Different contributing factors were reported in the vegetarian group and omnivore group. In conclusion, a vegetarian diet might improve sleep quality by moderating mental health, particularly depression condition.

Quality of plant-based diet and the risk of dementia and depression among middle-aged and older population

BACKGROUND

several previous studies have shown the importance of the plant-based diets. However, not all plant-based foods are necessarily beneficial for dementia or depression. This study aimed to prospectively investigate the association between an overall plant-based diet and the incidence of dementia or depression.

METHODS

we included 180,532 participants from the UK Biobank cohort study, free of a history of cardiovascular disease, cancer, dementia and depression at baseline. We calculated an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI) and an unhealthful plant-based diet index (uPDI) based on 17 major food groups from Oxford WebQ. Dementia and depression were evaluated using hospital inpatient records in UK Biobank. Cox proportional hazards regression models were used to estimate the association between PDIs and the incidence of dementia or depression.

RESULTS

during the follow-up, 1,428 dementia cases and 6,781 depression cases were documented. After adjusting for several potential confounders and comparing the highest with the lowest quintile of three plant-based diet indices, the multivariable hazard ratios (95% confidence intervals (CIs)) for dementia were 1.03 (0.87, 1.23) for PDI, 0.82 (0.68, 0.98) for hPDI and 1.29 (1.08, 1.53) for uPDI. The hazard ratios (95% CI) for depression were 1.06 (0.98, 1.14) for PDI, 0.92 (0.85, 0.99) for hPDI and 1.15 (1.07, 1.24) for uPDI.

CONCLUSION

a plant-based diet rich in healthier plant foods was associated with a lower risk of dementia and depression, whereas a plant-based diet that emphasises less-healthy plant foods was associated with a higher risk of dementia and depression.

From the need to the knowledge. Feeding emotions and thoughts: Assessing emotion regulation strategies in food tribes

Some people choose to follow a certain dietary habit because they are guided by strong beliefs, but also to pursue a healthy lifestyle. Food tribes are defined as social groups sharing common values and beliefs that underlie food and lifestyle choices. The current study aimed to investigate potential differences in emotion regulation between specific food tribes, and when comparing food tribes to people who conversely do not follow a dietary habit. Specifically, we examined the presence of rumination, psychological inflexibility, and emotional contagion as components of emotion dysregulation. A Google form was developed to obtain all the information needed to respond to our research questions and goals, and investigate the following food groups: Veganism, Fruitarianism, Raw Food Diet, Paleodiet, Blood Type group, Breatharianism, Macrobiotic Diet, and Other. The final sample consisted of 378 healthy subjects (117 males, 258 females, 3 other) ranging in age from 18 to 70 years. The first part of Google form consisted of general questions about the participant's dietary habits while the second part included specific questionnaires assessing the psychological constructs we investigated. Vegan people were less conditioned by others in their food choices when compared to the other food tribes. The Paleodiet group associated its food choice with health reasons as well as the Blood Type group. Differences were found in the presence of cognitive inflexibility and rumination, reflective thinking, emotional dysregulation, emotional contagion and also in the representation of their real and ideal (food) communities. Clinical implications are discussed.

Moral emotions and justifying beliefs about meat, fish, dairy and egg consumption: A comparative study of dietary groups

Meat eaters and meat abstainers differ in their beliefs and moral emotions related to meat consumption alongside gender differences. Few studies have investigated beliefs and moral emotions in pescatarians and vegans. Little is known about differences in moral emotions and beliefs regarding dairy, eggs, and fish or about speciesist beliefs within and between specific dietary groups. To address this gap, we investigated moral emotions (consumption-related disgust and guilt), attitudes towards animals (Animal Attitudes Scale) and justifying beliefs related to meat (Carnism Inventory), dairy, egg, and fish consumption in omnivores (n = 167), pescatarians (n = 110), vegetarians (n = 116), and vegans (n = 149). Results showed that people who consumed animal-derived products reported lower disgust and guilt and held stronger justifying beliefs about consumption of these products than those who did not consume animal products. All dietary groups significantly differed from each other in their attitudes about using animals for human benefit, with omnivores showing the least positive attitudes towards animals, followed by pescatarians and vegetarians, and with vegans showing the most positive attitudes towards animals. Women experienced greater moral emotions and held fewer justifying beliefs than men within groups where animal products were consumed and related to the animal-based products they consume (i.e., fish for pescatarians and eggs/dairy for vegetarians). These findings emphasise the importance of considering a wider range of animal products, such as eggs, dairy and fish, and dietary groups in order to obtain a comprehensive understanding of the psychological underpinnings of animal product consumption. The results highlight differences between dietary groups in attitudes and moral concern towards animals, which may be important to consider when designing interventions to reduce animal product consumption.

Life Satisfaction and Self-Esteem in Older Adults Engaging in Formal Volunteering: A Cross-Sectional Study in Taiwan

Previous research has reported an association between life satisfaction, self-esteem, and volunteering. However, it is unclear whether self-esteem is associated with life satisfaction in older adults who are already engaged in volunteering. Therefore, the present study aimed to investigate the association between life satisfaction and self-esteem in older adults who were formally volunteering at a non-governmental organization in Taiwan. A cross-sectional study was conducted on 186 formal volunteers aged ≥ 65 years who were recruited from the Keelung chapter of the Buddhist Compassion Relief Tzu Chi Foundation in Taiwan. A hierarchical stepwise linear regression was used to examine the association between scores on the Satisfaction With Life Scale (SWLS) with the Rosenberg Self-Esteem Scale (RSES) and the Hedonic and Eudaimonic Motives for Activities-Revised (HEMA-R) scale. The results showed that SWLS was significantly associated with RSES score (standardized beta (std. β) = 0.199, p = 0.003), the eudaimonic subscale score of the HEMA-R (std. β = 0.353, p < 0.001), a vegetarian diet (std. β = 0.143, p = 0.027), and volunteering for five days or more a week (std. β = 0.161, p = 0.011). In conclusion, improving self-esteem and promoting eudaimonic motives in older adults who are formally volunteering could be effective strategies for enhancing their levels of life satisfaction.

Mediterranean-Style Diet and Other Determinants of Well-Being in Omnivorous, Vegetarian, and Vegan Women

Due to the lack of studies comparing the determinants of well-being in omnivores and vegetarians, we examined associations of socio-demographic and lifestyle factors, including adherence to a Mediterranean-style diet, in relation to well-being in omnivorous, vegetarian, and vegan women. Well-being was assessed using a validated WHO-5 Well-Being Index. Adherence to the Mediterranean-style diet was determined using a modified Mediterranean diet score. The study was conducted on 636 women (23.9 ± 5.7 years), of whom 47.3% were omnivores, 33.2% vegetarians, and 19.5% vegans. The good well-being group (WHO-5 Index ≥ 13 points) comprised 30.9% of the omnivores, 46.0% of the vegetarians, and 57.3% of the vegans. The remaining participants were classified as belonging to the poor well-being group (<13 points). Compared to the omnivores, the vegetarians and vegans had a 1.6-fold (95% CI: 1.04-2.42) and a 2.4-fold (95% CI: 1.45-3.99) higher probability of having good well-being, respectively. In omnivores, the predictors of good well-being were adherence to the Mediterranean-style diet (a 1-score increment was associated with a 17% higher probability of good well-being, P-trend = 0.016), higher self-perceived health status, and lower levels of stress. In vegetarians and vegans, it was older age, higher physical activity (≥3 h/week), 7-8 h sleep time, and similarly to omnivores' higher self-perceived health status and lower stress level. Our findings indicate that following a Mediterranean-style diet was associated with better well-being in omnivores. Furthermore, we identified that different determinants were associated with well-being in omnivorous and vegetarian and vegan women.

Association of 100% Fruit Juice Consumption with Cognitive Measures, Anxiety, and Depression in US Adults

Cognitive decline, anxiety, and depression are significant contributors to human ill health and decreased quality of life. Intake of fruits including 100% juice is associated with beneficial effects on several health outcomes. The current study explored the potential associations between consumption of 100% fruit juice and neurocognitive markers in adults. Twenty-four-hour dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 1988-1994, 1999-2018 for adults 20+ years (N = 62,606) were used to assess 100% fruit juice intake, and NHANES questionnaire data were used for the assessment of neurocognition. Association of usual intake of 100% fruit juice with neurocognitive outcomes were assessed by regression analysis after adjusting for demographic, lifestyle, dietary, and health-related covariates. About 21% of adults were fruit juice consumers and the intake was a little over 2 oz per day. Consumers of 100% fruit juice had 16.3% fewer days per month of feeling anxious compared to non-consumers. There were no significant associations of 100% fruit juice usual intake with other neurocognitive measures. A large number of potential confounding variables have been identified to be associated with one or more neurocognitive measures suggesting that these may be important parameters to include in future studies.

Identity processes and food choice: predictors of dietary lapses among ethical and health vegans

An interesting finding in the literature on vegetarianism and veganism finds that vegetarians and vegans often report that they deviate from their diets from time to time. Work examining this phenomenon finds that these dietary lapses relate to many factors; however, little research examines how these factors collectively influence dietary lapses while also controlling for the relationships that may exist among factors. Here, I fill this gap by drawing from the unified model of vegetarian identity (UMVI) and identity theory (IT) to propose an inclusive model of dietary lapses. Structural equation model results from a sample of 488 vegans reveal differences in how identity and interactional processes relate to dietary lapses across ethical and health motivations. This work is important because it highlights how identities relate to dietary behaviors differently for ethical and health vegans; it also provides fruitful avenues for future work in this area.

The Effect of the Dietary Approaches to Stop Hypertension (DASH) Diet on Sleep, Mental Health, and Hormonal Changes: A Randomized Clinical Trial in Women With Type 2 Diabetes

Background

Some dietary patterns may improve diabetes complications through scavenging oxidants and anti-inflammatory properties. This study evaluated the effect of the Dietary Approaches to Stop Hypertension (DASH) diet on sleep status, mental health, and hormonal changes among Iranian women with type 2 diabetes.

Methods

This randomized controlled trial (RCT) included 66 diabetic women. Participants were randomly divided into the two different diet groups (the DASH diet and control diet; 33 patients in each group) for 3 months. The Pittsburgh Sleep Quality Index and the Depression, Anxiety, and Stress Scale-21 items were used to assess sleep and mental disorders, respectively. Fasting blood sugar, hemoglobin A1c (HbA1c), advanced glycation end products (AGEs), as well as several sex hormones were evaluated at the beginning and the end of the trial.

Results

Anthropometric indices, HbA1c (control: 8.77 ± 0.82 vs. 8.04 ± 1.03; the DASH diet 8.70 ± 1.05 vs.7.41 ± 1.03), and follicle-stimulating hormone (FSH) (control: 72.16 ± 26.02 vs. 68.12 ± 27.63; the DASH diet: 72.99 ± 25.19 vs. 67.43 ± 27.63) significantly decreased over 12 weeks in both the groups (P &lt; .0001). Testosterone, 2-h postprandial glucose (2hPPG), and AGEs significantly decreased over 12 weeks in the DASH diet group. Sleep, depression, and anxiety scores significantly decreased over 12 weeks in the DASH diet group. Night sleep duration significantly increased over 12 weeks in the DASH diet group (P &lt; 0.0001).

Conclusion

A 12-week DASH diet significantly decreases testosterone, 2hPPG, AGEs level, as well as sleep, depression, and anxiety scores in women with type 2 diabetes. However, more RCTs are needed to confirm these findings.

The effect of therapeutic exercise and vegan diet on pain and quality of life in young female patients with chronic non-specific neck pain

Background and purpose

In recent years, dietary practices have begun to be used in painful conditions. This study aimed to investigate the effect of a vegan diet and therapeutic exercise in patients with chronic non-specific neck pain.

Materials and methods

A total of 45 young female patients with chronic non-specific neck pain, aged 18–25 years, participated in the study. Body mass index and body fat percentage were measured with bioelectrical impedance analysis. Pain severity was assessed using the Visual Analogue Scale, quality of life with the short form-36 scale, kinesiophobia with the Tampa scale of kinesiophobia and neck disability with the Neck Disability Index.

Results

The pain severity reduced in the diet group and exercise group after treatment (p = 0.001). After treatment, Neck Disability Index score decreased in the diet group and exercise group (p = 0.001). Tampa scale of kinesiophobia score decreased in the diet group and exercise group (p = 0.001). The eight domains of the short form-36 scale score increased in the diet group and exercise group (p < 0.05). No difference was found in the body mass index and fat percentage in all groups before and after treatment (p˃ 0.05).

Conclusion

A vegan diet and therapeutic exercise are beneficial to patients with chronic non-specific neck pain in terms of pain severity and quality of life.

Placing a Well-Designed Vegan Diet for Slovenes

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.

Lifestyle Adjustments in Long-COVID Management: Potential Benefits of Plant-Based Diets

PURPOSE OF REVIEW

The SARS-CoV-2-pandemic has caused mortality and morbidity at an unprecedented global scale. Many patients infected with SARS-CoV-2 continue to experience symptoms after the acute phase of infection and report fatigue, sleep difficulties, anxiety, and depression as well as arthralgia and muscle weakness. Summarized under the umbrella term "long-COVID," these symptoms may last weeks to months and impose a substantial burden on affected individuals. Dietary approaches to tackle these complications have received comparably little attention. Although plant-based diets in particular were shown to exert benefits on underlying conditions linked to poor COVID-19 outcomes, their role with regard to COVID-19 sequelae is yet largely unknown. Thus, this review sought to investigate whether a plant-based diet could reduce the burden of long-COVID.

RECENT FINDINGS

The number of clinical trials investigating the role of plant-based nutrition in COVID-19 prevention and management is currently limited. Yet, there is evidence from pre-pandemic observational and clinical studies that a plant-based diet may be of general benefit with regard to several clinical conditions that can also be found in individuals with COVID-19. These include anxiety, depression, sleep disorders, and musculoskeletal pain. Adoption of a plant-based diet leads to a reduced intake in pro-inflammatory mediators and could be one accessible strategy to tackle long-COVID associated prolonged systemic inflammation. Plant-based diets may be of general benefit with regard to some of the most commonly found COVID-19 sequelae. Additional trials investigating which plant-based eating patterns confer the greatest benefit in the battle against long-COVID are urgently warranted.

Targeting DNA Methylation in the Adult Brain through Diet

Metabolism and nutrition have a significant role in epigenetic modifications such as DNA methylation, which can influence gene expression. Recently, it has been suggested that bioactive nutrients and gut microbiota can alter DNA methylation in the central nervous system (CNS) through the gut-brain axis, playing a crucial role in modulating CNS functions and, finally, behavior. Here, we will focus on the effect of metabolic signals in shaping brain DNA methylation during adulthood. We will provide an overview of potential interactions among diet, gastrointestinal microbiome and epigenetic alterations on brain methylation and behavior. In addition, the impact of different diet challenges on cytosine methylation dynamics in the adult brain will be discussed. Finally, we will explore new ways to modulate DNA hydroxymethylation, which is particularly abundant in neural tissue, through diet.

Vegetarian diet and depression scores: A meta-analysis

BACKGROUND

Several studies have suggested an association between vegetarian diet and higher depression scores. However, some studies have also shown an effect in the opposite direction, indicating lower depression scores in vegetarians. Given this discrepancy in the literature, this meta-analysis was aimed to determine whether there is a significant association between vegetarian diet and depression scores across different published studies.

METHODS

A keyword search in major databases was conducted. Studies reporting depression scores in vegetarians and a non-vegetarian control group were included. Meta-analysis following a conditional random-effects procedure was conducted in R.

RESULTS

After duplicates were removed and studies were analyzed for inclusion criteria, k=13 studies with an overall n of 49889 participants (8057 vegetarians and 41832 non-vegetarian controls) were included in the analysis. Random-effects meta-analysis revealed a significant difference between vegetarians and non-vegetarians, with vegetarians showing higher depression scores than non-vegetarians.

LIMITATIONS

The heterogeneity between studies was high and geographical variation in study location was low, limiting cross-cultural insights.

CONCLUSIONS

Vegetarians show higher depression scores than non-vegetarians. However, due to high heterogeneity of published studies, more empirical research is needed before any final conclusions can be drawn. Also, empirical studies from a higher number of different countries would be desirable.

Plant-based dietary quality and depressive symptoms in Australian vegans and vegetarians: a cross-sectional study

Plant-based dietary patterns (vegan and vegetarian) are often considered 'healthy' and have been associated with broad health benefits, including decreased risk of obesity and ill health (cardiovascular disease, blood glucose and type II diabetes). However, the association between plant-based diets and mood disorders such as depression remains largely equivocal. This cross-sectional study of 219 adults aged 18-44 (M=31.22, SD=7.40) explored the associations between an estimate of overall plant-based diet quality and depression in vegans (n=165) and vegetarians (n=54). Overall plant-based diet quality was associated with depressive symptoms in vegans and vegetarians F(1, 215)=13.71, p<0.001 accounting for 6% of the variation in depressive symptoms. For those without depression, higher diet quality was protective against depressive symptoms F(1, 125)=6.49, p=0.012. Conversely, for those with depression no association with diet quality was found F(1, 89)=0.01, p=0.963. These findings suggest that a high-quality plant-based diet may be protective against depressive symptoms in vegans and vegetarians. In line with emerging research between food and mental health, higher-quality dietary patterns are associated with a reduced risk of depressive symptoms. Given the rapidly increasing rate of vegan and vegetarian food products within Australia, understanding the potential mechanisms of effects through which a plant-based diet may influence depressive symptoms is required.

Inflammatory, oxidative and DNA damage status in vegetarians: is the future of human diet green?

The health benefit of a vegetarian diet is still under debate as it may result in a higher intake of some beneficial micronutrients, while others may be reduced, thus influencing various metabolic pathways and health-related biomarkers. This scoping review discusses inflammatory, oxidative and DNA damage status in vegetarians and vegans compared to omnivores. Most of the reviewed studies indicated favorable effects of a vegetarian diet on oxidative status compared to omnivores but did not clearly associate particular dietary habits to genome damage. The evidence on the effect of vegetarian diet on the inflammatory and immunological biomarkers is poor, which could at least partly be explained by methodological constraints such as small sample size, short duration of vegetarianism and inconsistent definitions of the omnivorous diet. The only inflammatory biomarker that seems to be associated with the vegetarian diet was inflammatory mediator C-reactive protein, which in several studies showed lower values in vegetarians as compared to omnivores. There were very few studies on immunological markers and the results on the difference between vegetarians and omnivores were inconclusive. Although several biomarkers involved in oxidative stress and inflammation showed a beneficial association with the vegetarian diet, further research in well-defined and sufficiently sized cohorts is needed to provide more evidence.

Meat and mental health: A meta-analysis of meat consumption, depression, and anxiety

In this meta-analysis, we examined the quantitative relation between meat consumption or avoidance, depression, and anxiety. In June 2020, we searched five online databases for primary studies examining differences in depression and anxiety between meat abstainers and meat consumers that offered a clear (dichotomous) distinction between these groups. Twenty studies met the selection criteria representing 171,802 participants with 157,778 meat consumers and 13,259 meat abstainers. We calculated the magnitude of the effect between meat consumers and meat abstainers with bias correction (Hedges's g effect size) where higher and positive scores reflect better outcomes for meat consumers. Meat consumption was associated with lower depression (Hedges's g = 0.216, 95% CI [0.14 to 0.30], p < .001) and lower anxiety (g = 0.17, 95% CI [0.03 to 0.31], p = .02) compared to meat abstention. Compared to vegans, meat consumers experienced both lower depression (g = 0.26, 95% CI [0.01 to 0.51], p = .041) and anxiety (g = 0.15, 95% CI [-0.40 to 0.69], p = .598). Sex did not modify these relations. Study quality explained 58% and 76% of between-studies heterogeneity in depression and anxiety, respectively. The analysis also showed that the more rigorous the study, the more positive and consistent the relation between meat consumption and better mental health. The current body of evidence precludes causal and temporal inferences.

Positive psychology in health care: defining key stakeholders and their roles

Lifestyle-related diseases have common risk factors: physical inactivity, poor diet, inadequate sleep, high stress, substance use, and social isolation. Evidence is mounting for the benefits of incorporating effective methods that promote healthy lifestyle habits into routine health care treatments. Research has established that healthy habits foster psychological and physiological health and that emotional well-being is central to achieving total well-being. The Happiness Science and Positive Health Committee of the American College of Lifestyle Medicine aims to raise awareness about strategies for prioritizing emotional well-being. The Committee advocates for collaborative translational research to adapt the positive psychology and behavioral medicine evidence base into methodologies that address emotional well-being in nonmental health care settings. Another aim is to promote health system changes that integrate evidence-based positive-psychology interventions into health maintenance and treatment plans. Also, the Committee seeks to ameliorate health provider burnout through the application of positive psychology methods for providers' personal health. The American College of Lifestyle Medicine and Dell Medical School held an inaugural Summit on Happiness Science in Health Care in May 2018. The Summit participants recommended research, policy, and practice innovations to promote total well-being via lifestyle changes that bolster emotional well-being. These recommendations urge stakeholder collaboration to facilitate translational research for health care settings and to standardize terms, measures, and clinical approaches for implementing positive psychology interventions. Sample aims of joint collaboration include developing evidence-based, practical, low-cost behavioral and emotional assessment and monitoring tools; grants to encourage dissemination of pilot initiatives; medical record dashboards with emotional well-being and related aspects of mental health as vital signs; clinical best practices for health care teams; and automated behavioral programs to extend clinician time. However, a few simple steps for prioritizing emotional well-being can be implemented by stakeholders in the near-term.

Nutrient Intake Differences Among Ethnic Groups and Risks of Depression

The cultural background of participants has not been considered in studies of dietary intake and depression, even though food choices are affected by culture. This study aims to examine the dietary patterns of people from diverse backgrounds and the correlation of diet and risk of depression. Relationships between depression and nutrient intake were analyzed with 4747 adult respondents from NHANES data. Multiple regressions were used with depression as dependent variable. Nutrient intake pattern differed among ethnic groups. After considering demographic factors, total fat and protein intake ratio to energy were associated with depressive symptoms among Hispanic respondents. Among White, dietary fiber and sugar were associated with depressive symptoms, and among Black, energy was associated with depressive symptoms. Total sugar and dietary fiber were associated with depressive symptoms among Asian. The relationship between depressive symptoms and nutrient intake varied based on the cultural background of participants.

The association between diet and mental health and wellbeing in young adults within a biopsychosocial framework

Objective

Predominantly plant-based diets can co-benefit human physical health and the planet. Young adults appear to be on the forefront of the shift to plant-based diets. However, little is known about the relationship between plant-based diets and mental health in this population even though mental health disorders contribute substantially to the global burden of disease, particularly among this age group.

Design

In this cross-sectional study we utilize a biopsychosocial framework to assess the association between dietary intake and mental health and wellbeing. Mental health was assessed using self-reported measures of anxiety (GAD-7), depression (PHQ-9) and quality of life (single-item). Dietary intake in the prior month was assessed using a dietary screener (DSQ) and participants were asked to self-identify a diet preference (e.g., vegan).

Setting and participants

339 university undergraduate students.

Results

A principal component analysis of dietary intake found three dominant dietary patterns (plant-based, animal-based, and ‘junk foods’); 28.1% (n = 95) of participants self-identified as pescatarian, vegetarian, vegan, other. The association between dietary patterns, diet preference and mental health was assessed through regression analysis. After controlling for covariables, we found a significant positive association between the junk food component and depression (z-score β = .21, p≤.001; adj. R² = .39) and anxiety (z-score β = .14; p≤.001; adj. R² = .32) while no association was found between plant-based, animal-based or self-identified diet preference and the mental health measures.

Conclusions

We did not find a negative association between predominantly plant-based diet patterns and mental health and wellbeing. It is important to consider dietary composition and to conceptualize diet as a health behaviour that is embedded in a biopsychosocial framework.

Plant-based dietary indices and stress in female college students: a cross-sectional study

Only a few studies have investigated the association between psychological stress and the healthfulness of plant-based diets while accounting for variances in age groups and regions. In light of this, this study aimed to identify the food groups that contribute the most to the relationship between the healthfulness of plant-based diets and psychological stress in female students in Saudi Arabia. This cross-sectional study, which included 401 female college students aged 19-35 years, collected data on blood, anthropometric indices, the perceived stress scale-10 (PSS-10) and diet using the Saudi food frequency questionnaire. An overall plant-based diet index (PDI), healthy PDI, and an unhealthy PDI (uPDI) were defined. Multiple linear regression analyses were applied to examine the associations between PSS-10 and PDI and hPDI and uPDI. No associations between the PSS-10 score and the overall PDI or uPDI scores were found; however, a six-point higher hPDI score was associated with a 0·16-point lower PSS-10 score (95 % CI, -0·24, -0·08) after controlling for lifestyle factors. Moreover, adjustments for healthy food groups, including vegetables and fruits, attenuated the association between the hPDI and PSS-10. In conclusion, healthy plant-based diets are associated with lower psychological stress in young Saudi women. This finding highlights the importance, especially for female students, of following diets that are not only plant-based but are also healthy and rich in fruits and vegetables.

Intake of vitamin B12 and other characteristics of women of reproductive age on a vegan diet in Australia

OBJECTIVE

(i) To examine demographic and health characteristics of women of reproductive age on a vegan diet in Australia and compare these to the general population; (ii) to identify sources and intake of vitamin B12 and compare intake to current recommendations and (iii) examine associations between participant characteristics and adequacy of vitamin B12 intake.

DESIGN

In this cross-sectional study, data were collected via an online survey. Demographic and health characteristics of women on a vegan diet were compared with women in the general population (using Australian Bureau of Statistics data). Intake of vitamin B12 was estimated using a FFQ and estimation of supplemental intake.

SETTING

Australia.

PARTICIPANTS

Participants (n 1530) were women aged 18-44 years who had been on a vegan diet for at least 6 months.

RESULTS

While BMI, smoking habits and intakes of fruit and vegetables compared favourably with the general population, 26 % of respondents had estimated intakes of vitamin B12 below recommendations. Analyses of relationships between vitamin B12 intake and participant characteristics revealed that the strongest predictor of intake was supplementation (P < 0·001); however, 25 % had not supplemented with vitamin B12 in the past 3 months.

CONCLUSIONS

The vitamin B12 intakes of a substantial proportion of Australian women of reproductive age consuming a vegan diet do not meet the recommended intake, which could adversely affect their health, and, if they are pregnant or lactating, that of their infants too. There is a need for further research in this area to identify effective strategies to address this situation.

Adherence to the vegetarian diet may increase the risk of depression: a systematic review and meta-analysis of observational studies

CONTEXT

Several epidemiological studies have investigated the association between a vegetarian diet and risk of depression, but because of inconsistency between studies, the exact association remains unclear.

OBJECTIVE

In this systematic review and meta-analysis, the relationship between vegetarian diets and risk of depression in observational studies was evaluated.

DATA SOURCES

The Medline, Embase, Scopus, ISI Web of Science, and Cochrane Library databases were searched from inception through September 1, 2020.

STUDY SELECTION

Observational studies were included that examined mean levels of depression and risk for depression in vegetarians compared with nonvegetarians.

DATA EXTRACTION

Pooled effect sizes were estimated using the random-effects model and were reported as standardized mean differences or odds ratios (ORs) with their corresponding 95%CIs. Heterogeneity was tested using the I2 statistic.

RESULTS

Combining 9 effect sizes in this meta-analysis illustrated that adherence to a vegetarian diet was associated with a 53% greater risk of depression compared with that of omnivores (95%CI, 1.14-2.07; I2 = 69.1%). Subgroup analysis of depression risk suggested that results depended on the type of vegetarian diet and country where the study was conducted. For studies that assessed a semivegetarian diet (OR, 1.86; 95%CI, 1.42-2.44; I2 = 35.7%) and those conducted in Europe and the United States (OR, 1.45; 95%CI, 1.06-1.98; I2 = 73.2%), there was a positive association between a vegetarian diet and depression, but in lacto-ovo vegetarians and Asian countries, a null association was found. Comparing mean depression scores showed no evidence of difference between vegetarians and nonvegetarians (n = 16; standardized mean difference, 0.10; 95%CI, -0.01 to 0.21; I2 = 79.1%).

CONCLUSION

Vegetarian diet significantly increased depression risk; however, the findings were not robust, and more studies are required to investigate the vegetarian diet and depression association.

Low prevalence of gastroesophageal reflux symptoms in vegetarians

BACKGROUND

Dietary modification could reduce the risk of gastroesophageal reflux disease. Circumstantial evidence suggests that gastroesophageal reflux is less prevalent in people adhering to a vegetarian diet. We aimed to study the relationship between vegetarianism and the occurrence of gastroesophageal reflux symptoms (GERS).

METHODS

This study compares the prevalence of GERS in vegetarians with non-vegetarian controls from the general population. Frequency and severity of GERS (heartburn and/or acid regurgitation) were assessed with a self-administrated questionnaire.

RESULTS

Within 1 year, any GERS were experienced by 19 of 100 (19%) vegetarians and by 98 of 250 (39.2%) non-vegetarian controls (p < 0.001). Frequent GERS, defined as GERS on at least 1 day per week, were noted in 3% of vegetarians and in 12.8% of controls (p = 0.006). Reflux symptoms were significantly less severe in vegetarians than in non-vegetarians (p < 0.001). According to multivariable analysis, independent predictors of GERS included male sex, current smoking, BMI ≥ 25 (odds ratio [OR] = 1.94; 95% confidence interval [CI], 1.14-3.31), and a non-vegetarian diet (OR = 2.19; 95% CI, 1.20-3.97); non-vegetarian diet independently predicted frequent GERS (OR 4.03; 95% CI, 1.17-13.9). An increased risk of GERS (OR = 2.17; 95% CI, 1.09-4.29) and frequent GERS (OR 4.00; 95% CI, 1.13-14.18) in non-vegetarians were also demonstrated by logistic regression of matched data. In non-vegetarians, the risk of reflux symptoms was not significantly related to meat intake.

CONCLUSIONS

The prevalence and severity of GERS are lower in vegetarians than in non-vegetarians from the general population. The results are in line with a mitigating effect of vegetarianism on GERS. Data must be interpreted with caution given the retrospective study design and the small sample size.

Vegetarianism and veganism compared with mental health and cognitive outcomes: a systematic review and meta-analysis

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.

Nutrition and behavioral health disorders: depression and anxiety

Suboptimal nutrition has been implicated in the underlying pathology of behavioral health disorders and may impede treatment and recovery. Thus, optimizing nutritional status should be a treatment for these disorders and is likely important for prevention. The purpose of this narrative review is to describe the global burden and features of depression and anxiety, and summarize recent evidence regarding the role of diet and nutrition in the prevention and management of depression and anxiety. Current evidence suggests that healthy eating patterns that meet food-based dietary recommendations and nutrient requirements may assist in the prevention and treatment of depression and anxiety. Randomized controlled trials are needed to better understand how diet and nutrition-related biological mechanisms affect behavioral health disorders, to assist with the development of effective evidence-based nutrition interventions, to reduce the impact of these disorders, and promote well-being for affected individuals.

Vegetarian Diets and Eating Disorders in Adolescents and Young Adults: A Systematic Review

BACKGROUND

Eating disorders are more common among adolescents and young adults. An increase in the rates of these disorders has been reported during the last years. Meanwhile, vegetarianism is becoming more popular in these age groups. The purpose of the present paper is to evaluate the association between eating disorders and vegetarian diets in adolescents and young adults.

METHODS

Systematic review of related articles published in PubMed, PsycInfo and Google Scholar up to 30 May 2019.

RESULTS

A total of 20 studies (14,391 subjects) were deemed eligible for this systematic review. The majority of the studies reported significant correlations between vegetarianism and eating disorders. However, due to the cross-sectional design, a causal link between eating disorders and vegetarian status cannot be established.

CONCLUSIONS

Vegetarianism seems to be associated with eating disorders. Longitudinal studies are needed to establish temporal patterns between vegetarianism and the emergence of disordered eating.

Vegetarian diets during pregnancy: effects on the mother's health. A systematic review

While interest in vegetarian nutrition has been steadily increasing, some aspects have not yet been consistently investigated. One topic requiring evidence-based confirmation is the adoption of a vegetarian diet during pregnancy and lactation. Maternal diet is not only correlated with the fetus's and infant's health, but appears relevant for that of the mother as well. Not only is an adequate delivery of nutrients to the fetus and infant mandatory, but the increased physiological needs of the maternal body require an adequate supply of nutrients and can represent harmful stress events that may lead to well-defined pathological conditions. In this review, we aim to systematically investigate state-of-the-art of vegetarian diets during pregnancy and lactation, focusing on maternal nutritional status and pregnancy outcomes. Data are scarce, often inconsistent and not homogeneous for many of the topics we considered, mainly because only a few studies have been performed in developed countries, whereas other studies have derived from developing countries, where vegetarianism can be a proxy indicator of malnutrition. For this reason, we did not find sufficient data to provide evidence-based information and recommendations. To date, the available literature does not clearly support a negative impact on the mother's health and pregnancy outcomes, but, analogously with the findings in the vegetarian adult population, an improvement in the quality of studies might facilitate finding more information on the possible positive impact of well-planned vegetarian diets during pregnancy and lactation. More epidemiological and interventional studies are warranted, in order to address the question as to whether vegetarian nutrition represents an advantage for the mother or poses nutritional issues that need further attention.

Young adults' transition to a plant-based diet as a psychosomatic process: A psychoanalytically informed perspective

This study examined transition to a plant-based diet by young adults and the challenges and conflicts this brings. Interviews were conducted with nine young adults in Sweden and the answers were analysed guided by a psychological method from descriptive phenomenology. The results indicate that the transition to a plant-based diet is a process comprising five dimensions: 1) Exploring new ways of living based on health anxieties, 2) regulating conflicting emotions through differentiation, 3) transforming traditional models into new alternatives, 4) confirming new skills and abilities and 5) integrating experiences and emotions into a whole. These five dimensions reflect how transition to a plant-based diet is experienced physically and emotionally. The results also indicate that plant-based meals and ingredients used in the new diet are loaded with symbols and conflicting emotions. Psychoanalytically informed theory, especially object relation theory, was used in discussing what can happen to the mind during the transition. In a wider perspective, this study provides insights into how a dietary transition can bring stability to the life of young adults and help them endure and master their situation. More research is needed to assess the role of mental health in transitioning to a plant-based diet and to draw more general conclusions, an area where psychodynamic theory can provide insights.

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.

Characteristics of Slovenian Adults in Community-Based Whole-Food Plant-Based Lifestyle Program

Objective

Adopting a plant-based diet (PBD) and lifestyle is healthy, sustainable, and increasingly popular, while also demanding. Individuals might face challenges to maintain this lifestyle. We aimed to determine the anthropometric values and lifestyle factors and motives of adults to adopt a whole-food, plant-based (WFPB) lifestyle by joining our ongoing, community-based, WFPB lifestyle program 0.5-10 years ago.

Methods

We measured body mass index (BMI) and body fat percentage status (BF%) using bioimpedance. Lifestyle status was obtained by standardized electronic questionnaires. For evaluating the motives for following strict PBD, the participants were asked to rank 8 different motives (i.e., 8: the most-, 1: the least important). Setting. A cross-sectional study in Slovenia. Participants. A total of 151 healthy adults with an average age of 39.6 years (SD: 12.5 years).

Results

The participants had an average BMI of 23.9 kg/m² (SD: 3.8 kg/m²) and an average BF% of 22.3% (SD: 7.3%), were physically very active, with an average Long International Physical Activity Questionnaire (L-IPAQ) score of 5541.2 metabolic equivalents (METs) min/week (SD: 4677.0 METs min/week), having good sleep quality, with an average Pittsburgh Sleep Quality Index (PSQI) score of 2.7 (SD: 1.8), perceiving low stress, and with an average Perceived Stress Questionnaire (PSQ) score of 0.29 (SD: 0.1). We discovered no significant differences in lifestyle between participants who were involved in our WFPB lifestyle program for short, medium, or long periods of time. The motives for WFPB lifestyle included health benefits (score: 7.9/8), body mass management (6.3), eating to satiety (4.9), convenience (4.3), environmental concerns (4.1), affordability (3.7), animal ethics (3.6), and religious reasons (1.1).

Conclusion

A WFPB lifestyle program for any length of time that includes an extensive support system provides favorable, long-term lifestyle changes.

Changes in plant-based diet quality and health-related quality of life in women

Few studies have evaluated the association between a healthful plant-based diet and health-related quality of life (HRQoL). We followed 50 290 women in the Nurses’ Health Study (NHS; 1992–2000) and 51 784 women in NHSII (1993–2001) for 8 years to investigate changes in plant-based diet quality in relation to changes in physical and mental HRQoL. Plant-based diet quality was assessed by three plant-based diet indices: overall plant-based diet index (PDI), healthful PDI (hPDI) and unhealthful PDI (uPDI). Physical and mental HRQoL were measured by physical component score (PCS) and mental component score (MCS) of the 36-Item Short Form Health Survey. Diet was assessed 2 years before the HRQoL measurements and both were updated every 4 years. The associations between 4-year changes in PDIs and HRQoL were evaluated. Each 10-point increase in PDI was associated with an improvement of 0·07 (95 % CI 0·01, 0·13) in PCS and 0·11 (95 % CI 0·05, 0·16) in MCS. A 10-point increase in hPDI was associated with an increment of 0·13 (95 % CI 0·08, 0·19) in PCS and 0·09 (95 % CI 0·03, 0·15) in MCS. Conversely, a 10-point increase in uPDI was associated with decreases in PCS and MCS (−0·07 (95 % CI −0·12, −0·02) and −0·10 (95 % CI −0·16, −0·05), respectively). Compared with a stable diet, an increase in hPDI was significantly associated with improvements in physical HRQoL in older women and with mental HRQoL in younger women. In conclusion, adherence to a healthful plant-based diet was modestly associated with improvements in both physical and mental dimensions of HRQoL.