Vegetarian nutrition: past, present, future

Eating to live well-Or worse? The role of vegan and vegetarian diets in mental health

BACKGROUND

Over the past two decades, there has been an increase in the prevalence of psychological conditions, such as depression, anxiety, disordered eating, and body image disturbances. In concert with this trend, there was a substantial rise in the advocacy and practice of restrictive dietary patterns, such as veganism and vegetarianism. These parallel developments suggest a relation between diet and mental health, but to date, research has failed to offer clear answers on whether these associations are causal, coincidental, or more complex than superficial analyses suggest.

AIM

Given this context, the purpose of this commentary is to offer a consilient perspective on the role of vegan and vegetarian diets in mental health.

METHODS

We performed a broad qualitative synthesis of the current literature on diet and mental health from sociologic and psychologic perspectives.

RESULTS

Several empirically supported hypotheses were presented with equivocal support.

CONCLUSION

The current evidence suggests that if a nutritionally adequate diet is consumed, the avoidance/consumption of meat and other animal foods will have no significant effects on physical and mental health.

Taylor dispersion analysis and release studies of β-carotene-loaded PLGA nanoparticles and liposomes in simulated gastrointestinal fluids

β-Carotene (βC), a natural carotenoid, is the most important and effective vitamin A precursor, known also for its antioxidant properties. However, its poor water solubility, chemical instability, and low bioavailability limit its effectiveness as an orally delivered functional nutrient. Nanoparticle encapsulation improves βC's bioaccessibility by enhancing its stability and solubility. This study compares two formulations, i.e. βC-loaded poly(lactic-co-glycolic acid) (PLGA) NPs and liposomes before and after exposure to simulated gastrointestinal fluids using various methods such as Taylor dispersion analysis (TDA), cryo-transmission electron microscopy, dynamic light scattering (DLS), and nanoparticle tracking analysis (NTA). TDA, a microfluidic technique, proved more effective than DLS and NTA in determining nanoparticle size in simulated gastrointestinal fluids. This highlights TDA's potential for assessing nanoparticle colloidal stability in simulated gastro-intestinal fluids, crucial for evaluating encapsulated bioactives' bioavailability. High-performance liquid chromatography (HPLC) revealed that PLGA nanoparticles incorporate and preserve βC more effectively during long-term storage compared to liposomes. Adding ascorbic acid significantly reduced degradation in simulated gastrointestinal fluids. Release studies showed that liposomes released 52% of βC after 36 hours, while PLGA nanoparticles released only 9% over 168 hours. These results provide valuable insights for selecting an appropriate βC nanocarrier for oral delivery based on desired release rates.

Are vegetarians' diets inherently healthy? Ultra-processed food consumption is associated with overweight among vegetarians: the brazilian survey on the health, food, and nutrition of vegetarians

This cross-sectional study investigated ultra-processed food (UPF) consumption and its association with overweight among Brazilian vegetarian adults (n = 925). Data were collected using a self-administered structured online questionnaire. The prevalence of overweight was 26.2% (95% confidence interval [CI] 23.3-29.1). The median UPF consumption was 1.8 times/day (1.0-3.1 interquartile range [IQR]). The multivariable generalised linear model identified an increase in overweight probability as the UPF intake - categorised into quintiles - increases (prevalence ratio [PR] 1.08 [95%CI 1.01-1.17]). Additionally, age (PR 1.03 [95%CI 1.02-1.04]), eating more than three meals/day away from home (PR 1.56 [95%CI 1.08-2.23]), duration of vegetarianism (PR 0.98 [95%CI 0.97-0.99]) and living in the wealthiest regions in the country (PR 1.35 [95%CI 1.06-1.71]) were associated with overweight. Although vegetarians have a lower average UPF intake and overweight prevalence than the general population, UPF exposure can still lead to excessive weight gain or maintenance. This study endorses generalising the Brazilian Dietary Guidelines for the vegetarian population.

The influence of a vegan diet on body composition, performance and the menstrual cycle in young, recreationally trained women- a 12-week controlled trial

BACKGROUND

An increasing number of people, including recreational trained individuals, choose not to consume animal products and follow a vegan diet. Young women in particular are switching to a vegan diet. Studies have shown no difference in performance and muscle adaptations between a balanced vegan and an omnivorous diet. However, there are hardly any studies on the transition phase from an omnivorous to a vegan diet and the potential difficulties. Therefore, this study aimed to investigate the influence of a vegan dietary transition and its effects on body composition, physical performance, and menstrual cycle in young, recreationally trained women.

METHODS

Ten young healthy women (23.8 ± 2.0 years, 173.0 ± 5.8 cm) were recruited to participate in this 12-week controlled study (4-week omnivorous phase, 8-week vegan intervention). At the beginning and before the vegan phase, all participants were informed about a balanced diet for fitness-oriented individuals and a vegan lifestyle. They were supervised by a sports dietitian for the entire 12 weeks. Explicit instructions and regular checks on macronutrient distribution were not carried out but had to be implemented independently. The diet was documented using FDDB Extender. The training habits were not explicitly specified, but should not be changed over the entire period. At baseline (T0) and 4-week intervals (T1, T2, T3), body composition (body weight, skeletal muscle mass, fat mass) and performance (squat, countermovement jump) were tested. In addition, the menstrual cycle was examined every two days using saliva samples and a cycle diary.

RESULTS

Between treatments, there was a significant decrease in absolute (T0: 94.44 ± 20.37 kcal; T3: 71.67 ± 27.64 kcal; p < 0.001) and in relative protein intake (T0: 1.39 ± 0.28 g/kg BW; T3: 1.06 ± 0.37 g/kg BW; p < 0.05). In carbohydrate consumption, a significant increase was observed (T0: 240.11 ± 53.15 kcal; T3: 266.89 ± 49.01 kcal; p < 0.001). During the vegan phase, a significant decrease in body weight (T0: 68.19 ± 6.47 kg, T3: 67.73 ± 6.07 kg; p < 0.001) and skeletal muscle mass (T0: 29.40 ± 2.23 kg; T3: 28.74 ± 2.55 kg; p < 0.001) was observed. No changes were noted in squat performance. The countermovement jump showed a significant decrease in the vegan phase (T0: 26.08 ± 3.44 cm; T3: 23,62 ± 1,00 p < 0.05), but also a significant time effect starting in the omnivorous phase (p < 0.001). No effects were found on hormone concentrations of individual menstrual cycles.

CONCLUSION

The dietary change resulted in a shift in overall macronutrient distribution. Relative protein intake was significantly lower during the vegan phase than during the omnivore phase. This was also observed in a slight decrease in skeletal muscle mass. No clear effects on performance and menstrual cycle were observed during the first eight weeks. The results suggest that despite the knowledge of a balanced diet and in particular the recommendations for a vegan diet, the implementation of a vegan diet in everyday life could be associated with a number of difficulties for recreationally trained women. However, it should be noted that the vegan phase was only conducted for eight weeks and no statement can be made about the long-term effects or on well-trained female athletes.

[Vitamin B12, fatty acids EPA and DHA during pregnancy and lactation in women with a plant-based diet]

Introduction

Pregnancy and lactation represent a complex stage from a nutritional point of view, since energy, protein and micronutrient requirements increase during these stages. The literature describes that a well-planned plant-based diet can be sufficient in energy, macronutrients and micronutrients, with the exception of vitamin B12 and possibly n3 polyunsaturated fatty acids, mainly EPA and DHA. During the last few years, adherence to this diet has increased rapidly in the population, so the main objective of this article is to review the current evidence on the intake and concentrations of vitamin B12, EPA and DHA during pregnancy and lactation in women following a plant-based diet. A literature search was performed in PubMed, Scopus, Web of Science and Ovid MedLine using free terms and MESH. Eleven articles were selected in this review. Well-planned vegetarian and vegan diets, with adequate supplementation of vitamin B12, EPA and DHA, are compatible during pregnancy and lactation, being a positive predictor of their content in breast milk. A similar situation was observed in plasma levels in women supplemented with B12. However, it is important to continue with research in this area that considers an adequate dietary anamnesis, integral evaluation of nutritional status, estimation of nutritional requirements and an individualized nutritional plan.

Biological properties of vitamin B12

Vitamin B12, cobalamin, is indispensable for humans owing to its participation in two biochemical reactions: the conversion of l-methylmalonyl coenzyme A to succinyl coenzyme A, and the formation of methionine by methylation of homocysteine. Eukaryotes, encompassing plants, fungi, animals and humans, do not synthesise vitamin B12, in contrast to prokaryotes. Humans must consume it in their diet. The most important sources include meat, milk and dairy products, fish, shellfish and eggs. Due to this, vegetarians are at risk to develop a vitamin B12 deficiency and it is recommended that they consume fortified food. Vitamin B12 behaves differently to most vitamins of the B complex in several aspects, e.g. it is more stable, has a very specific mechanism of absorption and is stored in large amounts in the organism. This review summarises all its biological aspects (including its structure and natural sources as well as its stability in food, pharmacokinetics and physiological function) as well as causes, symptoms, diagnosis (with a summary of analytical methods for its measurement), prevention and treatment of its deficiency, and its pharmacological use and potential toxicity.

Retrospective Cohort Study Demonstrates Tolerance and Adherence to Pea-Based Complete Enteral Formula When Transitioned from a Previous Hypoallergenic Product

BACKGROUND

Plant-based formulas have become increasingly popular due to their health benefits, environmental concerns, cultural beliefs, improved palatability, and decreased cost. A retrospective chart review of medically stable children transitioning from a hypoallergenic formula to a yellow pea protein plant-based formula (PPPBF) was included. This study aimed to assess gastrointestinal tolerance, weight changes, and adherence to receiving a unique PPPBF.

METHODS

Healthcare providers (HCPs) from pediatric clinics across the United States who requested increased PPPBF samples between the dates of 1 November 2021and 31 January 2022 and again from 1 February 2022 to 15 April 2022 inputted survey data. The HCPs selected participants based on the inclusion criteria.

RESULTS

Seventy-three completed patient surveys were included of children (ages 1-18 years old, 41% females, 59% males). After the transition to PPPBF, 38.4% experienced improvement in GI tolerance, 56.2% experienced no change, and 5.5% reported worsening GI tolerance. There was a 95% adherence rate, and 98.9% reported no adverse reactions or allergic manifestations after formula transition.

CONCLUSIONS

Transitioning from a hypoallergenic formula to a PPPBF showed a trend toward stable GI tolerance, weight gain or stability, and adherence. A PPPBF offers a first-choice option for children who are on hypoallergenic formulas due to intolerance.

Cysteine, sodium metabisulfite, and glutathione enhance crosslinking between proteins during high moisture meat analog extrusion processing and may improve the fibrousness of the products

BACKGROUND

High moisture meat analog (HMMA) products processed using extrusion have become increasingly popular in the last few years. Because the formation of disulfide bonds is believed to play a critical role in the texturization mechanism, this study aimed to understand how chemical compounds capable of reducing disulfide bonds, specifically cysteine, sodium metabisulfite, and glutathione, affect the texture and the chemical interactions between the proteins.

METHOD

Wheat protein blended with cysteine, sodium metabisulfite, or glutathione at levels of 0, 0.5, 1.0, 2.5, 5.0, and 7.5 g kg-1 was extruded at three different temperatures (115, 140, and 165 °C) using a co-rotating twin-screw extruder. The feed rate (85 g min-1), the moisture content (600 g kg-1), and the screw speed (300 rpm) were kept constant. Unextruded and extruded material was subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis, polymeric protein fractionation, and sulfhydryl group/disulfide bond analysis. Extruded samples were further analyzed for their hardness and their anisotropic index.

RESULTS

The inclusion of reductants significantly affected the structure of the obtained extrudates. Although reducing agents had a relatively small impact on the total amount of disulfide bonds, their action significantly enhanced crosslinking between the proteins. At select conditions, samples with high fibrousness were specifically obtained when cysteine or sodium metabisulfite was included at levels of 5.0 g kg-1.

DISCUSSION

In the presence of reducing agents, it is believed that disulfide bonds are split earlier during the process without binding to them, giving the protein strands more time to unravel and align, leading to a better flow behavior and more fibrous products. © 2024 Society of Chemical Industry.

The impact of temperature gradient, apparent shear rate, and inferred phase transition timing on extruded high moisture meat analog quality

Scalability of the cooling die unit operation is critical to lowering the manufacturing cost of high moisture meat analogs(HMMA), but it is unclear what scale-up criteria are important. An experiment consisting of two cooling die cross-section geometries (tall and narrow or short and wide), two production rates (2.7 or 4.5 kg/hr) and 4 cooling media inlet temperatures (36, 48, 60, and 72 °C) was employed to study their effect on product texture, anisotropy, and extrusion system parameters. Comprehensive temperature measurements were made along the dies to observe the product temperature gradient and to quantify the energy balance associated with cooling. It was found that textural hardness had a positive relationship with axial temperature gradient (p < 0.05), while anisotropy had a negative and positive relationship with axial temperature gradient and die height, respectively (p < 0.05). Extruder motor torque and die inlet pressure were found to be functions of the cooling media inlet temperature and apparent Newtonian shear rate applied to the material in the die (p < 0.05). The energy balance indicated that enhanced anisotropy is associated with more exothermic in-situ phase changes, which are controlled by the product formulation and applied die conditions. There are likely 3 scalable variables most relevant to controlling the HMMA product quality: 2 critical phase transition temperatures, and the axial product temperature gradient. Therefore, scaling up HMMA cooling dies will require balancing the heat transfer rate away from the product such that an optimal product temperature profile can be maintained at scale.

Modulation of gut-microbiota through probiotics and dietary interventions to improve host health

Dietary patterns play an important role in regards to the modulation and control of the gut microbiome composition and function. The interaction between diet and microbiota plays an important role in order to maintain intestinal homeostasis, which ultimately affect the host's health. Diet directly impacts the microbes that inhabit the gastrointestinal tract (GIT), which then contributes to the production of secondary metabolites, such as short-chain fatty acids, neurotransmitters, and antimicrobial peptides. Dietary consumption with genetically modified probiotics can be the best vaccine delivery vector and protect cells from various illnesses. A holistic approach to disease prevention, treatment, and management takes these intrinsically linked diet-microbes, microbe-microbe interactions, and microbe-host interactions into account. Dietary components, such as fiber can modulate beneficial gut microbiota, and they have resulting ameliorative effects against metabolic disorders. Medical interventions, such as antibiotic drugs can conversely have detrimental effects on gut microbiota by disputing the balance between Bacteroides and firmicute, which contribute to continuing disease states. We summarize the known effects of various dietary components, such as fibers, carbohydrates, fatty acids, vitamins, minerals, proteins, phenolic acids, and antibiotics on the composition of the gut microbiota in this article in addition to the beneficial effect of genetically modified probiotics and consequentially their role in regards to shaping human health. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Gene-vegetarianism interactions in calcium, estimated glomerular filtration rate, and testosterone identified in genome-wide analysis across 30 biomarkers

We examined the associations of vegetarianism with metabolic biomarkers using traditional and genetic epidemiology. First, we addressed inconsistencies in self-reported vegetarianism among UK Biobank participants by utilizing data from two dietary surveys to find a cohort of strict European vegetarians (N = 2,312). Vegetarians were matched 1:4 with nonvegetarians for non-genetic association analyses, revealing significant effects of vegetarianism in 15 of 30 biomarkers. Cholesterol measures plus vitamin D were significantly lower in vegetarians, while triglycerides were higher. A genome-wide association study revealed no genome-wide significant (GWS; 5×10-8) associations with vegetarian behavior. We performed genome-wide gene-vegetarianism interaction analyses for the biomarkers, and detected a GWS interaction impacting calcium at rs72952628 (P = 4.47×10-8). rs72952628 is in MMAA, a B12 metabolic pathway gene; B12 has major deficiency potential in vegetarians. Gene-based interaction tests revealed two significant genes, RNF168 in testosterone (P = 1.45×10-6) and DOCK4 in estimated glomerular filtration rate (eGFR) (P = 6.76×10-7), which have previously been associated with testicular and renal traits, respectively. These nutrigenetic findings indicate genotype can modify the associations between vegetarianism and health outcomes.

Adherence to different forms of plant-based diets and pregnancy outcomes in the Danish National Birth Cohort: A prospective observational study

INTRODUCTION

The number of people adhering to plant-based diets has been increasing dramatically in recent years, fueled by both environmental and animal welfare concerns. Beneficial or possible adverse consequences of such diets, particularly the most restrictive forms during pregnancy, have been minimally explored. The aim of this prospective observational study was to examine associations between different forms of plant-based diets during pregnancy with birth outcomes and pregnancy complications.

MATERIAL AND METHODS

The Danish National Birth Cohort included 100 413 pregnancies to 91 381 women in 1996-2002. The population consisted of 66 738 pregnancies, about which sufficient dietary data were available and included in the study. Dietary and supplemental intake was assessed by Food Frequency Questionnaire in gestational week 25 and women were characterized as fish/poultry-vegetarians, lacto/ovo-vegetarians, vegans or omnivorous, based on their self-report in gestational week 30. Main outcome measures were pregnancy and birth complications, birthweight and small for gestational age.

RESULTS

A total of 98.7% (n = 65 872) of participants were defined as omnivorous, whereas 1.0% (n = 666), 0.3% (n = 183) and 0.03% (n = 18) identified themselves as fish/poultry vegetarians, lacto/ovo-vegetarians or vegans, respectively. Protein intake was lower among lacto/ovo-vegetarians (13.3%) and vegans (10.4%) than among omnivorous participants (15.4%). Intake of micronutrients was also considerably lower among vegans, but when dietary supplements were taken into consideration, no major differences were observed. Compared with omnivorous mothers, vegans had a higher prevalence of preeclampsia and their offspring had on average -240 g (95% confidence interval -450 to -30) lower birthweight.

CONCLUSIONS

The women reporting that they adhered to vegan diets during pregnancy had offspring with lower mean birthweight and higher risk of preeclampsia compared with omnivorous mothers. Low protein intake might be one plausible explanation for the observed association with birthweight.

Defining Optimal Cobalamin Status for Neonates and Infants

BACKGROUND

An optimal cobalamin status is necessary for normal neurodevelopment.

OBJECTIVE

To give a description of the epidemiology, pathophysiology and diagnostic challenges related to cobalamin insufficiency in neonates and infants in order to prevent its occurence.

RESULTS

Inadequate cobalamin status is prevalent among neonates and young infants, due to a high prevalence of maternal cobalamin deficiency, exclusive breastfeeding for extended periods and late introduction of animal food. Cobalamin insufficiency is associated with delayed neurodevelopment and subtle clinical symptoms like feeding difficulties, regurgitations and constipation in young infants. Early diagnosis and treatment of impaired cobalamin status is important to prevent neurologic damage.

CONCLUSION

Clinical suspicion of cobalamin insufficiency in infants should infer immediate biochemical testing and a plasma total homocysteine > 5.0 µmol/L indicate cobalamin insufficiency in need of intramuscular treatment with hydroxycobalamin, followed by introduction of animal food after 4 months of age.

Prevalence of Vegetarianism and Lifestyle Correlates in a National Study

INTRODUCTION

Vegetarianism in its various forms has gained global recognition in part because of the notion that it is healthier; however, associations between plant-based diets and selected lifestyle practices in Israel have yet to be clarified.

METHODS

A population-based sample consisting of 1396 Israeli adults was collected via telephone survey, between the years 2013-2014. Differentiation between self-defined and actual vegetarians was initially verified (based on food intake). Next, "actual" vegetarian status was studied in relation to demographics and health behaviors.

RESULTS

Approximately 5% (N = 65) of respondents (5.8% Jews and 3.0% Arabs) were "self-defined" vegetarians; but only about half (N = 33) adhered to genuine vegetarian diets. By contrast, nearly 2% (N = 26) of those self-identified as non-vegetarians were "actual" vegetarians; thus, 4.4% (N = 59) of the sample were verified "vegetarians." And while socio-demographic features did not meaningfully capture differences by vegetarianism status, "actual" vegetarians were significantly more likely than non-vegetarians to be physically active (OR = 1.7), use nutritive supplements (OR = 2.4) and read food product labels (OR = 1.9; all P < .01).

CONCLUSIONS

Aggregately, "actual" vegetarian participants were more inclined to have healthier lifestyle practices relative to their non-vegetarian counterparts. Forthcoming research using larger samples should however exploit constant assessment measures to validate the link between vegetarianism and health-promoting correlates.

Review of dietary patterns and gastric cancer risk: epidemiology and biological evidence

Due to rapid research expansion on dietary factors and development of cancer prevention guidelines, the field of dietary pattern and its relationship to cancer risk has gained more focus. Numerous epidemiology studies have reported associations between Gastric Cancer (GC) and both data-driven posteriori dietary pattern and priori dietary pattern defined by predetermined dietary indexes. As dietary patterns have evolved, a series of patterns based on biological markers has advanced, offering deeper insights into the relationship between diet and the risk of cancer. Although researches on dietary patterns and cancer risk are booming, there is limited body of literature focusing specifically on GC. In this study, we compare the similarities and differences among the specific components of dietary patterns and indices, summarize current state of knowledge regarding dietary patterns related to GC and illustrate their potential mechanisms for GC prevention. In conclusion, we offer suggestions for future research based on the emerging themes within this rapidly evolving field.

Meat consumption & positive mental health: A scoping review

The objective of this scoping review was to examine the breadth of the existing literature on the relation between meat consumption or meat abstention and positive psychological functioning. In April 2022, we conducted a systematic search of online databases (PubMed, PsycINFO, CINAHL Plus, Medline, Cochrane Library, and Web of Science) for primary research examining positive psychological functioning in meat consumers and those who abstain from meat. Thirteen studies met the inclusion/exclusion criteria, representing 89,138 participants (54,413 females and 33,863 males) with 78,562 meat consumers and 10,148 meat abstainers (13-102 years) from multiple geographic regions. The primary outcomes were life satisfaction, "positive mental health", self-esteem, and vigor. The secondary outcomes were "meaning in life", optimism, positive emotions, and psychological well-being. Eight of the 13 studies demonstrated no differences between the groups on positive psychological functioning, three studies showed mixed results, and two studies showed that compared to meat abstainers, meat consumers had greater self-esteem, "positive mental health", and "meaning in life". Studies varied substantially in methods and outcomes. Although a small minority of studies showed that meat consumers had more positive psychological functioning, no studies suggested that meat abstainers did. There was mixed evidence for temporal relations, but study designs precluded causal inferences. Our review demonstrates the need for future research given the equivocal nature of the extant literature on the relation between meat consumption and meat abstention and positive psychological functioning.

Ultra-processing markers are more prevalent in plant-based meat products as compared to their meat-based counterparts in a German food market analysis

OBJECTIVE

To compare ultra-processing markers and nutrient composition in plant-based meat products (PBMP) with equivalent meat-based products (MBP).

DESIGN

A total of 282 PBMP and 149 MBP within 18 product categories were assessed. Based on the NOVA classification, 33 ultra-processing markers were identified and six ultra-processing bullet categories were defined, that is flavour, flavour enhancer, sweetener, colour, other cosmetic additives and non-culinary ingredients. The ingredient lists were analysed concerning these ultra-processing markers and ultra-processing bullet categories, as well as nutrient composition, for all PBMP and MBP. Differences between PBMP and MBP were assessed using chi-square and Mann-Whitney U tests, respectively.

SETTING

Cross-sectional analysis.

PARTICIPANTS

282 PBMP and 149 MBP.

RESULTS

The percentage of ultra-processed food (UPF) items was significantly higher in PBMP (88 %) as compared to MBP (52 %) (P < 0·0001). The proportion of UPF items was numerically higher in 15 out of 18 product categories with differences in six categories reaching statistical significance (P < 0·05). Flavour, flavour enhancer, colour, other cosmetic additives and non-culinary ingredients were significantly more prevalent in PBMP as compared to MBP (P < 0·0001). Concerning nutrient composition, median energy, total fat, saturated fat and protein content were significantly lower, whereas the amounts of carbohydrate, sugar, fibre and salt were significantly higher in PBMP (P < 0·05).

CONCLUSIONS

Ultra-processing markers are significantly more prevalent in PBMP as compared to MBP. Since UPF intake has been convincingly linked to metabolic and CVD, substituting MBP with PBMP might have negative net health effects.

The Nutritional Benefit of UV-Exposed Mushrooms for the Dutch Population: Modeling the Addition of UV-Exposed Mushrooms to the Diet

Background

Mushrooms are rich in fiber and vitamins B and vitamin D when exposed to UV light and are sometimes used as a meat substitute. A modeling study showed that adding a mushroom portion (84 g/d) to the diet of an American population caused a significant improvement in the intake of several nutrients.

Objective

To study the association between habitual intake of mushrooms and nutrient intake and to assess the change in micronutrient intake with the modeled addition of 60 or 84 grams of UV-exposed mushrooms to the diet of the Dutch population, with a subanalysis on subjects with a low animal: plant protein ratio.

Methods

A modeling study was conducted in 3121 Dutch persons aged 9-80 y, using cross-sectional data from the Dutch National Food Consumption Survey 2012-2016. Linear regression was used to explore the association between habitual intake of mushrooms and nutrients. Habitual intake and nutritional adequacy were calculated before and after the modeled addition of mushrooms.

Results

A small association was observed between the habitual intake of mushrooms and the intake of copper, niacin, and vitamin B2 (beta ranging from 0.002 to 0.039). The modeled addition of UV-exposed mushrooms increased the intakes of plant protein (by 5-7%), fiber (4-6%), niacin (10-20%), vitamin D (176-388%), folate (11-17%), potassium (6-10%), and copper (29-48%). Nutritional adequacy also improved significantly. For subjects with a low animal:plant protein ratio, the added mushrooms increased the intakes of niacin (11-22%), potassium (6-11%), and vitamin D (190-445%).

Conclusions

Consumption of mushrooms contributes to higher intakes of copper, niacin, and vitamin B2. Addition of UV-exposed mushrooms to the diet of the Dutch further improves nutrient intakes and, most notably, vitamin D, especially for people with low animal food consumption.

A Review of Healthy Dietary Choices for Cardiovascular Disease: From Individual Nutrients and Foods to Dietary Patterns

Cardiovascular disease (CVD) remains the first cause of mortality globally. Diet plays a fundamental role in cardiovascular health and is closely linked to the development of CVD. Numerous human studies have provided evidence on the relationship between diet and CVD. By discussing the available findings on the dietary components that potentially influence CVD progression and prevention, this review attempted to provide the current state of evidence on healthy dietary choices for CVD. We focus on the effects of individual macronutrients, whole food products, and dietary patterns on the risks of CVD, and the data from population-based trials, observational studies, and meta-analyses are summarized. Unhealthy dietary habits, such as high intake of saturated fatty acids, sugar-sweetened beverages, red meat, and processed meat as well as high salt intake are associated with the increased risk of CVD. Conversely, increased consumption of plant-based components such as dietary fiber, nuts, fruits, and vegetables is shown to be effective in reducing CVD risk factors. The Mediterranean diet appears to be one of the most evidence-based dietary patterns beneficial for CVD prevention. However, there is still great debate regarding whether the supplementation of vitamins and minerals confers cardioprotective benefits. This review provides new insights into the role of dietary factors that are harmful or protective in CVD, which can be adopted for improved cardiovascular health.

[Nutritional problems of vegetarian and vegan children]

Introduction

The number of people following plant-based diets to a greater or lesser degree is increasing, but the more restrictive a diet, the greater the risk of nutritional deficiencies. The childhood stage is a stage of great physical and maturational growth, therefore, nutritional deficiencies at this stage can have serious and sometimes permanent consequences. People who follow restrictive diets of any kind, such as plant-based diets, should receive support from specialized staff to ensure that their diets are varied and balanced, as is desirable in any case.

Plant-based alternative proteins-are they nutritionally more advantageous?

BACKGROUND

The transition towards sustainable nutrition as well as the exploration of alternative sources of protein have been at the forefront of thinking in the 21st century. However, further research is required to ascertain if a diet composed of alternative plant-based proteins has similar nutritional advantages to a plant-based diet. This study aims to model the replacement of a diet consisting of animal-based proteins with plant-based alternatives (PBA), in a group of Asians.

METHODS

A 4-day food record was collected from 50 individuals residing in Singapore and nutrient profiles were generated for each individual. Food records were analysed, and meat, dairy, and seafood ingredients were substituted gram-for-gram with their PBA. The original and replaced nutrient profiles were compared against each other and the differences in macro and micronutrients were analysed.

RESULTS

A significant increase in carbohydrates, dietary fibre, as well as in micronutrients such as sodium and calcium was observed. Conversely, there was a significant decreased intake in overall energy, protein and fat (p < 0.005).

CONCLUSIONS

The significant nutritional impact of substituting animal-based proteins for PBA may present benefits for bone health and individuals on a caloric restriction diet. However, higher sodium levels may be undesirable for individuals with cardiovascular conditions and hypertension, and the low bioavailability of iron in plant-based sources may present issues for iron deficient populations. Bearing some of these key findings in mind, researchers and manufacturers need to consider these when developing alternative protein products to meet consumer demands for palatable and nutritious plant-based products.

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

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

Genetics of vegetarianism: A genome-wide association study

A substantial body of evidence points to the heritability of dietary preferences. While vegetarianism has been practiced for millennia in various societies, its practitioners remain a small minority of people worldwide, and the role of genetics in choosing a vegetarian diet is not well understood. Dietary choices involve an interplay between the physiologic effects of dietary items, their metabolism, and taste perception, all of which are strongly influenced by genetics. In this study, we used a genome-wide association study (GWAS) to identify loci associated with strict vegetarianism in UK Biobank participants. Comparing 5,324 strict vegetarians to 329,455 controls, we identified one SNP on chromosome 18 that is associated with vegetarianism at the genome-wide significant level (rs72884519, β = -0.11, P = 4.997 x 10-8), and an additional 201 suggestively significant variants. Four genes are associated with rs72884519: TMEM241, RIOK3, NPC1, and RMC1. Using the Functional Mapping and Annotation (FUMA) platform and the Multi-marker Analysis of GenoMic Annotation (MAGMA) tool, we identified 34 genes with a possible role in vegetarianism, 3 of which are GWAS-significant based on gene-level analysis: RIOK3, RMC1, and NPC1. Several of the genes associated with vegetarianism, including TMEM241, NPC1, and RMC1, have important functions in lipid metabolism and brain function, raising the possibility that differences in lipid metabolism and their effects on the brain may underlie the ability to subsist on a vegetarian diet. These results support a role for genetics in choosing a vegetarian diet and open the door to future studies aimed at further elucidating the physiologic pathways involved in vegetarianism.

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.

Gradual behaviour change towards meat reduction: Development and validation of a novel decisional balance scale

Meat reduction is gaining attention among consumers, marketers, policymakers and scientists. Yet little is known about decision-making processes and behaviour change towards meat reduction. This paper explores the applicability of the decisional balance (DB) framework to the field of meat reduction. A novel DB scale to measure the perceived importance of beliefs about meat reduction at different stages of behaviour change was developed and validated in two studies with German meat eaters. In Study 1 (N = 309), the item inventory was tested using an exploratory factor analysis and then validated in Study 2 (N = 809). The results yielded two higher-order DB factors (pros and cons), which were subdivided into five lower-order factors (perceived benefits of a plant-based diet, downsides of factory farming, health barriers, legitimation barriers and feasibility barriers). The pros and cons were summarised in a DB index. All DB factors and the DB index were tested for internal consistency (Cronbach's alpha ≥.70) and aspects of validity. The typical DB pattern of the pros and cons of behaviour change was confirmed: the cons outweighed the pros for consumers who did not intend to reduce meat consumption, while the pros outweighed the cons for consumers who intended to reduce meat consumption. The new DB scale for meat reduction has proven to be a suitable measure to gain insights into consumers' decision making and could be used to develop targeted meat reduction interventions.

The motivations and practices of vegetarian and vegan Saudis

In the Middle East, particularly in Saudi Arabia, the offering of a meat dish to guests is a deeply embedded cultural tradition, and a meat-based diet is the standard in Saudi Arabia. Thus, the rise of veganism and vegetarianism within Saudi Arabia is surprising and worthy of attention, as is understanding the perceptions and motivations behind this phenomenon, particularly as they relate to food and sustainability. This research was designed to investigate this emerging phenomenon and to identify key differences in dietarian identity between Saudi vegetarians and vegans using Rosenfeld and Burrow's Dietarian Identity Questionnaire. Among other results, the vegan group scored significantly higher on the prosocial motivation construct, suggesting the desire to help society as a whole is a stronger motivating factor for vegans. As well, the vegan cohort scored higher in the personal motivation category. From an environmental and public health perspective, understanding the key factors motivating individuals to adopt a vegetarian or vegan diet in a meat-based culture like Saudi Arabia can be used to encourage others to pursue more healthy and sustainable food behaviors.

Vegetarian diets in Spain: Temporal evolution through national health surveys and their association with healthy lifestyles

OBJECTIVE

To assess the prevalent consumption trend between 2001 and 2017 and the healthy lifestyles associated with consuming a plant-based diet in the Spanish population.

METHODOLOGY

A representative Spanish sample was analysed (>15 years old) from the Spanish National Health Survey for years 2001 (n=8568), 2006 (n=25,649), 2011 (n=19,027) and 2017 (n=21,986). The population was classified as omnivore, vegetarian, or vegan. The lifestyle variables were physical activity, tobacco and alcohol consumption, and body mass index (BMI). The χ2 test was used to evaluate diet change between 2001 and 2017. T-Student and χ2 were used to compare lifestyles of omnivores and vegetarians/vegans. Logistic regression was used to analyse lifestyles associated with plant-based diets.

RESULTS

0.2% of the Spanish population followed a plant-based diet. Between plant-based diet consumers there was an increase in vegans vs. vegetarians between 2001 (9.5% vs. 90.5%) and 2017 (65.3% vs. 34.7%) (p=0.007). Compared to 2001, following a plant-based diet was more likely in 2006 (OR=2.08, p=0.004), 2011 (OR=1.89, p=0.02) and 2017 (OR=1.75, p=0.04). Those who consume alcohol (OR=0.65, p=0.008), who were overweight (OR=0.48, p<0.001) or who were obese (OR=0.40, p=0.001) were less likely to consume a plant-based diet.

CONCLUSIONS

Despite an increase in the consumption of plant-based diets between 2001 and 2017, there was a low prevalence of consumption in all years studied. There was a greater probability of consuming plant-based diets among the Spanish population with healthy behaviours. These findings could help design strategies focused on healthy nutritional behaviours.

Risk Assessment of Micronutrients Deficiency in Vegetarian or Vegan Children: Not So Obvious

Vegetarian diets have gained in popularity worldwide and therefore an increasing number of children may be exposed to the resulting nutritional consequences. Among them, the risk of micronutrient shortfall is particularly of concern. This narrative review aims to assess and discuss the relevance of micronutrient deficiency risk based on the available data. It mainly draws attention to iron, zinc, iodine, and vitamins B12 and D intake. Diets that are more restrictive in animal source foods, such as vegan diets, have a greater likelihood of nutritional deficiencies. However, the actual risk of micronutrient deficiency in vegetarian children is relatively difficult to assert based on the limitations of evidence due to the lack of well-designed studies. The risk of vitamin B12 deficiency must be considered in newborns from vegan or macrobiotic mothers and children with the most restrictive diet, as well as the risk of iron, zinc, and iodine deficiency, possibly by performing the appropriate tests. A lacto-ovo-vegetarian diet exposes a low risk if it uses a very varied diet with a sufficient intake of dairy products. Vegan and macrobiotic diets should be avoided during pregnancy and childhood. There is a need for education and nutrition guidance and the need for supplementation should be assessed individually.

The Nutritional Quality of Food Provision at UK Government-Funded Holiday Clubs: A Cross-Sectional Analysis of Energy and Nutrient Content

A large proportion of children are at risk of food insecurity during school holidays in the UK. The government-funded Holiday Activities and Food (HAF) programme provides free holiday clubs offering at least one healthy meal/day to eligible children and adolescents. This study aims at evaluating the nutritional quality of food provision at HAF holiday clubs, particularly hot/cold and vegetarian/non-vegetarian meals. Menu variants (n = 2759) from 49 HAF holiday clubs were assessed for adherence to School Food Standards (SFS) and their notional compositional quality, which was scored utilising a novel nutrient-based meal quality index. The median adherence to SFS across all available menus was 70% (IQR 59-79%). Overall, hot variants scored statistically higher menu quality scores than cold variants for both 5-11y (92.3 (80.7-102.7) vs. 80.4 (69.3-90.6)) and 11-18y (73.5 (62.5-85.8) vs. 58.9 (50.0-70.7)) criteria. Cold and hot menu variants tended to score differentially for quality sub-components. These findings highlight areas for potential future improvement in HAF holiday club provision with a tendency for food provision to appear less ideal for attendees for those aged 11-18. Ensuring that children from low-income households have access to a healthy diet is crucial to reduce UK health inequalities.

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 VegPlate for Sports: A Plant-Based Food Guide for Athletes

Background: Nutrition strategies improve physiological and biochemical adaptation to training, facilitate more intense workouts, promote faster recoveries after a workout in anticipation of the next, and help to prepare for a race and maintain the body’s hydration status. Although vegetarianism (i.e., lacto-ovo and veganism) has become increasingly popular in recent years, the number of vegetarian athletes is not known, and no specific recommendations have been made for vegetarian dietary planning in sports. Well-planned diets are mandatory to obtain the best performance, and the available literature reports that those excluding all types of flesh foods (meat, poultry, game, and seafood) neither find advantages nor suffer from disadvantages, compared to omnivorous diets, for strength, anaerobic, or aerobic exercise performance; additionally, some benefits can be derived for general health. Methods: We conceived the VegPlate for Sports, a vegetarian food guide (VFG) based on the already-validated VegPlate facilitating method, designed according to the Italian dietary reference intakes (DRIs). Results: The VegPlate for Sports is suitable for men and women who are active in sports and adhere to a vegetarian (i.e., lacto-ovo and vegan) diet, and provides weight-based, adequate dietary planning. Conclusions: The VegPlate for Sports represents a practical tool for nutrition professionals and gives the possibility to plan diets based on energy, carbohydrate (CHO), and protein (PRO) necessities, from 50 to 90 Kg body weight (BW).

The importance of vitamin B12 for individuals choosing plant-based diets

Vitamin B₁₂ is an essential nutrient that is not made by plants; consequently, unfortified plant-based foods are not a reliable supply. Recent estimates suggest high rates of vitamin B₁₂ deficiency among the vegetarian and vegan populations, particularly in pregnant women or women of child-bearing age who, for ethical and health reasons, are shifting towards higher consumption of plant-based foods in ever-increasing numbers. Vitamin B₁₂ plays crucial metabolic roles across the life-course and in particular during pregnancy and in early development (first 1000 days of life). Evidence now implicates vitamin B₁₂ deficiency with increased risk to a range of neuro, vascular, immune, and inflammatory disorders. However, the current UK recommended nutrient intake for vitamin B₁₂ does not adequately consider the vitamin B₁₂ deficit for those choosing a plant-based diet, including vegetarianism and in particular veganism, representing a hidden hunger. We provide a cautionary note on the importance of preventing vitamin B₁₂ deficits for those individuals choosing a plant-based diet and the health professionals advising them.

Nutritional Status of Vegetarian Patients Before and After Bariatric Surgery: a Monocentric Retrospective Observational Case-Control Study

The obesity pandemic is associated with an increasing number of bariatric surgeries which allow improvement in obesity-related comorbidities and life expectancy but potentially induce nutritional deficiencies. Vegetarianism becomes more and more popular and exposes as well to vitamin and micronutrient deficiencies. Only one study has explored the impact of vegetarianism on the preoperative nutritional status of eligible patients for bariatric surgery, but none in postoperative care.

MATERIALS AND METHODS

We conducted a retrospective case-control study in our cohort of bariatric patients, matching 5 omnivores for each vegetarian. We compared their biological profile regarding vitamin and micronutrient blood levels before and 3, 6, 12, and 30 months after surgery.

RESULTS

We included 7 vegetarians including 4 lacto-ovo-vegetarians (57%), 2 lacto-vegetarians (29%), and one lacto-ovo-pesco-vegetarian (14%). Three years after surgery with equivalent daily standard vitamin supplementation, the two groups showed a similar biological profile including blood levels of ferritin (p = 0.6), vitamin B1 (p = 0.1), and B12 (p = 0.7), while the total median weight loss at 3 years was comparable (39.1% [27.0-46.6] in vegetarians vs 35.7% [10.5-46.5] in omnivores, p = 0.8). We observed no significant difference between vegetarians and omnivores before surgery regarding comorbidities and nutritional status.

CONCLUSION

It seems that, after bariatric surgery, vegetarian patients taking a standard vitamin supplementation do not show an increased risk of nutritional deficiencies compared to omnivores. However, a larger study with a longer follow-up is needed to confirm these data, including an evaluation of different types of vegetarianism such as veganism.

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.

Effects of a dietary intervention with Mediterranean vs lacto-ovo vegetarian diets on HDL function: Results from the CARDIVEG study

BACKGROUND AND AIM

HDL-cholesterol efflux capacity (CEC) has been shown to be a better cardiovascular (CVD) risk marker than serum HDL concentration. Several foods and nutrients have been shown to improve HDL functions, however no effective dietetic nor pharmacological strategy is available to increase CEC. This study aims to evaluate the possible effect of Mediterranean diet (MD) and lacto-ovo-vegetarian diet (VD) on HDL function in a group of clinically healthy subjects at low-to-moderate CVD risk.

METHODS AND RESULTS

Thirty apparently healthy subjects with a low-to-moderate cardiovascular risk profile (21 F; mean age: 51.3 ± 9.7 years) were randomly assigned to a 3-month MD or VD diet and then crossed. Participants on VD showed a reduction in total HDL CEC by 8.99% (p < 0.001) as well as a reduction in ABCA1 mediated-CEC by 18.62% (p < 0.001) compared to participants on MD. Regarding CEC mediated by aqueous diffusion, no significant changes were observed after treatment with either diet. Finally, a significant positive association between CEC mediated by the ABCA1 transporter and adiponectin was found (r = 0.462; p = 0.010).

CONCLUSION

The results of this study suggest that HDL activity in promoting cholesterol efflux and thereby reducing the concentration of pro-atherogenic lipoproteins was more effective in participants undergoing MD than VD. Based on these findings, the MD could be considered a better therapeutic strategy for cardiovascular prevention than VD.

CLINICAL TRIAL REGISTRATION URL

http://www.

CLINICALTRIALS

gov. Unique identifier: NCT02641834.

Influence of the vegan, vegetarian and omnivore diet on the oral health status in adults: a systematic review and meta-analysis

OBJECTIVE

This systematic review aimed to evaluate the influence of the nature of diet (vegan, vegetarian, and omnivore) on the oral health status in adults.

METHODS

This systematic review and meta-analysis was performed using the PRISMA guidelines. Electronic databases [PubMed, Embase, CENTRAL], online search engines (Google Scholar), research portals, and hand searches were performed systematically to identify studies. The last literature search was performed February 1st, 2021. Studies were included if they reported on the influence of the nature of diet on the oral health status (oral hygiene, periodontal health, dental status, and salivary function) in adults, by two investigators. Inter-investigator reliability was evaluated using Kappa (κ) statistics. PROSPERO registration number: CRD42020211567.

RESULTS

Twenty-two studies were included for data extraction and final analysis. The meta-analysis revealed that the bleeding on probing measure was higher in omnivores (Z = -4.057, p < 0.0001; 95% CI: -0.684, -0.238; I² = 0.0%) and the overall periodontal health was significantly better in vegan/vegetarians than omnivores (Z = -2.632, p = 0.008; 95% CI: -0.274, -0.073; I² = 29.7%). Vegan/vegetarians demonstrated more dental erosion (Z = 3.325, p = 0.001; 95% CI: 0.170, 0.659; I² = 0.0%). In adults over 60 years old, the prevalence of caries was higher in omnivores (Z = 3.244, p = 0.001; 95% CI: 0.092, 0.371; I² = 0.0%), while complete edentulism was more prevalent in vegetarians (Z = -4.147, p < 0.0001; 95% CI: -0.550, -0.197; I² = 0.0%).

CONCLUSIONS

This review reveals that adults on an omnivore diet may be associated with a higher risk for periodontal problems and dental caries, while vegetarians/vegans may be associated with a higher risk for dental erosion.

Dietary Habits and Lifestyle, Including Cardiovascular Risk among Vegetarians and Omnivores during the COVID-19 Pandemic in the Polish Population

Background: This study assessed how two food groups—omnivores (OMN) and vegetarians (VEGE)—differ in lifestyle changes, including dietary habits during the COVID-19 pandemic. Materials: A total of 861 persons participated in the survey and were divided into two groups: persons following a mixed diet (n = 489) and vegetarians, including vegans (n = 372). The mean age shows no significant differences. Methods: An online survey was conducted on the Polish population during the COVID-19 pandemic. Data was collected using social media; the survey was intended for adults and included separate sheets for different diets (OMN vs. VEGE). Results: The results in both groups were similar regarding the burden of premature diseases. Most respondents (~90%) did not indicate cardiovascular disease abnormalities. In the OMN group, overweight and obesity occurred more often, and the OMN group also showed a higher percentage of people reporting weight gain (OMN 42.7% vs. VEGE 35.9%). The results disclosed the VEGE group significantly more frequently chose products, i.e., vegetables (p = 0.029), legumes (p < 0.001), and dairy products or their plant substitutes (p = 0.002), compared to the OMN group. Conclusions: The VEGE group revealed the most regularities in dietary habits during the pandemic.

Examining dietary behaviours, diet quality, motives and supplementation use in physically active individuals following vegetarian-based eating patterns

The adoption of vegetarian-based dietary patterns among athletes has been gaining popularity. However, limited research examines the dietary behaviours within this group. Therefore, the aim of this study was to examine self-reported dietary behaviours in a cohort of physically active individuals following vegetarian-based dietary patterns, recruited via social media. A 52-item online survey was created with questions related to demographics, physical activity, eating patterns and supplementation use. An external link to the Australian Automated Self-Administered 24-h (ASA24-AU) recall was included to examine nutrient intakes. Dietary quality was assessed using the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Dietary Phytochemical Index (DPI) tools. A total of 781 (84.8%) respondents completed the survey in 2018. Principal motives for adhering to a vegetarian-based dietary pattern included animal rights (86.5%), environmental concerns (75.4%), health reasons (69.6%) and improving physical performance (24.1%). Vitamin B12 was the most commonly reported supplement (58.1%) followed by protein powder (36.3%) and vitamin D (35.9%). A total of 133 respondents completed the ASA24-AU dietary recall with generally adequate nutrient intakes and a high-quality diet as assessed by the AHEI-2010 and DPI. A significant minority of physically active individuals following vegetarian-based diets do so with the aspiration of improving their exercise performance. Dietary quality was considered high in this group for recreational physical activity, although intakes of vitamin B12 and LC n-3 PUFA were low.

Investigation of Trace Elements in Vegan Foods by ICP-MS After Microwave Digestion

Veganism is gaining popularity around the world day by day. Vegan nutrition is a diet in which not all animal foods are used. A vegan diet does not contain meat, fish, milk and dairy products, and eggs and consists of vegetables, fruits, grains, legumes, and nuts. Vegan diets maintain energy balances in a wide variety of plant foods. So, health problems can be seen due to nutrient and mineral deficiencies in the long-term continuation of the vegan diet. Due to insufficient intake of vitamins and minerals such as vitamin D, vitamin B12, calcium, iron, and zinc, energy and protein balance in the body may not be achieved by vegan individuals. The contents of aluminum, chromium, manganese, iron, cobalt, nickel, copper, zinc, arsenic, mercury, cadmium, and lead have been analyzed by inductively coupled plasma mass spectrometer (ICP-MS) in 10 different vegan foods purchased from Turkey. Certified reference material (1547 peach leaves) was used for validating the digestion procedure. Dry, wet, and microwave processes were compared, and it was found that the microwave digestion method was the best. Element levels in the analyzed samples were found below the legal limits. The purpose of this work is to investigate the trace element content of various foods used in vegan nutrition.

On-campus food purchase behaviors, choice determinants, and opinions on food availability in a Spanish university community

OBJECTIVE

The aim of this study was to investigate food purchasing behaviors, choice determinants, and opinions about on-campus food availability by a university community and to analyze differences in these aspects between students, education and/or research staff (ERS), and administrative and services staff (ASS), and between males and females.

METHODS

This was a cross-sectional study that involved a representative sample of students (n = 1089), ERS (n = 396), and ASS (n = 300) who completed an anonymous online survey. A previously adapted version of the questionnaire was administered. The results were weighted to ensure representativeness of this community population using weighted coefficients.

RESULTS

The results showed that most of the participants purchased food on campus (91.6%), especially for lunch (67.4% of foods and 37.4% of drinks) and snack (65.4% of foods and 45.4% of drinks). Hot drinks (i.e., coffee, tea, hot chocolate etc.; 60.5%), bottled water (49.2%), and hot foods (i.e., small servings [38.2%] and sandwiches/hamburgers [31.7%]) were the most purchased items. Taste (98.6%) was the most important determinant in choice, followed by price for students, nutritional value for ASS, and health value for ERS. The "top 5" opinions suggested for the campus food environment and potential changes were "greater capacity to access free filtered drinking water", "greater capacity to recycle food packaging," "more healthy options in vending machines", "discounts for healthy choices," and "allergen labeling."

CONCLUSION

Interventions that improve sustainability and the affordability of products with high nutritional quality, price-manipulation directives, and allergen information on labeling would be well received among this community.

Vegan milk and egg alternatives commercialized in Brazil: A study of the nutritional composition and main ingredients

Worldwide, there is an increasing demand for plant-based food due to sustainable, health, ethical, religious, philosophical, and economic reasons. In Brazil, 14% of the population declares themselves vegetarians, and a noticeable increase in the consumption of vegan products is also noted. Substitution of animal dairy and egg is challenging from both sensory and nutritional aspects. Yet, there are no data regarding the nutritional value and ingredients of Brazilian commercial dairy and egg substitutes. Therefore, this study aimed to analyze the nutritional composition and used ingredients in Brazilian commercial vegan alternatives to dairy and eggs to provide information for Brazilian consumers of these products. A cross-sectional quantitative study was carried out in three steps: (i) sample mapping. (ii) data collection, and (iii) statistical analysis. A total of 152 samples were included. No differences were found between the energy value and total fat of vegan products and their animal counterparts. Vegan products showed higher amounts of carbohydrates and dietary fiber, and only the vegan versions of beverages and cheeses showed less protein than their counterparts. Cashews, rice, coconut, and soy were the most used ingredients in dairy substitutes. Emulsions of oil, starch, and isolated protein were used in vegan egg products. Most vegan beverages presented sugar in their composition. Vegan alternatives of dairy and eggs might be suitable for substituting their animal counterparts, but given that traditional versions of cheeses and milk are sources of protein in omnivorous diets, for equivalent nutritional replacement in vegan products, it is necessary to improve the protein content of their vegan counterparts.

“Be rational!” Epistemic aims and socio-cognitive tension in argumentation about dietary choices

Argumentation is a social practice that can lead to epistemic outcomes, that is, to the construction of knowledge. Recent research in collaborative learning has pointed out the significance of affective and motivational aspects, as well as the influence of socio-relational concerns, which have been found to frequently take priority over epistemic ones. Our research objective is to investigate how the epistemic and socio-relational dimensions of students' argumentative interactions are intertwined. We apply discourse analysis to examine the interactions in a small group of four 11th-graders evaluating the nutritional acceptability of omnivorous and vegetarian diets. The epistemic dimension is analyzed in terms of the aims pursued by the participants and the epistemic outcomes achieved. The socio-relational dimension is analyzed in terms of fluctuations of interpersonal tensions and their relaxations. The results show a convergence of participants' epistemic aims and the epistemic statuses of the options. Most of the epistemic outcomes are produced in sequences in which socio-cognitive tension arises and then relaxes. Enduring high socio-cognitive tension and overcoming conflict seem to have encouraged the adoption of epistemic aims. Moreover, our findings suggest that driven by epistemic aims in high socio-cognitive tensed contexts, students can refine the conditions by which they engage in argumentation. These results call for further investigating on what constitutes an appropriate or productive level of interpersonal tension for learning. Educational implications are related to the design of argumentative learning environments promoting epistemic aims and outcomes through the encouragement of suitable socio-cognitive climates leading to them.

Prevalence of Female and Male Vegan and Non-Vegan Endurance Runners and the Potential Associations of Diet Type and BMI with Performance-Results from the NURMI Study (Step 1)

This study aims to investigate vegetarian and mixed diet type prevalences among distance runners at running events around the world and associations with running-related patterns and performance. Following a cross-sectional approach, linear regression analyses were carried out to identify potential associations among body mass index (BMI), diet type, and average best performance times of half-marathon and marathon events for males and females. From a sample of 3835 runners who completed an online questionnaire, 2864 all-distance runners (age: 37 years; 57% females) were included in inferential analyses and categorized into dietary subgroups according to self-reports: 994 vegans (34.7%), 598 vegetarians (20.9%), and 1272 omnivores (44.4%). Significant associations were identified between kind of diet and best average time to finish (i) half-marathons in females where vegans (p = 0.001) took longer than omnivores, (ii) half-marathons in males where vegans (p < 0.001) and vegetarians (p = 0.002) took longer than omnivores, and (iii) marathons in males where vegans (p < 0.001) and vegetarians (p = 0.043) averaged slower than omnivores. Increased units of BMI (+1.0) in males influenced best runtimes: 2.75 (3.22−2.27) min slower for HM and 5.5 (5.69−4.31) min slower for M. The present study did not take detailed confounders into account such as runner motives or training behaviors; however, the results may provide valuable insight for running event organizers, nutrition experts, coaches, and trainers advising runners who adhere to a general diet type regarding the basic question of who participates in running events around the world.

The Nutritional Adequacy and Diet Quality of Vegetarian Menu Substitutions in Urban Kansas Childcare Centers

While plant-based eating has become increasingly popular, little is known of how this trend has impacted childcare center meals. The purpose of this study was to measure the nutrient content and diet quality of vegetarian alternative lunches and compare these measures to those of standard childcare lunches and nutrient benchmarks representing one-third of the Dietary Reference Intake for 3-year-olds and 4-5-year-olds. Menu data were obtained from seven urban Kansas childcare centers participating in the Child and Adult Care Food Program and regularly providing a vegetarian alternative lunch. The centers provided detailed menu information for 27 days' worth of meals. The most common vegetarian substitution was cheese, which was used to fulfill all or part of the meat/meat alternative requirement in over three-quarters of the vegetarian alternative meals (n = 22). Compared to the standard meals, the vegetarian alternative meals were higher in calories, fat, saturated fat, calcium, and sodium and lower in protein, choline, and diet quality (p = 0.05). Both lunch options met the benchmarks for vitamin A, vitamin D, vitamin B12, calcium, and protein. Iron content for both (95% CI: standard 1.61-2.17 mg; vegetarian 1.37-2.7 mg) was below the benchmark. Although additional research is needed to better understand how vegetarianism has impacted childcare meals in the U.S., important differences in the nutrient contents were observed between the standard and vegetarian alternative meals. In addition, the results suggest vegetarian alternative meals that rely heavily on cheese may be of lower diet quality.

Are Vegan Alternatives to Meat Products Healthy? A Study on Nutrients and Main Ingredients of Products Commercialized in Brazil

Proteins are essential components in human nutrition, and animal products are usually the primary sources of human ingestion. However, the number of adherents to vegetarian and vegan diets has grown significantly, highlighting the need for alternatives to replace animal proteins. Meat substitutes aim to mimic the nutritional value and sensory characteristics of meat. However, studies suggest differences in their composition. This study is the first to evaluate Brazilian meat substitutes' nutritional quality and ingredients. A quantitative cross-sectional survey was performed in three steps: (i) Sample mapping of products commercialized nationwide; (ii) Ingredients and nutritional data collection and classification; (iii) Statistical analysis. One hundred twenty-five meat substitutes were included and described. The primary protein sources were soy, gluten, and pea protein ingredients. Vegan meat substitutes presented similar energy and protein values, with few exceptions among samples, with vegan canned fish alternatives presenting less protein than their counterparts. Overall vegan products did not differ regarding sodium levels but showed high amounts to compose a lunch or dinner meal. Vegan meat substitutes showed higher carbohydrates, dietary fiber concentrations, and few differences regarding total and saturated fat. Vegan meat substitutes may contribute to the adherence and maintenance of vegan and vegetarian diets. However, future studies about the implemented ingredients are needed.