Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts

Mediterranean diet and spirituality/religion: eating with meaning

The interest in the Mediterranean diet has grown considerably due to its potential health benefits on the prevention of diverse age-related chronic diseases and its association with longevity. This dietary pattern, considered among the healthiest in the world, is not simply a combination of healthy foods but goes further in its historical and cultural roots. Mediterranean diet is not intrinsically tied to any specific religion or spiritual system, but its cultural and geographical context has influenced the dietary practices of its inhabitants, encompassing the history of Western civilization and of the three Monotheistic religions Christianity, Judaism, and Islam. These religions may have some impact on dietary choices due to religious customs and practices. In 2010 the Mediterranean diet was inscribed on the UNESCO's Representative List of Intangible Cultural Heritage of Humanity, highlighting it as a social and cultural expression of the different food cultures of the Mediterranean region and indicating that the importance of this dietary and lifestyle pattern lies not only in its specific foods and nutrients, but in the way in which its characteristic foods are produced, cooked, and eaten. In this narrative review we will discuss the possible connections between the main religions originated in the Mediterranean basin and their influence on the composition of the Mediterranean diet, and the links between spirituality/religion and this dietary pattern. This traditional model can represent a form of conscious healthy eating and lifestyle in contrast to the unhealthy Western lifestyle and ultra-processed food consumption widespread throughout the world.

Blue Zone Loma Linda: Assessing the Relationship Between Lifestyle and Oral Health

Objectives: Assess the relationship between lifestyle and oral health-related quality-of-life (OHRQoL) of residents in a blue zone, Loma Linda. Methods: A cross-sectional study was conducted using a questionnaire including demographics, lifestyle, and Oral Health Impact Profile (OHIP-14). Lifestyle cumulative scores ranged from 8-32, lower scores indicating greater conformity to Power 9® lifestyle, characterized by observing Sabbath, time with friends, volunteering, exercising, eating lots of plants, eating meat in moderation, drinking a lot of water, snacking on nuts, and eating an early dinner. OHIP-14 assessed OHRQoL, with scores from 0-56. Negative binomial regression was used, with significance of alpha = 0.05. Results: A total of 350 surveys were collected. Cumulative lifestyle showed a mean of 13.9. Spending time with friends was the most adhered to activity (96%) while the least followed was having early dinners (71.2%). Asians (Mean = 14.2) had significantly higher lifestyle scores than Whites (Mean = 13.7). The mean OHIP-14 was 7.01. Whites had lower OHIP-14 scores than Asians, indicating better OHRQoL. Race, nut consumption and exercise were significant predictors for increased OHRQoL (P < 0.05, in all instances). Conclusions: Loma Linda residents adhere well to the Power 9® lifestyle. There are significant predictors such as nut consumption and exercise for increased OHRQoL.

The Polypharma Study: Association Between Diet and Amount of Prescription Drugs Among Seniors

Polypharmacy, commonly described as the use of five or more prescribed medications, is a prevalent health issue among seniors because of the potential adverse side effects due to medication interactions. The main purpose of this study was to investigate the association between dietary patterns and number of medications used. We hypothesized that a plant-based diet and healthy lifestyle choices decreases morbidities and number of medications taken. Data on 328 participants, aged 60 years or older, were collected through questionnaires and measurements at the Loma Linda University Drayson Center in Loma Linda, CA, between 2015 and 2016. The dependent variable was the number of pills taken, used as counts, and the main exposure was the type of diet adopted. Negative binomial regression was used for analysis. Results suggest that a vegan diet reduces the number of pills by 58% compared to non-vegetarian (IRR=.42 [95% CI: .25-.70]), even after adjusting for covariates. Increases in age, body mass index (BMI), and presence of disease suggest an increased number of pills taken. A vegan diet showed the lowest amount of pills in this sample. Body mass index also had a significant positive association with the number of pills.

Vegetarian Diet Reduced Gastroesophageal Reflux Disease in a Nationwide Longitudinal Survey in Taiwan

BACKGROUND/OBJECTIVES

This large, longitudinal follow-up cohort study aimed to explore how being a vegetarian and related factors impacted the incident gastroesophageal reflux disease (GERD) in a comprehensive Taiwanese cohort.

METHODS

The study cohort was enrolled from the Taiwan Biobank. Vegetarian status, duration of being a vegetarian, type of vegetarian diet, and whether or not the participants had GERD were recorded from self-reported surveys. Associations between vegetarian status, duration, and type of diet with incident GERD were analyzed with multivariate logistic regression with adjustments for confounding variables.

RESULTS

After excluding participants with pre-existing GERD, we included 23,714 participants into the study. Multivariable analysis showed that vegetarian status (current vs. never; hazard ratio [HR], 0.697; 95% confidence interval [CI], 0.546 to 0.889; p = 0.004) was significantly inversely associated with incident GERD; conversely, ever being a vegetarian was not associated (p = 0.489). In addition, those who had been a vegetarian for 6 years or more had 0.72 times lower risk of GERD compared to those who had never been a vegetarian (HR, 0.717; 95% CI 0.558 to 0.922, p = 0.009). No significant differences were observed regarding the type of vegetarian diet with incident GERD.

CONCLUSIONS

The results showed that following a vegetarian diet was an independent protective factor for incident GERD, with a significant protective effect observed in those who adhered to a vegetarian diet for at least 6 years. Future research is warranted to explore the underlying mechanisms and whether adopting a vegetarian diet can decrease the incidence of GERD.

Frailty and chronic diseases: A bi-directional relationship

Frailty is a multidimensional syndrome associated with a decline in reserve capacity across multiple organ systems involving physical, psychological, and social aspects. Weakness is the earliest indicator of the frailty process. Multi-morbidity is the state of presence of two or more chronic diseases. Frailty and chronic diseases are interlinked as frail individuals are more prone to develop chronic diseases and multi-morbid individuals may present with frailty. They share common risk factors, pathogenesis, progression, and outcomes. Significant risk factors include obesity, smoking, aging, sedentary, and stressful lifestyle. Pathophysiological mechanisms involve high levels of circulating inflammatory cytokines as seen in individuals with frailty and chronic diseases such as hypertension, cardiovascular diseases, type 2 diabetes mellitus, chronic kidney disease, and anemia. Hence, frailty and chronic diseases go hand in hand and it is of utmost importance to identify them and intervene during early stages. Screening frailty and treating multi-morbidity incorporate both pharmacological and majorly non- pharmacological measures, such as physical activities, nutrition, pro-active care, minimizing polypharmacy and addressing reversible medical conditions. The purpose of this mini-review is to highlight the interrelation of frailty and chronic diseases through the discussion of their predictors and outcomes and how timely interventions are essential to prevent the progression of one to the other.

Diet and exercise in relation to lower extremity artery disease

Adherence to the Mediterranean diet (MeD) has been associated with a reduced incidence of peripheral arterial disease (PAD)/lower extremity arterial disease (LEAD) in observational trials and in a randomized trial. In secondary prevention, a lower hazard ratio for composite major adverse cardiovascular events has been associated with better adherence to MeD in a relatively small, randomized trial. This has not been confirmed in a sub-analysis of a large interventional trial of dual antithrombotic treatment. The effects of vegetarian, vegan or low carbohydrate/ketogenic diets on the incidence and outcomes of PAD/LEAD are not known. While abdominal obesity is associated with diabetes mellitus and PAD/LEAD, the lowest incidence of PAD/LEAD has been found in subjects with a body mass index 25-29.9 kg/m2. Malnutrition is a negative prognostic factor for survival of patients with chronic limb threatening ischemia. Physical activity (PA) is an acute stressor, but habitual recreational PA results in beneficial adaptations and improved health. In observational studies, lower levels of exercise and lower physical fitness have been associated with more prevalent PAD/LEAD. In contrast to coronary artery disease, that shows a reverse J-shaped relationship between long-term endurance exercise and coronary atherosclerosis, such a relationship is not known for PAD/LEAD. A general recommendation for maintaining cardiovascular health is performing regular moderate-intensity exercise with some vigorous-intensity aerobic PA, and resistance exercise at least twice a week. Combinations of healthy behaviors are more effective in preventing PAD/LEAD than a single behavioral component. In treatment of PAD/LEAD causing intermittent claudication, supervised walking training is recommended among measures of first-line treatment, while unsupervised walking training should be considered as an alternative.

Plant foods, healthy plant-based diets, and type 2 diabetes: a review of the evidence

Type 2 diabetes (T2D) is a metabolic chronic disease in which insulin resistance and insufficient insulin production lead to elevated blood glucose levels. The prevalence of T2D is growing worldwide, mainly due to obesity and the adoption of Western diets. Replacing animal foods with healthy plant foods is associated with a lower risk of T2D in prospective studies. In randomized controlled trials, the consumption of healthy plant foods in place of animal foods led to cardiometabolic improvements in patients with T2D or who were at high risk of the disease. Dietary patterns that limit or exclude animal foods and focus on healthy plant foods (eg, fruits, vegetables, whole grains, nuts, legumes), known as healthy, plant-based diets, are consistently associated with a lower risk of T2D in cohort studies. The aim of this review is to examine the differential effects of plant foods and animal foods on T2D risk and to describe the existing literature about the role of healthy, plant-based diets, particularly healthy vegan diets, in T2D prevention and management. The evidence from cohort studies and randomized controlled trials will be reported, in addition to the potential biological mechanisms that seem to be involved.

Nutritional Barriers to the Adherence to the Mediterranean Diet in Non-Mediterranean Populations

Adherence to the Mediterranean diet has been shown to lower the risk of developing chronic non-communicable diseases like cardiovascular and neurodegenerative diseases and cancer. Improvements in depression, participation in daily activities in older individuals, weight loss and a reduction in adverse pregnancy outcomes are associated with adherence to the Mediterranean diet. The number of studies that have evaluated barriers to adherence to the Mediterranean diet in the US and, in particular, in racial and ethnic minority populations within the US are few. Among Native American and Alaskan Native populations, studies evaluating traditional or alternative Mediterranean diet adherence for chronic non-infectious diseases is unavailable. Mediterranean diet scoring instruments used in studies in European and Mediterranean countries and among white participants in the US fail to capture the dietary patterns of racial and ethnic minority populations. In this narrative review, the food components of the traditional Mediterranean diet are discussed, adherence to the Mediterranean diet is examined in Mediterranean and non-Mediterranean countries and barriers preventing adherence to the Mediterranean diet in the US and among racial and ethnic minority populations is reviewed. Recommendations for improving nutrition education and intervention and for increasing adherence and cultural adaptions to the Mediterranean diet are provided.

A Case Report and Literature Review on Dietary Practices and Megaloblastic Anemia in a Young Female: Unraveling the Impact of Nutrition on Hematological Health

Megaloblastic anemia, stemming from vitamin B12 or folate deficiencies, poses diagnostic challenges due to its diverse clinical presentation. We report a case of a 25-year-old female college student presenting with symptoms indicative of megaloblastic anemia, attributed to her recent adoption of a strict vegetarian and vegan diet. Clinical manifestations included dizziness, palpitations, blurred vision, vertigo, headaches, burning sensations, excessive sweating, mouth ulcers, and unintentional weight loss. Physical examination revealed pale palpebral conjunctiva and sweating on the palms and soles. Laboratory findings confirmed megaloblastic anemia secondary to vitamin B12 deficiency, with elevated mean corpuscular volume (MCV), reticulocyte count, serum methylmalonic acid (MMA), and homocysteine levels. Treatment with intramuscular cyanocobalamin injections and oral vitamin B12 supplementation led to symptomatic improvement and normalization of hematological parameters. This case underscores the crucial role of dietary habits in hematological health. Vegetarian and vegan diets, devoid of animal products rich in vitamin B12, increase the risk of deficiency. Early recognition and management of such deficiencies are imperative to prevent long-term complications. A literature review corroborates the association between vegetarianism/veganism and megaloblastic anemia risk. Healthcare providers should vigilantly assess dietary histories, particularly in patients with hematological abnormalities. Further research is warranted to explore strategies for optimizing nutrient intake in individuals adhering to vegetarian or vegan diets, aiming to mitigate the risk of nutritional deficiencies and associated complications.

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.

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.

Eating vegan due to cancer: A different social experience than other vegan dieters?

Many diagnosed with cancer change their diet in response to the diagnosis, with a vegan diet being a common choice. There may be health benefits to this, but research has demonstrated that following a vegan diet can have negative social ramifications. These social ramifications seem to be experienced to a lesser extent by those who following a vegan diet for health versus moral reasons, but this is a heterogeneous group; people may choose the diet for a myriad of different health reasons. In two pre-reregistered studies, we examined the social experience of those who adopt a vegan diet following a cancer diagnosis. Study 1, an experimental study, demonstrated that omnivores responded more positively to a friend who was vegan for cancer reasons than animal or general health reasons, which was explained by increased empathy. In Study 2, a cross-sectional survey study, those who adopted a vegan diet due to cancer reported (overall) less negative social experiences than those following a vegan diet more generally. These participants reported that cancer represented a greater social challenge than their diet. Taken together, these findings suggest that "vegan due to cancer" is a unique social identity and a unique social experience, relative to that of those motivated by other reasons, including general health reasons.

Vegan diet: nutritional components, implementation, and effects on adults' health

Vegan diet has emerged as a popular dietary choice for people worldwide in recent times, due to concerns such as health issues, animal rights and welfare, and the sustainability of the environment. The purpose of this literature review was to explain how a vegan diet may affect the health of adults and to point out beneficial components found in it as well as any difficulties associated with its implementation. Evidence supports that a vegan diet can reduce the risk of chronic diseases, such as type 2 diabetes, hypertension, and certain types of cancer. A well-planned vegan diet must include adequate calories and nutrients, as well as the necessary supplements, such as vitamin B12, vitamin D and EPA/DHA. Given the current growing interest in plant-based diets among the general population, it is crucial to understand both the barriers, risks, and benefits of the vegan diet among physicians, policy makers, and the general population.

The Impact of Maternal Plant-Based Diet on Obstetric and Neonatal Outcomes-A Cross-Sectional Study

BACKGROUND

In the last decades, plant-based diets have gained popularity. Pregnancy is not a contraindication to follow a meat-free diet. This study aimed to compare maternal and neonatal outcomes between women who followed a plant-based diet with those on an omnivore diet. Our second purpose was to investigate the association between physical activity level in combination with diet type and the occurrence of GDM and gestational hypertension.

METHODS

A questionnaire was distributed electronically via social media. The survey was conducted on a population of Polish women.

RESULTS

The final research group included 1015 women. The results showed that a maternal plant-based diet 6 months before pregnancy and during pregnancy does not change the incidence of GDM, anemia, and gestational hypertension. Moreover, no association was found between a diet type before conception and a delivery method or newborn birth weight. Among women who followed an omnivore diet, the risk of GDM was lower in a group with adequate physical activity during 6 months before conception (p = 0.0166). However, the combination of a plant-based diet with adequate activity during the preconception period did not influence GDM incidence.

CONCLUSIONS

Our study indicates that a plant-based diet during the preconception period is not worse than an omnivore diet.

Implementing nutritional medicine into medical curricula: A student-initiated course improves knowledge and attitudes

BACKGROUND & AIMS

Although the risks and opportunities of nutrition in health trajectories are well known, it is rarely addressed in doctors' daily routine. This is partly related to physicians' lack of confidence in their ability to provide nutritional counselling, possibly due to insufficient training in medical school. Our study aimed at assessing the status quo of nutrition in the German medical curricula and the impact of a recently implemented, student-initiated online teaching initiative on perceived competence, knowledge and attitudes.

METHODS

"Eat This!" was the first Germany-wide initiative for online nutritional medicine (NM) education, consisting of 11 digital lectures on nutrition basics, nutrition medicine and public health nutrition. The contact time with NM during studies as well as the effects on students' attitudes towards NM, their self-perceived competence in NM and their nutrition knowledge were assessed from October 2020 to February 2021 in a cross-sectional as well as a prospective study using online questionnaires.

RESULTS

Over 1500 medical students from 42 German faculties participated in the lecture series and the online survey. One hundred and twenty-two students formed a control group. Although considering the topic relevant, students rated their training in NM as insufficient, in terms of both quality and quantity. Initially, they did not feel able to counsel patients and rated their knowledge as low. However, self-ratings and the score in a 33-item multiple-choice test knowledge improved by participating in Eat This! as did their attitude towards nutrition and planetary health. No such changes were observed in the control group of 122 students not attending the course.

CONCLUSION

Our results show that education in NM at German medical schools is perceived insufficient despite high student interest. But even low-threshold educational options like "Eat This!" can improve students' perceived competence, knowledge, and attitudes, and thus be an efficient and cost-effective way to address related deficits.

Genomic Instability and Cytotoxicity Evaluation of Two Communities Exposed to Pesticides in the Mexicali Valley by the L-CBMN Assay

The continuous biomonitoring of a population directly or indirectly exposed to pesticides could be an additional tool for decision makers to improve their health conditions. In this work, we performed biomonitoring on two groups of people from the Mexicali Valley who were continuously exposed to pesticides using the cytokinesis-block micronucleus cytome assay (L-CBMN) to evaluate cytotoxic and genotoxic damage in human peripheral blood lymphocytes. The study groups comprised 14 indigenous Cucapah with non-vegetarian habits (NV group) from Ejido el Mayor (32.12594°, -115.27265°) and 21 lacto-ovo vegetarian (LOV) persons from the Seventh-day Adventist Church of Ejido Vicente Guerrero (32.3961°, -115.14023°). The L-CBMN assay determines the nuclear division index (NDI), apoptosis, necrosis, micronuclei (MNs), nuclear buds (NBUDs), and nucleoplasmic bridges (NPBs). Our results show that, regardless of diet or daily habits, both the studied groups presented with cytogenotoxic damage compared with non-exposed pesticide individuals, without modifications to the nuclear division index. In the rest of the evaluated biomarkers, the NV group exhibited greater cytotoxic and genotoxic damage than the LOV group. Nevertheless, individuals practicing a lacto-ovo vegetarian diet (LOV) showed lower damage than those with non-vegetarian habits (NV), suggesting a better antioxidant response that helps decrease the genotoxic damage due to the enhanced intake of folates and antioxidants from a plant-based diet.

Dietary Models and Cardiovascular Risk Prevention in Pediatric Patients

Nutritional intervention is worldwide recognized as a first step treatment for subjects with increased cardiovascular risk and it is of utmost importance especially for children and adolescents. Currently scientific evidence supports the role of dietary patterns instead of simple single nutrients or foods in cardiovascular risk prevention. Indeed, the American Heart Association dietary guidelines have expanded beyond nutrients to dietary pattern, that comprise not only single food items but also behavioral or cultural habits of specific populations. The aim of our narrative review is to analyze the most frequently adopted dietary patterns in children and adolescents and to evaluate their effect on cardiovascular risk factors and in cardiovascular risk prevention. Literature review showed that children cannot be considered as little adults: nutritional intervention must always grant adequate growth and neurodevelopment before reaching the proposed goals, therefore dietary patterns considered heart-healthy for adult subjects might not be suitable for pediatric patients. Mediterranean diet, DASH diet, Nordic diet and some plant-based diets seem to be the most promising dietary patterns in terms of cardiovascular health in the developmental age, even if further studies are needed to better standardize and analyze their effect on growing up individuals.

Selenium, Zinc, and Copper Status of Vegetarians and Vegans in Comparison to Omnivores in the Nutritional Evaluation (NuEva) Study

Plant-based diets usually contain more nutrient-dense foods such as vegetables, legumes, whole grains, and fruits than a standard Western diet. Yet, the amount and especially the bioavailability of several nutrients, such as trace elements, is supposed to be lower in comparison to diets with consumption of animal-derived foods. Based on this, the Nutritional Evaluation (NuEva) study (172 participants) was initiated to compare the trace element status of omnivores, flexitarians, vegetarians, and vegans. Serum selenium, zinc, and copper concentrations and biomarkers were evaluated at baseline and during a 12-month intervention with energy- and nutrient-optimized menu plans. The implementation of optimized menu plans did not substantially influence the status of trace elements. At baseline, serum selenium biomarkers were lower in vegetarians and vegans compared to omnivores and flexitarians. The zinc intake of vegetarians and vegans was significantly lower compared to omnivores, whereas the Phytate Diet Score was increased. Accordingly, total serum zinc concentrations were reduced in vegans which was, however, only significant in women and was further supported by the analysis of free zinc. Regarding copper status, no differences were observed for total serum copper. Overall, we identified selenium and zinc as critical nutrients especially when maintaining a vegan diet.

Sialic acids Neu5Ac and KDN in adipose tissue samples from individuals following habitual vegetarian or non-vegetarian dietary patterns

Sialic acids (Sias) are a class of sugar molecules with a parent nine-carbon neuraminic acid, generally present at the ends of carbohydrate chains, either attached to cellular surfaces or as secreted glycoconjugates. Given their position and structural diversity, Sias modulate a wide variety of biological processes. However, little is known about the role of Sias in human adipose tissue, or their implications for health and disease, particularly among individuals following different dietary patterns. The goal of this study was to measure N-Acetylneuraminic acid (Neu5Ac), N-Glycolylneuraminic acid (Neu5Gc), and 2-keto-3-deoxy-D-glycero-D-galacto-nononic acid (KDN) concentrations in adipose tissue samples from participants in the Adventist Health Study-2 (AHS-2) and to compare the abundance of these Sias in individuals following habitual, long-term vegetarian or non-vegetarian dietary patterns. A method was successfully developed for the extraction and detection of Sias in adipose tissue. Sias levels were quantified in 52 vegans, 56 lacto-vegetarians, and 48 non-vegetarians using LC-MS/MS with Neu5Ac-D-1,2,3-13C3 as an internal standard. Dietary groups were compared using linear regression. Vegans and lacto-ovo-vegetarians had significantly higher concentrations of Neu5Ac relative to non-vegetarians. While KDN levels tended to be higher in vegans and lacto-ovo-vegetarians, these differences were not statistically significant. However, KDN levels were significantly inversely associated with body mass index. In contrast, Neu5Gc was not detected in human adipose samples. It is plausible that different Neu5Ac concentrations in adipose tissues of vegetarians, compared to those of non-vegetarians, reflect a difference in the baseline inflammatory status between the two groups. Epidemiologic studies examining levels of Sias in human adipose tissue and other biospecimens will help to further explore their roles in development and progression of inflammatory conditions and chronic diseases.

Nutritional Considerations for the Vegan Athlete

Accepting a continued rise in the prevalence of vegan-type diets in the general population is also likely to occur in athletic populations, it is of importance to assess the potential impact on athletic performance, adaptation, and recovery. Nutritional consideration for the athlete requires optimization of energy, macronutrient, and micronutrient intakes, and potentially the judicious selection of dietary supplements, all specified to meet the individual athlete's training and performance goals. The purpose of this review is to assess whether adopting a vegan diet is likely to impinge on such optimal nutrition and, where so, consider evidence based yet practical and pragmatic nutritional recommendations. Current evidence does not support that a vegan-type diet will enhance performance, adaptation, or recovery in athletes, but equally suggests that an athlete can follow a (more) vegan diet without detriment. A clear caveat, however, is that vegan diets consumed spontaneously may induce suboptimal intakes of key nutrients, most notably quantity and/or quality of dietary protein and specific micronutrients (eg, iron, calcium, vitamin B12, and vitamin D). As such, optimal vegan sports nutrition requires (more) careful consideration, evaluation, and planning. Individual/seasonal goals, training modalities, athlete type, and sensory/cultural/ethical preferences, among other factors, should all be considered when planning and adopting a vegan diet.

The Impacts of Animal-Based Diets in Cardiovascular Disease Development: A Cellular and Physiological Overview

Cardiovascular disease (CVD) is the leading cause of death in the United States, and diet plays an instrumental role in CVD development. Plant-based diets have been strongly tied to a reduction in CVD incidence. In contrast, animal food consumption may increase CVD risk. While increased serum low-density lipoprotein (LDL) cholesterol concentrations are an established risk factor which may partially explain the positive association with animal foods and CVD, numerous other biochemical factors are also at play. Thus, the aim of this review is to summarize the major cellular and molecular effects of animal food consumption in relation to CVD development. Animal-food-centered diets may (1) increase cardiovascular toll-like receptor (TLR) signaling, due to increased serum endotoxins and oxidized LDL cholesterol, (2) increase cardiovascular lipotoxicity, (3) increase renin-angiotensin system components and subsequent angiotensin II type-1 receptor (AT1R) signaling and (4) increase serum trimethylamine-N-oxide concentrations. These nutritionally mediated factors independently increase cardiovascular oxidative stress and inflammation and are all independently tied to CVD development. Public policy efforts should continue to advocate for the consumption of a mostly plant-based diet, with the minimization of animal-based foods.

Diets, Gut Microbiota and Metabolites

The gut microbiota refers to the gross collection of microorganisms, estimated trillions of them, which reside within the gut and play crucial roles in the absorption and digestion of dietary nutrients. In the past decades, the new generation 'omics' (metagenomics, transcriptomics, proteomics, and metabolomics) technologies made it possible to precisely identify microbiota and metabolites and describe their variability between individuals, populations and even different time points within the same subjects. With massive efforts made, it is now generally accepted that the gut microbiota is a dynamically changing population, whose composition is influenced by the hosts' health conditions and lifestyles. Diet is one of the major contributors to shaping the gut microbiota. The components in the diets vary in different countries, religions, and populations. Some special diets have been adopted by people for hundreds of years aiming for better health, while the underlying mechanisms remain largely unknown. Recent studies based on volunteers or diet-treated animals demonstrated that diets can greatly and rapidly change the gut microbiota. The unique pattern of the nutrients from the diets and their metabolites produced by the gut microbiota has been linked with the occurrence of diseases, including obesity, diabetes, nonalcoholic fatty liver disease, cardiovascular disease, neural diseases, and more. This review will summarize the recent progress and current understanding of the effects of different dietary patterns on the composition of gut microbiota, bacterial metabolites, and their effects on the host's metabolism.

Knowledge, attitudes, and factors associated with vegetarianism in the Saudi Population

BACKGROUND

In recent years, there has been great interest in the dietary practices of vegetarians in addition to an increasing awareness of the potential benefits of vegetarian diets. However, there are insufficient data on the spread of vegetarianism in Arab countries. The aim of this study was to investigate knowledge and attitudes about vegetarianism and associated factors in the Saudi population and to understand the reasons for its growing prevalence.

METHOD

This is a cross-sectional study began in May 2020 and ended in September 2020. Researchers distributed the questionnaire electronically through social media. Data were collected electronically and exported to Excel by the researchers .The electronic questionnaire comprised three sections: sociodemographic questions, reasons for following a vegetarian diet, and beliefs and knowledge about vegetarianism.

RESULTS

There were 3,035 responses, of which 80.2% of respondents were female and 19.8% were male. Participant were aged 18-65. Vegetarians represented 37.5% (15.7% semivegetarians, 8.1% pescovegetarians, 64.3% lacto-ovo-vegetarians, and 11.3% vegans), and the rest were nonvegetarians. The majority of the vegetarian participants (92.9%) had a low vegetarianism knowledge level. Health issues, followed by ethical and environmental concerns, were the most common motivators for adopting a vegetarian diet; these reasons were cited by 72.5%, 59.3%, and 47.9% of participants, respectively. Factors associated with increased vegetarianism were engaging in exercise for half an hour to two hours, while factors associated with decreased vegetarianism were male, aged 51-64 years, being married, having a higher education, working in the health sector, being a housewife, and having an income between 5,000 and 10,000 SR/month.

CONCLUSION

Vegetarianism appears to be a growing phenomenon among the Saudi population. Increased awareness of health issues and the desire to live a healthy lifestyle might be the strongest motives. This study offers an opportunity to better understand vegetarianism in Saudi Arabia along with the possibility of expanding vegetarian food choices for the general public.

The vegan dilemma: Do peaceful protests worsen attitudes to veganism?

A body of research has shown that violent protests reduce support for social movements. However, few studies have examined whether the same is true for protests which are peaceful, yet disruptive (e.g., blocking traffic). Across two pre-registered experimental studies, we explored whether pro-vegan protests that are depicted as causing social disruption lead to more negative attitudes towards veganism, compared to non-disruptive protests or a control condition. Study 1 utilised a combined sample of Australian and United Kingdom residents (N = 449; M_age = 24.7 years). Study 2 employed a larger sample of undergraduate Australian students (N = 934; M_age = 19.8 years). In Study 1, disruptive protests were associated with more negative attitudes towards vegans, but only among women. In Study 2, no such effect was found. Instead, a significant main effect was found for the protest's cause (vegan vs. fast fashion), but not protest type (disruptive vs. non-disruptive). That is, reading about a vegan protest, irrespective of how disruptive it was, led to worse attitudes towards vegans, and greater defense of meat consumption (i.e., endorsement of meat eating as natural, necessary, and normal), than reading about a control protest. This effect was mediated by the perceived immorality of the protestors, and, in turn, reduced identification with them. Taking together both studies, the purported location of the protest (i.e., domestic vs. overseas) did not significantly impact attitudes toward the protestors. The current findings suggest that depictions of vegan protests elicit worse attitudes toward this movement, regardless of how peaceful that protest may be. Future research is needed to examine whether other forms of advocacy can ameliorate negative reactions to vegan activism.

The Effect of a Vegan Diet on the Cardiovascular System

The vegan diet, often known as a plant-rich diet, consists primarily of plant-based meals. This dietary approach may be beneficial to one’s health and the environment and is valuable to the immune system. Plants provide vitamins, minerals, phytochemicals, and antioxidants, components that promote cell survival and immune function, allowing its defensive mechanisms to work effectively. The term “vegan diet” comprises a range of eating patterns that prioritize nutrient-rich foods such as fruits and vegetables, legumes, whole grains, nuts, and seeds. In comparison to omnivorous diets, which are often lower in such products, the vegan diet has been favorably connected with changes in cardiovascular disease (CVD) risk markers such as reduced body mass index (BMI) values, total serum cholesterol, serum glucose, inflammation, and blood pressure. Reduced intake of low-density lipoprotein (LDL), saturated fat, processed meat, and greater consumption of fiber and phytonutrients may improve cardiovascular health. However, vegans have much smaller amounts of nutrients such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), selenium, zinc, iodine, and vitamin B12, compared to non-vegans, which may lead to detrimental cardiovascular effects. This review aims to present the effect of plant-based diets (PBDs), specifically vegan diets, on the cardiovascular system.

Change to a Plant-Based Diet Has No Effect on Strength Performance in Trained Persons in the First 8 Weeks-A 16-Week Controlled Pilot Study

Over the past few years, the number of people who have avoided animal products has been rising steadily. A plant-based diet is associated with a healthier lifestyle and has positive effects on various diseases. More and more healthy active people and performance-orientated athletes are giving up animal products for various reasons, such as for an improved performance or faster regeneration. However, the data in this context are limited. This study aimed to obtain initial findings on the influence of a diet change to veganism on the performance of strength-trained individuals. For this study, a total of 15 omnivorous individuals were recruited. They documented their dietary food intakes over 16 weeks. Every four weeks, the strength performance was tested via a leg press and bench press. In the first 8 weeks, the participants maintained their omnivorous diet, followed by 8 weeks of a vegan dietary phase. In total, 10 subjects participated successfully, and their data were part of the statistical analyses. There was no difference in the absolute and relative strength performance for the leg and bench press after changing to a vegan diet. For the total calorie intake and carbohydrates, only a small treatment effect, but no time effect, was observed. However, for the protein intake, a time and group effect were detected. In addition, the relative protein intake decreased significantly and was lower than the current recommendations for athletes. The results demonstrate that a change to a vegan diet has no beneficial nor negative effect on the strength performance when the total calorie intake and carbohydrate content are covered in the first 8 weeks.

Exploring user-generated content related to vegetarian customers in restaurants: An analysis of online reviews

This study aimed to explore and evaluate factors that impact the dining experience of vegetarian consumers within a range of vegetarian-friendly restaurants. To explore the factors and understand consumer experience, this study analyzed a vast number of user-generated contents of vegetarian consumers, which have become vital sources of consumer experience information. This study utilized machine-learning techniques and traditional methods to examine 54,299 TripAdvisor reviews of approximately 1,008 vegetarian-friendly restaurants in London. The study identified 21 topics that represent a holistic opinion influencing the dining experience of vegetarian customers. The results suggested that "value" is the most popular topic and had the highest topic percentage. The results of regression analyses revealed that five topics had a significant impact on restaurant ratings, while 12 topics had negative impacts. Restaurant managers who pay close attention to vegetarian aspects may utilize the findings of this study to satisfy vegetarian consumer requirements better and enhance service operations.

Fracture Risk in Vegetarians and Vegans: the Role of Diet and Metabolic Factors

PURPOSE OF REVIEW

There is strong evidence that poor dietary intake of certain micro- and macro-nutrients can negatively affect bone health. It is unclear if diet is the primary culprit for poor bone health in the vegan population.

RECENT FINDINGS

Plant-based diets are gaining public interest since they may improve metabolic health. Studies that examine vegetarians and vegans together show a lower bone mineral density (BMD), but not always increased fracture risk compared to omnivores. However, vegans consistently have higher risk of fracture at multiple bone sites, especially at the hip. There is higher fracture risk in vegans which may be due to calcium and vitamin D intake, as well as amount of dietary protein and quality. Other nutrients (B vitamins, Se, Zn, Fe, iodine) or physiological factors (lower body mass index, microbiome, or endocrine profile) may also play a role but have not been examined and require further study.

Does a Plant-Based Diet Stand Out for Its Favorable Composition for Heart Health? Dietary Intake Data from a Randomized Controlled Trial

A plant-based diet (PBD) can provide numerous health benefits for patients with cardiovascular risk factors. However, an inadequately planned PBD also bear the potential for deficiencies in certain macro- and micronutrients. The present study analyzed nutrient profiles of individuals who adopted a PBD as part of the CardioVeg study. Participants with cardiovascular risk factors were randomly assigned to either a whole-food PBD intervention (n = 36; eight 90 min group meetings including two 120 min cooking sessions) or a control group asked to maintain an omnivorous diet (n = 34) for eight weeks. Food intake data were collected using three-day weighed food records and analyzed with NutriGuide software, including the German Nutrient Data Base (German: Bundeslebensmittelschlüssel). Nutrient intake was compared before and after eight weeks as well as between the groups. The results for both groups were then contrasted to the current dietary recommendations published by the societies for nutrition in Germany, Austria, and Switzerland. Moreover, anthropometric/laboratory data and ambulatory blood pressure monitoring were determined at baseline and after 8 weeks. Data of a subsample (n = 18 in the PBD group and n = 19 in the control group) were used for the present analyses of the dietary intake data. A PBD yielded several benefits including (but not limited to) a lower energy density, a lower intake of cholesterol and saturated fat, an increased consumption of fiber, and a lower intake of salt. Recommended intakes of most vitamins and minerals were generally met, except for vitamin B12 in the PBD group. A low intake of several other critical nutrients (vitamin D, iodine) was observed in both groups. Compared with the control group, PBD resulted in a significant decrease in body weight, body mass index, waist circumference, HbA1c, and fasting blood glucose after 8 weeks. Overall, it can be concluded that a PBD had a more favorable nutrient composition for cardiovascular health than the omnivorous dietary pattern of the control group.

School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School

The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.

Human health in peril: The need to upgrade medical education in light of COVID-19

While we might leave the COVID-19 pandemic behind, future health professionals are still confronted with another global phenomenon: the increasing pandemic of non-communicable diseases (NCDs). Both issues are strongly interwoven, yet current medical education fails to address their syndemic nature accordingly. There is scientific consensus that (i) most emerging infectious diseases are zoonotic, (ii) the overexploitation of earth's resources for animal protein production (i.e., tropical deforestation) rapidly escalates human contact with unknown pathogens, and (iii) people following a healthy plant-based diet present fewer rates of NCDs as well as severe illness and mortality from COVID-19. A shift toward whole food plant-based nutrition in the general population thus holds the potential to tackle both public health threats. We are convinced that it is every physician's responsibility to care for individual, public, and global health issues; however, future health professionals are not trained and educated regarding the health potential of plants and plant-based diets. The COVID-19 pandemic has demonstrated the urgent need for a "prevention first" approach. Therefore, in order to upgrade medical education worldwide and protect current and future human health properly, greater medical professional awareness of evidence on plant-based diets is urgently needed in classes, universities, and hospitals.

Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools

The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10-19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the "From Science 2 School" study.

Functional constituents of plant-based foods boost immunity against acute and chronic disorders

Plant-based foods are becoming an increasingly frequent topic of discussion, both scientific and social, due to the dissemination of information and exchange of experiences in the media. Plant-based diets are considered beneficial for human health due to the supply of many valuable nutrients, including health-promoting compounds. Replacing meat-based foods with plant-based products will provide many valuable compounds, including antioxidants, phenolic compounds, fibers, vitamins, minerals, and some ω3 fatty acids. Due to their high nutritional and functional composition, plant-based foods are beneficial in acute and chronic diseases. This article attempts to review the literature to present the most important data on nutrients of plant-based foods that can then help in the prevention of many diseases, such as different infections, such as coronavirus disease, pneumonia, common cold and flu, asthma, and bacterial diseases, such as bronchitis. A properly structured plant-based diet not only provides the necessary nutrients but also can help in the prevention of many diseases.

Characteristics of the Gut Bacterial Composition in People of Different Nationalities and Religions

High-throughput sequencing has made it possible to extensively study the human gut microbiota. The links between the human gut microbiome and ethnicity, religion, and race remain rather poorly understood. In this review, data on the relationship between gut microbiota composition and the nationality of people and their religion were generalized. The unique gut microbiome of a healthy European (including Slavic nationality) is characterized by the dominance of the phyla Firmicutes, Bacteroidota, Actinobacteria, Proteobacteria, Fusobacteria, and Verrucomicrobia. Among the African population, the typical members of the microbiota are Bacteroides and Prevotella. The gut microbiome of Asians is very diverse and rich in members of the genera Prevotella, Bacteroides Lactobacillus, Faecalibacterium, Ruminococcus, Subdoligranulum, Coprococcus, Collinsella, Megasphaera, Bifidobacterium, and Phascolarctobacterium. Among Buddhists and Muslims, the Prevotella enterotype is characteristic of the gut microbiome, while other representatives of religions, including Christians, have the Bacteroides enterotype. Most likely, the gut microbiota of people of different nationalities and religions are influenced by food preferences. The review also considers the influences of pathologies such as obesity, Crohn’s disease, cancer, diabetes, etc., on the bacterial composition of the guts of people of different nationalities.

Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD)

Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.

Prevalence of vegan/vegetarian diet and eating behavior among Saudi adults and its correlation with body mass index: A cross-sectional study

Background

Globalization has steered the spread of vegetarianism around the world. Vegetarianism has achieved increased acceptance by different populations.

Objective

The present study aims to assess vegetarian diet, and eating behavior prevalence among Saudi adults and their association with demographics and body mass index.

Method

A cross-sectional study conducted on 1,143 Saudi adults [418 (36.6%) males and 725 (63.4%) females]. An online survey questionnaire containing questions on demographics, type of diet, eating behavior and physical activity was provided to participants for self-administration. Statistical analysis was performed to associate demographic and eating behavior variables with the type of diet using Pearson's Chi-square test and Spearman's partial correlation test was used to correlate BMI and eating behavior.

Results

Prevalence of veganism was 4.7% (n = 54/1,143) and vegetarianism was 7.8% (89/1,143). A significantly higher prevalence of vegan diet was observed in females than males (79.6% vs. 20.4%, p < 0.0001). A significantly higher proportion of participants on vegetarian diet selected "Always" as response for eating breakfast, vegetables and fruits as well as for eating or drinking dairy foods, and for eating canned food than participants on non-vegetarian diet (p < 0.0001). A significantly higher proportion of participants on vegan diet selected 'Never' for eating fast-food and fried food as well as for drinking fizzy or soft drinks (p < 0.0001). A positive moderate correlation was found between BMI and eating fast-food and fried food [r(1, 140) = 0.529, p < 0.0001], drinking fizzy or soft drinks with meals [r(1, 140) = 0.495, p = 0.001], and eating canned food [r(1, 140) = 0.510, p < 0.0001].

Conclusion

Our study shows that vegan and vegetarian diet have gained access into the lifestyle of Saudi adults with a prevalence of 4.7 and 7.8%, respectively. Participants on vegetarian diet showed better lifestyle like higher physical activity level, higher consumption of fruits, vegetables, dairy products and low intake of fast-foods and fizzy beverages.

Plasma Leptin and Adiponectin after a 4-Week Vegan Diet: A Randomized-Controlled Pilot Trial in Healthy Participants

Adiponectin and leptin are important mediators of metabolic homeostasis. The actions of these adipokines extend beyond adipocytes and include systemic modulation of lipid and glucose metabolism, nutrient flux, and the immune response to changes in nutrition. Herein, we hypothesized that short-term intervention with a vegan diet might result in an improvement of plasma concentrations of adiponectin and leptin and the leptin/adiponectin ratio. We investigated the response of plasma adiponectin and leptin to a 4-week intervention with a vegan or meat-rich diet and its associations with sex, BMI and nutritional intake. Fifty-three healthy, omnivore participants (62% female, average age 31 years and BMI 23.1 kg/m²) were randomly assigned to a vegan or meat-rich diet for 4 weeks. Plasma adiponectin and leptin were lower in men compared to women both at the beginning and end of the trial. The concentration of adiponectin in women was significantly higher both when comparing their transition from omnivorous to vegan diet (p = 0.023) and also for vegan versus meat-rich diet at the end of the trial (p = 0.001), whereas plasma leptin did not vary significantly. No changes in adiponectin were identified in men, yet an increase in leptin occurred upon their transition from an omnivorous to a meat-rich diet (p = 0.019). Examination of plasma adiponectin/leptin ratio, a proposed marker of cardiovascular risk, did not differ after 4-weeks of dietary intervention. Our study revealed that adiponectin and leptin concentrations are sensitive to short-term dietary intervention in a sex-dependent manner. This dietary modification of leptin and adiponectin not only occurs quickly as demonstrated in our study, but it remains such as published in studies with individuals who are established (long-term) vegetarians compared to omnivorous.

Arterial Stiffness and Endothelial Function are Comparable in Young Healthy Vegetarians and Omnivores

Vegetarians (VEG) are reported to have lower body weight, blood pressure (BP), and cardiovascular disease (CVD) risk compared with omnivores (OMN), yet the mechanisms remain unclear. A vegetarian diet may protect the vascular endothelium, reducing the risk of atherosclerosis and CVD. This cross-sectional study compared vascular function between OMN and VEG. We hypothesized that VEG would have greater vascular function compared with OMN. Fifty-eight normotensive young healthy adults participated (40 women [W]/18 men [M]; 28 OMN [15W/13M] and 30 VEG [25W/5M]; 26 ± 7 years; BP: 112 ± 11/67 ± 8 mm Hg). Arterial stiffness, assessed by carotid-to-femoral pulse wave velocity (OMN: 5.6 ± 0.8 m/s, VEG: 5.3 ± 0.8 m/s; P = .17) and wave reflection assessed by aortic augmentation index (OMN: 6.9 ± 12.3%, VEG: 8.8 ± 13.5%; P = .57) were not different between groups. However, central pulse pressure (OMN: 32 ± 5; VEG: 29 ± 5 mm Hg; P = .048) and forward wave reflection were greater in omnivores (OMN: 26 ± 3; VEG: 24 ± 3 mm Hg; P = .048). Endothelial-dependent dilation measured by brachial artery flow-mediated dilation was not different between groups (OMN: 6.0 ± 2.9%, VEG: 6.9 ± 3.3%; P = .29). Percent change in femoral blood flow from baseline during passive leg movement, another assessment of nitric oxide-mediated endothelial dilation, was similar between groups (OMN: 203 ± 88 mL/min, VEG: 253 ± 192 mL/min; P = .50). These data suggest that in healthy young adults, normotensive VEG do not have significantly improved vascular function compared with OMN; however, they have a lower central pulse pressure and forward wave amplitude which may lower the risk of future CVD.

Do Vegetarian Diets Provide Adequate Nutrient Intake during Complementary Feeding? A Systematic Review

During the complementary feeding period, any nutritional deficiencies may negatively impact infant growth and neurodevelopment. A healthy diet containing all essential nutrients is strongly recommended by the WHO during infancy. Because vegetarian diets are becoming increasingly popular in many industrialized countries, some parents ask the pediatrician for a vegetarian diet, partially or entirely free of animal-source foods, for their children from an early age. This systematic review aims to evaluate the evidence on how vegetarian complementary feeding impacts infant growth, neurodevelopment, risk of wasted and/or stunted growth, overweight and obesity. The SR was registered with PROSPERO 2021 (CRD 42021273592). A comprehensive search strategy was adopted to search and find all relevant studies. For ethical reasons, there are no interventional studies assessing the impact of non-supplemented vegetarian/vegan diets on the physical and neurocognitive development of children, but there are numerous studies that have analyzed the effects of dietary deficiencies on individual nutrients. Based on current evidence, vegetarian and vegan diets during the complementary feeding period have not been shown to be safe, and the current best evidence suggests that the risk of critical micronutrient deficiencies or insufficiencies and growth retardation is high: they may result in significantly different outcomes in neuropsychological development and growth when compared with a healthy omnivorous diet such as the Mediterranean Diet. There are also no data documenting the protective effect of vegetarian or vegan diets against communicable diseases in children aged 6 months to 2-3 years.

Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: results from the UK Women's Cohort Study

BACKGROUND

The risk of hip fracture in women on plant-based diets is unclear. We aimed to investigate the risk of hip fracture in occasional meat-eaters, pescatarians, and vegetarians compared to regular meat-eaters in the UK Women's Cohort Study and to determine if potential associations between each diet group and hip fracture risk are modified by body mass index (BMI).

METHODS

UK women, ages 35-69 years, were classified as regular meat-eaters (≥ 5 servings/week), occasional meat-eaters (< 5 servings/week), pescatarian (ate fish but not meat), or vegetarian (ate neither meat nor fish) based on a validated 217-item food frequency questionnaire completed in 1995-1998. Incident hip fractures were identified via linkage to Hospital Episode Statistics up to March 2019. Cox regression models were used to estimate the associations between each diet group and hip fracture risk over a median follow-up time of 22.3 years.

RESULTS

Amongst 26,318 women, 822 hip fracture cases were observed (556,331 person-years). After adjustment for confounders, vegetarians (HR (95% CI) 1.33 (1.03, 1.71)) but not occasional meat-eaters (1.00 (0.85, 1.18)) or pescatarians (0.97 (0.75, 1.26)) had a greater risk of hip fracture than regular meat-eaters. There was no clear evidence of effect modification by BMI in any diet group (p-interaction = 0.3).

CONCLUSIONS

Vegetarian women were at a higher risk of hip fracture compared to regular meat-eaters. Further research is needed to confirm this in men and non-European populations and to identify factors responsible for the observed risk difference. Further research exploring the role of BMI and nutrients abundant in animal-sourced foods is recommended.

TRIAL REGISTRATION

ClinicalTrials.gov , NCT05081466.

α-linolenic acid interconversion is sufficient as a source of longer chain ω-3 polyunsaturated fatty acids in humans: An opinion

α-linolenic acid (αLNA) conversion into the functionally important ω-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), has been regarded as inadequate for meeting nutritional requirements for these PUFA. This view is based on findings of small αLNA supplementation trials and stable isotope tracer studies that have been interpreted as indicating human capacity for EPA and, in particular, DHA synthesis is limited. The purpose of this review is to re-evaluate this interpretation. Markedly differing study designs, inconsistent findings and lack of trial replication preclude robust consensus regarding the nutritional adequacy of αLNA as a source of EPC and DHA. The conclusion that αLNA conversion in humans is constrained is inaccurate because it presupposes the existence of an unspecified, higher level of metabolic activity. Since capacity for EPA and DHA synthesis is the product of evolution it may be argued that the levels of EPA and DHA it maintains are nutritionally appropriate. Dietary and supra-dietary EPA plus DHA intakes confer health benefits. Paradoxically, such health benefits are also found amongst vegetarians who do not consume EPA and DHA, and for whom αLNA conversion is the primary source of ω-3 PUFA. Since there are no reported adverse effects on health or cognitive development of diets that exclude EPA and DHA, their synthesis from αLNA appears to be nutritionally adequate. This is consistent with the dietary essentiality of αLNA and has implications for developing sustainable nutritional recommendations for ω-3 PUFA.

Can Multiple Attributes of Vegan Restaurants Affect the Behavioral Intentions by Customer Psychological Factors?

Over the past decade, there has been an increased interest in veganism in several nations across the world. In 2021, there were around 79 million vegans. While veganism is growing, it still covers only 1% of the global population. But if the diet keeps its steady growth rate, it's predicted to increase to one in 10 people within the next 10 years. However, in addition to the traditional, though poorly studied, multiple attributes ascribed to vegan restaurants, there may be other factors influencing the approach intentions of vegan restaurant customers. Within this context, this study investigated the psychological resilience associated with customer engagement (identification, enthusiasm, attention, absorption, and interaction) with the vegan movement for Korean vegan customers. The analysis was conducted using SPSS 22.0 and AMOS 22.0. The results revealed that numerous attributes ascribed to vegan restaurants positively affected customer engagement, especially identification, and strongly influenced psychological resilience as well. However, the identification customer engagement factor did not significantly affect the approach intentions of vegan restaurant customers. The study results suggested that when eliciting customer engagement to increase approach intentions toward vegan restaurants, it is necessary to emphasize customer psychological resilience, enthusiasm, attention, absorption, and interaction. This study contributes to food and consumer behavior literature on the approach intentions toward vegan restaurants.

Owner perception of health of North American dogs fed meat- or plant-based diets

BACKGROUND

Some dog owners elect to feed their dog a plant-based food either as part of or for their entire dietary intake. Being omnivores or facultative carnivores, a strictly plant-based diet is not the natural type of food dogs evolved to consume, leaving some question as to whether this feeding management strategy is safe and healthy for dogs.

OBJECTIVES

This study surveyed owner perceptions of health and wellbeing of dogs and compared between those fed meat-based and plant-based diets.

METHODS

A web-based questionnaire was distributed to pet owners to collect data on dog characteristics, husbandry, health and wellbeing. Univariate comparisons between diet groups was made by chi square analyses or Kaplan-Meier tests as appropriate, with a significance cut-off value of 0.05. Multivariate models were negative binomial and logistic regression for count and categorical data, respectively.

RESULTS

Owners feeding plant-based diets to their dog reported fewer health disorders, specifically with respect to ocular or gastrointestinal and hepatic disorders. Dog longevity was reported to be greater for dogs fed plant-based diets. Owners feeding plant-based diets to their dogs relied less on veterinary associates for nutrition information, versus dog owners feeding meat-based diets.

CONCLUSIONS

Dog owners feeding a plant-based diet did not perceive adverse health effects in their dogs. The results might suggest an association between feeding a plant-based diet and perceived health and longevity, however inherent bias and limitations associated with surveys of owner perception must be considered, and objective research is required to determine if plant-based diets truly affect canine health.

Obese Vegetarians and Omnivores Show Different Metabolic Changes: Analysis of 1340 Individuals

Our study evaluated the association between the increase in body mass index (BMI) in men and women (menstruating and non-menstruating) (n = 1340) with different dietary groups (omnivores, semi-vegetarians, lacto-ovo-vegetarian, and vegans) and the measurement of the biochemical markers high-sensitive C-reactive protein (hs-CRP), ferritin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), glycated hemoglobin (HbA1C), and insulin resistance index (HOMA-IR). Increasing BMI values in all groups and dietary profiles were related to a significant increase in hs-CRP (p < 0.0001), ALT (p = 0.02), ferritin (p = 0.009), and HbA1C (p < 0.0001), with no difference between dietary groups (p < 0.05). The increase in BMI increases the levels of HOMA-IR (p < 0.0001) and GGT (p < 0.05), with higher values found in men when compared to women (p < 0.0001 for HOMA- IR and p = 0.0048 for GGT). The association between ALT and BMI was different between dietary groups, as it showed a decrease in vegan women who do not menstruate compared to other dietary groups (p = 0.0099). When including only obese individuals (BMI ≥ 30 kg/m2, n = 153) in the analysis, we observed lower concentrations of GGT and ferritin in vegetarians than in omnivores, regardless of gender and menstrual blood loss (p = 0.0395). Our data showed that for both vegetarians and omnivores, the higher the BMI, the worse the metabolic parameters. However, regarding obesity, vegetarians showed better antioxidant status (lower GGT elevation) and lower inflammatory status (lower ferritin elevation), which may provide them with potential protection in the development of morbidities associated with overweight.

Is vegetarianism related to anxiety and depression? A cross-sectional survey in a French sample

OBJECTIVE

The relationship between vegetarianism and mental health is controversial. The aim of the present study is to examine the cross-sectional association between anxiety, depression, and vegetarianism in a French sample while controlling for potential confounders.

DESIGN

Self-reported questionnaire data were obtained from a large cross-sectional sample.

PARTICIPANTS AND SETTING

We included an online sample of 6578 participants aged 18-90, 70.8% females.

RESULTS

Analyses of variance with age, gender, body mass index (BMI), educational level, monthly income, and city size as covariates showed that vegetarians and non-vegetarians did not appear to have significantly different levels of anxiety or depression.

CONCLUSION

Our findings do not suggest a link between plant-based diet and anxiety or depression, either before or after adjustment for relevant factors.

Non-Pharmacological Treatments for Insulin Resistance: Effective Intervention of Plant-Based Diets—A Critical Review

Plant-based diets are becoming increasingly popular. Vegetarian diets are better for the environment and exhibit health benefits. A correctly balanced plant-based diet is appropriate at every stage of life. Compared to omnivores, vegetarians consume more fruits and vegetables, more fibre, vitamins C and E, magnesium and less saturated fats. In general, they have better nutrition knowledge, and they are slimmer, healthier and live longer than omnivores. It also seems that following a plant-based diet prevents the onset of chronic diseases such as cardiovascular diseases, hypertension, type 2 diabetes, obesity and some cancers. Food intake has a key influence on insulin resistance. Consumption of calorie-rich and highly processed foods, meats and sweetened beverages is a characteristic element of Western diets. They promote and elevate insulin resistance and type 2 diabetes. In contrast, intake of pulses and exclusion of meats as well as animal products bring significant benefits to vegetarian diets. According to studies, vegetarians and vegans have better blood parameters, including better glucose, insulin, total cholesterol, and LDL cholesterol levels. Their homeostatic model assessment for insulin resistance (HOMA-IR) test results are also better. More plant-based foods and fewer animal foods in a diet result in lower insulin resistance and a lower risk of prediabetes and type 2 diabetes. The aim of the study was to investigate the effect of plant-based diets on insulin resistance. In this review, we focused on presenting the positive effects of vegetarian and vegan diets on insulin resistance while showing possible clinical applications of plant-based diets in the treatment and prevention of modern-age diseases. Current and reliable publications meeting the requirements of Evidence-Based Medicine (EBM) were taken into account in this review.

Benefits of a plant-based diet and considerations for the athlete

Individuals may opt to follow a plant-based diet for a variety of reasons, such as religious practices, health benefits or concerns for animal or environmental welfare. Such diets offer a broad spectrum of health benefits including aiding in the prevention and management of chronic diseases. In addition to health benefits, a plant-based diet may provide performance-enhancing effects for various types of exercise due to high carbohydrate levels and the high concentration of antioxidants and phytochemicals found in a plant-based diet. However, some plant-based foods also contain anti-nutrional factors, such as phytate and tannins, which decrease the bioavailability of key nutrients, such as iron, zinc, and protein. Thus, plant-based diets must be carefully planned to ensure adequate intake and absorption of energy and all essential nutrients. The current narrative review summarizes the current state of the research concerning the implications of a plant-based diet for health and exercise performance. It also outlines strategies to enhance the bioavailability of nutrients, sources of hard-to-get nutrients, and sport supplements that could interest plant-based athletes.