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Dal N, Bilici S. Dietary Modulations in Preventing Cardiometabolic Risk in Individuals with Type 2 Diabetes. Curr Nutr Rep 2024:10.1007/s13668-024-00541-z. [PMID: 38767826 DOI: 10.1007/s13668-024-00541-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE OF REVIEW Type 2 diabetes mellitus (T2DM) is a complex health issue include obesity, high cholesterol, high blood pressure, and chronic inflammation that increase the risk of cardiovascular diseases (CVDs). CVDs are of great concern in the disease progression and prognosis of T2DM. This review is a comprehensive examination of the literature on the relationship between T2DM and cardiovascular risk, nutrition-related cardiometabolic risk (CMR) factors, and impact of dietary modulations on CMR. RECENT FINDINGS In recent years the researches has been focus on the importance of a comprehensive treatment approach like dietary modulations to address multiple cardiovascular risk reductions, including hypertension and dyslipidemia. Modulation of dietary patterns are the most promising interventions to prevent CMR factors and T2DM via affecting the body weight, glucose control, and microbial diversity of individuals. Current evidence suggests that high-quality dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) eating plan and the Mediterranean diet is important in the metabolic control processes of T2DM with anti-inflammatory and antioxidant compounds, glucagon-like peptide agonist compounds, and intestinal microbiota changes. Nutrition plays a critical role in preventing and improving CVD outcomes in patients with T2DM. Dietary modulations should be planned considering individual differences in responses to dietary composition and nutritional changes, personal preferences, eating behaviors and gut microbiota differences.
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Affiliation(s)
- Nursel Dal
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey.
| | - Saniye Bilici
- Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
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Bassin SR, Ferreira De Carvalho J, Gulati M. A Review of Plant-Based Diets for Obesity Management. Endocr Pract 2024:S1530-891X(24)00513-5. [PMID: 38729570 DOI: 10.1016/j.eprac.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/03/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Obesity is the most prevalent chronic disease in the United States with over 70% of the American population suffering from overweight/obesity. Recently, the popularity of plant-based diets has grown, with individuals adopting these diets for ethical, health and environmental reasons. Our aim is to evaluate the effect of a plant-based diet (PBD) on weight loss among patients who are overweight or obese. METHODS A literature review of PBDs for the treatment of obesity was conducted using PubMed and Scopus. Our search yielded 27 intervention trials (3361 participants) and six metanalyses (9168 participants, 61 trials). RESULTS Among the intervention trials evaluated, 75% showed a significant decrease in weight loss in the intervention group, on average -5.0kg (range -1.8 to -12.1kg). Other outcomes included energy intake (-420 Kcal/day), systolic blood pressure (-3.78 mmHg), fasting plasma glucose (-2.0 mmol/L), HbA1c (-0.5%, -3.4 mmol/L), total cholesterol (-0.40 mmol/L), low-density lipoprotein (-0.38 mmol/L), triglyceride levels (+0.13 mmol/L), and fiber intake (+10.8 g/day). The six meta-analyses showed weight loss (average -2.9 kg , range -2.02 kg to -4.1 kg), BMI reduction, and improvements in HbA1c, LDL, and total cholesterol. CONCLUSION PBDs result in significant weight loss and improve metabolic outcomes. PBDs offer a sustainable approach to long-term weight loss maintenance. Healthcare providers should encourage open discussions with their patients regarding their dietary habits to assist them in setting feasible lifestyle goals and consider shared medical appointments to support patients in transitioning to PBDs.
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Affiliation(s)
| | | | - Mahima Gulati
- Department of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University
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Shrestha A, Tamrakar D, Ghinanju B, Shrestha D, Khadka P, Adhikari B, Shrestha J, Waiwa S, Pyakurel P, Bhandari N, Karmacharya BM, Shrestha A, Shrestha R, Bhatta RD, Malik V, Mattei J, Spiegelman D. Effects of a dietary intervention on cardiometabolic risk and food consumption in a workplace. PLoS One 2024; 19:e0301826. [PMID: 38656951 PMCID: PMC11042715 DOI: 10.1371/journal.pone.0301826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Worksite-based health programs have shown positive impacts on employee health and have led to significant improvements in cardiovascular risk factor profiles. We aimed to determine the effect of cafeteria intervention on cardio-metabolic risk factors diet in a worksite setting (Dhulikhel Hospital) in Nepal. METHODS In this one-arm pre-post intervention study, we recruited 277 non-pregnant hospital employees aged 18-60 with prediabetes or pre-hypertension. The study was registered in clinicaltrials.gov (NCT03447340; 2018/02/27). All four cafeterias in the hospital premises received cafeteria intervention encouraging healthy foods and discouraging unhealthy foods for six months. We measured blood pressure, fasting glucose level, glycated hemoglobin, cholesterol in the laboratory, and diet intake (in servings per week) using 24-hour recall before and six months after the intervention. The before and after measures were compared using paired-t tests. RESULTS After six months of cafeteria intervention, the median consumption of whole grains, mono/polyunsaturated fat, fruits, vegetable and nuts servings per week increased by 2.24(p<0.001), 2.88(p<0.001), 0.84(p<0.001) 2.25(p<0.001) and nuts 0.55 (p<0.001) servings per week respectively. The median consumption of refined grains decreased by 5.07 servings per week (p<0.001). Mean systolic and diastolic blood pressure decreased by 2 mmHg (SE = 0.6; p = 0.003) and 0.1 mmHg (SE = 0.6; p = 0.008), respectively. The low-density lipoprotein (LDL) was significantly reduced by 6 mg/dL (SE = 1.4; p<0.001). CONCLUSION Overall, we found a decrease in consumption of refined grains and an increase in consumption of whole grains, unsaturated fats, fruits, and nuts observed a modest reduction in blood pressure and LDL cholesterol following a 6-month cafeteria-based worksite intervention incorporating access to healthy foods.
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Affiliation(s)
- Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Dipesh Tamrakar
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Bhawana Ghinanju
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Deepa Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Parashar Khadka
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Bikram Adhikari
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Jayana Shrestha
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Suruchi Waiwa
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Prajjwal Pyakurel
- Department of Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Niroj Bhandari
- Department of Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Biraj Man Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Akina Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Rajeev Shrestha
- Department of Pharmacology, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Rajendra Dev Bhatta
- Department of Biochemistry, Kathmandu University School of Medical Sciences, Dhulikhel, Bagmati, Nepal
| | - Vasanti Malik
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Donna Spiegelman
- Department of Biostatistics and Center of Methods for Implementation and Prevention Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
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Goldner B, Staffier KL. Case series: raw, whole, plant-based nutrition protocol rapidly reverses symptoms in three women with systemic lupus erythematosus and Sjögren's syndrome. Front Nutr 2024; 11:1208074. [PMID: 38505266 PMCID: PMC10949923 DOI: 10.3389/fnut.2024.1208074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/05/2024] [Indexed: 03/21/2024] Open
Abstract
Systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS) are chronic autoimmune diseases. Symptoms of SLE can vary widely but often include fatigue, pain, photosensitivity, and, in some cases, nephritis. SS is frequently characterized by extreme dry eye and mouth, resulting from damage to moisture-producing glands, and is often present in combination with SLE. While the health benefits of plant-based diets have been well-established with respect to weight and cardiometabolic outcomes, less research is available to support the role of diet in treatment and management of autoimmune disease. This case series presents three women with SLE and SS who adopted a nutrition protocol to reverse symptoms of autoimmune disease. The protocol emphasizes leafy greens, cruciferous vegetables, omega-3 polyunsaturated fatty acids, and water, and includes predominately raw foods. The three patients reported dramatic improvements in physical symptoms, with nearly all symptoms of SLE and SS resolving after 4 weeks or less of adhering to the protocol. All three patients have remained symptom-free, two of whom have remained symptom-free for 6+ years with no recent medication use. Patients and practitioners should be made aware of the promising possibility of food as medicine in the treatment of SLE and SS. Future research should explore whether dietary changes may be a potential treatment strategy for individuals suffering from severe symptoms and poor quality of life due to SLE and SS.
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Jannati N, Mahmoodi MR, Azadbakht L. Adherence to plant-based dietary patterns and anthropometric indices among primary school girls in Kerman: A cross-sectional study. PLoS One 2024; 19:e0298454. [PMID: 38394287 PMCID: PMC10890736 DOI: 10.1371/journal.pone.0298454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
The objective of the study was to evaluate the association between adherence to plant-based dietary patterns and anthropometric indices among primary school girls in Kerman. This cross-sectional study included 330 girls aged 6-12. A reliable and validated dish-based food frequency questionnaire was used to collect dietary data. Weight, height, and mid-arm circumference were measured, and z-score charts from the World Health Organization for girls between the ages of 5 and 19 were utilized. We used Satija et al. method to calculate plant-based diet index scores. After adjusting for age and energy, participants in the higher tertile of the overall plant-based diet index (PDI) had a lower height-for-age z score (HAZ) (0.38±0.12 vs. 0.59±0.12 kg; P = 0.033). Higher unhealthful plant-based diet index (uPDI) scores were significantly associated with decreased HAZ in models 2 (p = 0.028) and 3 (p = 0.035). A higher PDI score was associated with lower odds of being underweight and overweight, respectively (Model 1: P trend = 0.007, <0.001; Model 2: P trend = 0.010, 0.001). A significant inverse association was found between healthful plant-based diet index (hPDI) scores and underweight risk in the crude and adjusted models. (Model 1: P trend = 0.021; model 2: P trend = 0.018; Model 3: P trend = 0.031). Higher uPDI scores were associated with increased odds of being overweight and obese in all three models (Model 1: p trend<0.001; Model 2: p trend<0.001; Model 3: p trend = 0.001). We concluded that children who followed a plant-based diet had lower odds of being overweight and obese. Higher scores on the hPDI were linked to a decreased risk of being underweight, while higher scores on the uPDI were associated with an increased risk of being overweight and obese. The study suggests healthy plant-based diet may benefit children's weight and growth.
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Affiliation(s)
- Nooshin Jannati
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Reza Mahmoodi
- Faculty of Public Health, Institute of Neuropharmacology & Department of Nutrition, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Wiśniewska K, Okręglicka KM, Nitsch-Osuch A, Oczkowski M. Plant-Based Diets and Metabolic Syndrome Components: The Questions That Still Need to Be Answered-A Narrative Review. Nutrients 2024; 16:165. [PMID: 38201994 PMCID: PMC10780839 DOI: 10.3390/nu16010165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Metabolic syndrome (MetS) is defined as the co-occurrence of at least three of the following metabolic disorders: abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), high blood glucose, and hypertension. The treatment of MetS involves lifestyle changes, including following an appropriate diet. In addition to weight reduction, it is crucial to search for optimal nutritional patterns that are highly effective in optimizing other MetS markers, such as glucose and lipid metabolism, and reducing blood pressure. To date, the effects of a Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet on MetS have been extensively evaluated. Recent epidemiological studies suggest that plant-based diets (PBDs) may be effective in treating MetS; however, there is still a lack of experimental data. This review aims to analyze the potential benefits of different PBDs on MetS determinants based on the available studies. The findings may help personalize dietary interventions and improve patient care for those with MetS.
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Affiliation(s)
- Klaudia Wiśniewska
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.M.O.); (A.N.-O.)
- Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Katarzyna Małgorzata Okręglicka
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.M.O.); (A.N.-O.)
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland; (K.M.O.); (A.N.-O.)
| | - Michał Oczkowski
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159c Nowoursynowska Street, 02-776 Warsaw, Poland;
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Pavlidou E, Papadopoulou SK, Fasoulas A, Papaliagkas V, Alexatou O, Chatzidimitriou M, Mentzelou M, Giaginis C. Diabesity and Dietary Interventions: Evaluating the Impact of Mediterranean Diet and Other Types of Diets on Obesity and Type 2 Diabetes Management. Nutrients 2023; 16:34. [PMID: 38201865 PMCID: PMC10780530 DOI: 10.3390/nu16010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Diabesity, the intersection of obesity and diabetes, presents a global health crisis with profound implications. Addressing diabesity requires multifaceted strategies, with diet playing a pivotal role. Over the last 15 years, clinical studies have intensified their exploration of various dietary approaches in diabesity management. This literature review aims to synthesize findings from clinical studies conducted in the last 15 years, shedding light on the efficacy, mechanisms, and nuances of different diet types in diabesity management with special focus on the Mediterranean diet (MD). METHODS Thorough research of academic databases yielded a collection of relevant clinical studies. These studies encompassed a range of dietary strategies, including the MD, low-carbohydrate diets, plant-based diets, high-protein diets, low-fat regimens, and intermittent fasting. Key findings, methodologies, and outcomes were thoroughly extracted and analyzed. RESULTS The last 15 years have witnessed considerable improvements in recognizing the role of human nutritional habits in diabesity management. The MD appears to be the most well-recognized diet, exerting favorable effects against both obesity and diabetes. Low-carbohydrate diets were found to enhance glycemic regulation and decrease insulin resistance. Plant-based diets demonstrated potential benefits in weight management and cardiometabolic health. High-protein, low-fat dietary models exhibited positive effects on satiety and body weight decline. Intermittent fasting regimens also exerted metabolic improvements and body weight decline. Personalization emerged as a crucial factor in dietary recommendations. CONCLUSIONS Clinical studies from the last 15 years underscore the intricate relationship between diet types and diabesity management. The above results contribute to an increasing body of evidence, emphasizing the need for tailored dietary approaches and especially the MD. Healthcare providers can utilize this knowledge to offer personalized dietary recommendations for individuals with diabesity, potentially curbing the rise of these twin epidemics and improving the well-being of affected populations.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (A.F.); (O.A.); (M.M.); (C.G.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Aristeidis Fasoulas
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (A.F.); (O.A.); (M.M.); (C.G.)
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (V.P.); (M.C.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (A.F.); (O.A.); (M.M.); (C.G.)
| | - Maria Chatzidimitriou
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (V.P.); (M.C.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (A.F.); (O.A.); (M.M.); (C.G.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece; (E.P.); (A.F.); (O.A.); (M.M.); (C.G.)
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Melgar B, Diaz-Arocutipa C, Huerta-Rengifo C, Piscoya A, Barboza JJ, Hernandez AV. Vegetarian diets on anthropometric, metabolic and blood pressure outcomes in people with overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. Int J Obes (Lond) 2023; 47:903-910. [PMID: 37528197 DOI: 10.1038/s41366-023-01357-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 07/01/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND It is unknown whether vegetarian diets (VDs) may improve outcomes in people with overweight and obesity. OBJECTIVE To systematically assess the effects of VDs vs. omnivore diets on anthropometric, metabolic, and blood pressure outcomes in people with overweight and obesity. METHODS We searched for randomized controlled trials (RCTs) in EMBASE, PubMed, Web of Science, and Scopus until February 2, 2022. Primary outcomes were anthropometric risk factors (weight, body mass index [BMI], waist circumference [WC], hip circumference [HC], and body fat percentage). Secondary outcomes were metabolic risk factors (fasting serum glucose, HbA1c, insulin levels) and blood pressure (systolic blood pressure [SBP], diastolic blood pressure [DBP]). Random-effects meta-analyses were performed and effects were expressed as mean difference (MD) and their 95% confidence intervals (CI). The quality of evidence was assessed using GRADE methods. RESULTS Nine RCTs (n = 1628) were included. VDs decreased weight (MD -3.60 kg, 95%CI -4.75 to -2.46) and glucose (MD -10.64 mg/dL, 95%CI -15.77 to -5.51), but did not decrease WC (MD -3.00 cm, 95%CI -6.20 to 0.20), BMI (MD -0.87 kg/m2, 95%CI -1.80 to 0.06), or HC (MD: -0.86 cm, 95%CI -3.46 to 1.74). VDs did not decrease HbA1c (MD -0.40%, 95%CI -0.89 to 0.10), insulin (MD -3.83 mU/L, 95%CI -8.06 to 0.40), SBP (MD -0.25 mmHg, 95%CI -2.58 to 2.07), or DBP (MD -1.57 mmHg, 95%CI -3.93 to 0.78). Subgroup analyses by type of VD (four RCTs evaluated lacto-ovo-vegetarian diets and five RCTs vegan diets) showed similar results to the main analyses. QoE was very low for most of the outcomes. CONCLUSIONS In comparison to an omnivorous diet, VDs may reduce weight and glucose, but not blood pressure or other metabolic or anthropometric outcomes. However, the QoE was mostly very low. Larger RCTs are still needed to evaluate the effects of VD on anthropometric, metabolic factors, and blood pressure in people with overweight and obesity.
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Affiliation(s)
- Beatriz Melgar
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
| | - Carlos Diaz-Arocutipa
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Claudia Huerta-Rengifo
- Tau Relaped Group, Trujillo, Peru
- Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
| | - Alejandro Piscoya
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Hospital Guillermo Kaelin de la Fuente, Lima, Peru
| | - Joshuan J Barboza
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Tau Relaped Group, Trujillo, Peru
| | - Adrian V Hernandez
- Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
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Wirnitzer KC, Motevalli M, Cocca A, Tanous DR, Wirnitzer G, Wagner KH, Schätzer M, Drenowatz C, Ruedl G, Kirschner W. Health behavior of Austrian tertiary students focusing on diet type linked to sports and exercise-first glimpse of results from the "sustainably healthy-from science 2 high school and university" study. Front Public Health 2023; 11:1129004. [PMID: 37533531 PMCID: PMC10392833 DOI: 10.3389/fpubh.2023.1129004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Background There is a strong association between lifestyle behavior and health status. While young adulthood is a critical period for adopting and stabilizing lifelong healthy behavior, university life is independently associated with psychological stressors that may further affect health and well-being. Objective The present multidisciplinary study aimed to examine the health behavior of Austrian college and university students, differentiated based on diet types (vegan, vegetarian, and omnivorous) and physical activity (PA) habits. Methods Following a cross-sectional study design, a total number of 6,148 students (65.3% females; 66.1% bachelor students, 67.0% from urban areas; mean age: 24.8 years) from 52 Austrian college/universities participated in an online survey and provided data on sociodemographic characteristics, dietary patterns, PA habits, and other lifestyle behavior characteristics, including alcohol intake and smoking. Results Across the total sample, 74.0% had a normal weight (BMI = 18.5-25.0 kg/m2), while the prevalence of overweight/obesity (BMI ≥ 30.0 kg/m2) was lower in females than males and more in rural than urban students (p < 0.01). The general prevalence of vegetarian and vegan diets was 22.8 and 6.0%, respectively, with a predominance of females, graduates, and urban students compared to their peers (p < 0.01). The majority of students (79.3%) had a regular engagement in sport/exercise, with a predominance of vegetarian or vegan students compared to omnivores (p < 0.01). Vegans and vegetarians had a lower alcohol intake (p < 0.01) but no differences in smoking habits (p > 0.05) compared to omnivores. Students engaging in sport/exercise had a lower smoking rate and higher intake of fruits, vegetables, and fluids compared to inactive students (p < 0.01). Conclusion The present findings suggest that diet type and PA habits of college/university students have an impact on other health behaviors, highlighting the interconnected nature of lifestyle habits and health behavior.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition (SIPCAN), Elsbethen, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Agnoli C, Baroni L, Bertini I, Ciappellano S, Fabbri A, Goggi S, Metro D, Papa M, Sbarbati R, Scarino ML, Pellegrini N, Sieri S. A comprehensive review of healthy effects of vegetarian diets. Nutr Metab Cardiovasc Dis 2023; 33:1308-1315. [PMID: 37217433 DOI: 10.1016/j.numecd.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/24/2023]
Abstract
AIMS A comprehensive review comparing the effect of vegetarian (V) and non-vegetarian (NV) diets on the major cardiometabolic diseases' outcomes was performed. DATA SYNTHESIS We performed literature research (up to December 31, 2022) of the evidence separately for vascular disease (VD), obesity (OB), dyslipidemia (Dysl), hypertension (HPT), type 2 diabetes (T2D), metabolic syndrome (MetS), analyzing only cohort studies and randomized controlled studies (RCTs) and comparing the effect of V and NV diets. Cohort studies showed advantages of V diets compared to NV diets on incidence and/or mortality risk for ischemic heart disease, overweight and OB risk. Most cohort studies showed V had lower risk of HPT and lower blood pressure (BP) than NV and V diets had positive effects on T2D risk or plasma parameters. The few cohort studies on the risk of MetS reported mixed results. In RCTs, V diets, mainly low-fat-vegan ones, led to greater weight loss and improved glycemic control than NV diets and in the only one RCT a partial regression of coronary atherosclerosis. In most RCTs, V diets significantly reduced LDL-C levels (but also decreased HDL-C levels) and BP. CONCLUSIONS In this comprehensive review of the association between V diets and cardiometabolic outcomes, we found that following this type of diet may help to prevent most of these diseases. However, the non-uniformity of the studies, due to ethnic, cultural, and methodological differences, does not allow for generalizing the present results and drawing definitive conclusions. Further, well-designed studies are warranted to confirm the consistency of our conclusions.
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Affiliation(s)
- C Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Baroni
- Scientific Society for Vegetarian Nutrition - SSNV, Venice (VE), Italy
| | | | - S Ciappellano
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Division of Human Nutrition, University of Milan, Italy
| | - A Fabbri
- Department of Food and Drug Science, University of Parma, Italy
| | - S Goggi
- Nutrition and Dietetic Department, Plant Based Clinic, via Giannone 9, 20154, Milano, Italy
| | - D Metro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125, Messina, Italy
| | - M Papa
- Messina Provincial Health Authority, Messina, Italy
| | | | - M L Scarino
- Research Institute for Food and Nutrition, Council for Agricultural Research and Economics, Rome, Italy
| | - N Pellegrini
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, Udine, Italy.
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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11
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Clemente-Suárez VJ, Beltrán-Velasco AI, Redondo-Flórez L, Martín-Rodríguez A, Tornero-Aguilera JF. Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients 2023; 15:2749. [PMID: 37375654 DOI: 10.3390/nu15122749] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The Western diet is a modern dietary pattern characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy, sweets, fried foods, conventionally raised animal products, high-fat dairy products, and high-fructose products. The present review aims to describe the effect of the Western pattern diet on the metabolism, inflammation, and antioxidant status; the impact on gut microbiota and mitochondrial fitness; the effect of on cardiovascular health, mental health, and cancer; and the sanitary cost of the Western diet. To achieve this goal, a consensus critical review was conducted using primary sources, such as scientific articles, and secondary sources, including bibliographic indexes, databases, and web pages. Scopus, Embase, Science Direct, Sports Discuss, ResearchGate, and the Web of Science were used to complete the assignment. MeSH-compliant keywords such "Western diet", "inflammation", "metabolic health", "metabolic fitness", "heart disease", "cancer", "oxidative stress", "mental health", and "metabolism" were used. The following exclusion criteria were applied: (i) studies with inappropriate or irrelevant topics, not germane to the review's primary focus; (ii) Ph.D. dissertations, proceedings of conferences, and unpublished studies. This information will allow for a better comprehension of this nutritional behavior and its effect on an individual's metabolism and health, as well as the impact on national sanitary systems. Finally, practical applications derived from this information are made.
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Affiliation(s)
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, 28670 Villaviciosa de Odón, Spain
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12
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Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J 2023:7177660. [PMID: 37226630 PMCID: PMC10361023 DOI: 10.1093/eurheartj/ehad211] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/23/2023] [Accepted: 03/24/2023] [Indexed: 05/26/2023] Open
Abstract
AIMS Due to growing environmental focus, plant-based diets are increasing steadily in popularity. Uncovering the effect on well-established risk factors for cardiovascular diseases, the leading cause of death worldwide, is thus highly relevant. Therefore, a systematic review and meta-analysis were conducted to estimate the effect of vegetarian and vegan diets on blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, and apolipoprotein B. METHODS AND RESULTS Studies published between 1980 and October 2022 were searched for using PubMed, Embase, and references of previous reviews. Included studies were randomized controlled trials that quantified the effect of vegetarian or vegan diets vs. an omnivorous diet on blood lipids and lipoprotein levels in adults over 18 years. Estimates were calculated using a random-effects model. Thirty trials were included in the study. Compared with the omnivorous group, the plant-based diets reduced total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels with mean differences of -0.34 mmol/L (95% confidence interval, -0.44, -0.23; P = 1 × 10-9), -0.30 mmol/L (-0.40, -0.19; P = 4 × 10-8), and -12.92 mg/dL (-22.63, -3.20; P = 0.01), respectively. The effect sizes were similar across age, continent, duration of study, health status, intervention diet, intervention program, and study design. No significant difference was observed for triglyceride levels. CONCLUSION Vegetarian and vegan diets were associated with reduced concentrations of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B-effects that were consistent across various study and participant characteristics. Plant-based diets have the potential to lessen the atherosclerotic burden from atherogenic lipoproteins and thereby reduce the risk of cardiovascular disease.
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Affiliation(s)
- Caroline A Koch
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Emilie W Kjeldsen
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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13
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Chew HSJ, Heng FKX, Tien SA, Thian JY, Chou HS, Loong SSE, Ang WHD, Chew NWS, Lo KHK. Effects of Plant-Based Diets on Anthropometric and Cardiometabolic Markers in Adults: An Umbrella Review. Nutrients 2023; 15:nu15102331. [PMID: 37242214 DOI: 10.3390/nu15102331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
We conducted an umbrella review to consolidate the evidence of adopting plant-based diets on anthropometric and cardiometabolic outcomes. Six electronic databases (CINAHL, EMBASE, PubMed, Scopus, the Cochrane Library, and Web of Science) were searched for systematic reviews with meta-analysis (SRMAs) published from each journal's inception until 1 October 2022. Effect sizes from SRMAs and primary studies were pooled separately using random effects models. Overlapping primary studies were removed for primary studies' analyses. Seven SRMAs representing 51 primary studies were included, suggesting significant benefits of plant-based diets on weight (-2.09 kg, 95% CI: -3.56, -0.62 kg, p = 0.01, I2 = 95.6%), body mass index (-0.95 kg/m2, 95% CI: -1.26, -0.63 kg/m2, p = 0.002; I2 = 45.1%), waist circumference (-2.20 cm, 95% CI: -0.08, 0.00 cm, p = 0.04; I2 = 88.4%), fasting blood glucose (-0.11 mmol/L, 95% CI: -0.13, -0.09 mmol/L, p < 0.001, I2 = 18.2%), and low-density lipoprotein cholesterol (-0.31 mmol/L, 95% CI: -0.41, -0.20 mmol/L, p < 0.001, I2 = 65.6%). Changes in high-density lipoprotein cholesterol, triglycerides, and blood pressure were not statistically significant. Generally, plant-based diets were recommended to improve anthropometry, lipid profile, and glucose metabolism. However, findings should be interpreted with caution, because most of the reviews were rated to be of low credibility of evidence and were largely based on Western eating habits and traditions, which may limit the generalizability of findings.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Felicia Kai Xin Heng
- Department of Nursing, Ng Teng Fong General Hospital, Singapore 609606, Singapore
| | - Si Ai Tien
- Department of Nursing, Khoo Teck Puat Hospital, Singapore 768828, Singapore
| | - Jie Yun Thian
- Department of Nursing, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Hui Shan Chou
- Department of Nursing, Singapore General Hospital, Singapore 169608, Singapore
| | - Shaun Seh Ern Loong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore
| | - Ka-Hei Kenneth Lo
- Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hong Kong
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14
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Vajdi M, Karimi A, Tousi AZ, Hosseini B, Nikniaz Z, Farhangi MA. Association between plant-based diets and metabolic syndrome in obese adults from Iran: a cross-sectional study. BMC Endocr Disord 2023; 23:109. [PMID: 37193979 DOI: 10.1186/s12902-023-01358-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity. METHODS In Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed. RESULTS The average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m2. There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54-1.47), hPDI (OR: 0.82; 95% CI: 0.48-1.40), and uPDI (OR: 0.83; 95% CI: 0.87-2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13-5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04-6.04) and second (OR: 2.58; 95% CI: 1.05-6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass. CONCLUSION We found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings.
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Affiliation(s)
- Mahdi Vajdi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Karimi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayda Zahiri Tousi
- Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran
| | - Babak Hosseini
- Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran.
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15
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Aldubayan MA, Mao X, Laursen MF, Pigsborg K, Christensen LH, Roager HM, Nielsen DS, Hjorth MF, Magkos F. Supplementation with inulin-type fructans affects gut microbiota and attenuates some of the cardiometabolic benefits of a plant-based diet in individuals with overweight or obesity. Front Nutr 2023; 10:1108088. [PMID: 37181156 PMCID: PMC10167298 DOI: 10.3389/fnut.2023.1108088] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/30/2023] [Indexed: 05/16/2023] Open
Abstract
Background The gut microbiota has emerged as a potential therapeutic target to improve the management of obesity and its comorbidities. Objective We investigated the impact of a high fiber (∼38 g/d) plant-based diet, consumed ad libitum, with or without added inulin-type fructans (ITF), on the gut microbiota composition and cardiometabolic outcomes in subjects with obesity. We also tested if baseline Prevotella/Bacteroides (P/B) ratio predicts weight loss outcomes. Methods This is a secondary exploratory analysis from the PREVENTOMICS study, in which 100 subjects (82 completers) aged 18-65 years with body mass index 27-40 kg/m2 were randomized to 10 weeks of double-blinded treatment with a personalized or a generic plant-based diet. Changes from baseline to end-of-trial in gut microbiota composition (16S rRNA gene amplicon sequencing), body composition, cardiometabolic health and inflammatory markers were evaluated in the whole cohort (n = 82), and also compared in the subgroup of subjects who were supplemented with an additional 20 g/d ITF-prebiotics (n = 21) or their controls (n = 22). Results In response to the plant-based diet, all subjects lost weight (-3.2 [95% CI -3.9, -2.5] kg) and experienced significant improvements in body composition and cardiometabolic health indices. Addition of ITF to the plant-based diet reduced microbial diversity (Shannon index) and selectively increased Bifidobacterium and Faecalibacterium (q < 0.05). The change in the latter was significantly associated with higher values of insulin and HOMA-IR and lower HDL cholesterol. In addition, the LDL:HDL ratio and the concentrations of IL-10, MCP-1 and TNFα were significantly elevated in the ITF-subgroup. There was no relationship between baseline P/B ratio and changes in body weight (r = -0.07, p = 0.53). Conclusion A plant-based diet consumed ad libitum modestly decreases body weight and has multiple health benefits in individuals with obesity. Addition of ITF-prebiotics on top this naturally fiber-rich background selectively changes gut microbiota composition and attenuates some of the realized cardiometabolic benefits. Clinical trial registration [https://clinicaltrials.gov/ct2/show/NCT04590989], identifier [NCT04590989].
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Affiliation(s)
- Mona Adnan Aldubayan
- Department of Clinical Nutrition, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Xiaotian Mao
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Kristina Pigsborg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Lars H. Christensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Henrik M. Roager
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Dennis S. Nielsen
- Department of Food Science, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Mads Fiil Hjorth
- Obesity and Nutritional Sciences, Novo Nordisk Foundation, Tuborg Havnevej, Hellerup, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
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16
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The Effect of a Vegan Diet on the Cardiovascular System. J Cardiovasc Dev Dis 2023; 10:jcdd10030094. [PMID: 36975858 PMCID: PMC10052889 DOI: 10.3390/jcdd10030094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
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.
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17
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Tsampoula I, Kelesi M, Papathanasiou IV, Thanasa G, Goula A, Papageorgiou D, Kaba E. Introduction of Alternative Proteins for Health Professionals' Diet: The Transtheoretical Model and Motivational Interviewing of Nutritional Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3097. [PMID: 36833794 PMCID: PMC9966611 DOI: 10.3390/ijerph20043097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
The World Health Organization has documented the impact that a balanced diet has on disease prevention. Overconsumption of meat can lead to obesity, arteriosclerosis, thrombosis, type 2 diabetes and many life-threatening diseases. A new group of proteins has currently emerged in the scientific community of alternative nutrition called "alternative proteins". Several interventions have been introduced by a large number of healthcare providers in order to promote and enhance people's dietary habits. Two of the most prevalent models of health-related behaviour modification are the transtheoretical-stages of change-model (TM) and motivational interviewing (MI). The purpose of this study is to research and examine how the ΤΜ and MI could be effectively implemented in the diet of health professionals through alterations of eating habits. The population of the study is to comprise health professionals from «AΤΤΙΚOΝ» University General Hospital, Athens, Greece. The sample of participants is to be selected by the professional environment of the researcher. Participants, through random selection, are to be divided into two groups: the control group, consisting of 50 individuals, and the intervention group, consisting of 50 individuals. The duration of the study is to be from November 2022 to November 2024. The present study is concerned with productive mixed-quantitative and qualitative-evolutionary research along with the application testing of both the ΤΜ and the MI. It is to be conducted specifically on health professionals via self-administered questionnaires and semi-structured interviews.
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Affiliation(s)
| | - Martha Kelesi
- Nursing Department, University of West Attica, 11521 Athens, Greece
| | | | - Georgia Thanasa
- General Hospital of Athens “G. Gennimatas”, 11527 Athens, Greece
| | - Aspasia Goula
- Business Administration, University of West Attica, 11521 Athens, Greece
| | | | - Evridiki Kaba
- Nursing Department, University of West Attica, 11521 Athens, Greece
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18
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Kelly RK, Calhoun J, Hanus A, Payne-Foster P, Stout R, Sherman BW. Increased dietary fiber is associated with weight loss among Full Plate Living program participants. Front Nutr 2023; 10:1110748. [PMID: 37139446 PMCID: PMC10150096 DOI: 10.3389/fnut.2023.1110748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Prior studies have demonstrated that an intake of foods rich in dietary fiber is associated with a favorable impact on health status and body weight. However, the association between fiber intake and weight loss has not been well-studied in employer settings. This research aimed to assess the relationship between dietary fiber and weight loss among individuals participating in the Full Plate Living (FPL) program. Methods The 16-week plant-predominant fiber-rich eating program was delivered to 72 employers, primarily in the Southwest U.S., over 3 years (2017-2019). Participants received weekly video lessons, FPL materials, and additional online resources. A retrospective analysis of repeated measures was conducted using participant data obtained from 4,477 participants, of which 2,792 (62.5%) reduced body weight. Analysis of variance with post hoc analysis was used to assess the statistical significance of the changes between baseline and follow-up measures of dietary fiber intake in each of the food categories, specifically the relationship between changes in individual and combined (composite) daily servings of fruits, vegetables, whole grains, beans, and nuts on body weight measures among three groups at follow-up: those who lost, maintained, or gained weight. Multilevel modeling was used to test the hypothesis that increased intake of fiber was associated with greater weight loss. Results The mean weight loss for the weight loss group was 3.28 kg. As compared to the two other groups, the intake of whole fiber-rich foods at follow-up was significantly higher among the weight loss group with fruits (2.45 servings), vegetables (2.99 servings), beans (1.03 servings), and total fiber composites (9.07 servings; P < 0.001). A significant increase in servings of grains was also noted (P < 0.05). Multilevel modeling demonstrated that a higher total fiber composite (Model 1), as well as higher intakes of either vegetables or fruits (Model 2), resulted in greater weight loss. Discussion Our findings indicate that the FPL program can be a part of a lifestyle medicine approach to healthy eating and weight loss. Delivering the program in clinical, community, and workplace settings can increase its reach as an effective and low-cost offering.
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Affiliation(s)
| | - Janet Calhoun
- Ardmore Institute of Health (AIH), Ardmore, OK, United States
| | - Amy Hanus
- Ardmore Institute of Health (AIH), Ardmore, OK, United States
- *Correspondence: Amy Hanus
| | - Pamela Payne-Foster
- College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, United States
| | - Ron Stout
- Ardmore Institute of Health (AIH), Ardmore, OK, United States
| | - Bruce W. Sherman
- School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, United States
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19
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Elliott PS, Kharaty SS, Phillips CM. Plant-Based Diets and Lipid, Lipoprotein, and Inflammatory Biomarkers of Cardiovascular Disease: A Review of Observational and Interventional Studies. Nutrients 2022; 14:nu14245371. [PMID: 36558530 PMCID: PMC9787709 DOI: 10.3390/nu14245371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
Plant-based diets (PBDs) are becoming increasingly popular. Thus far, the literature has focused on their association with lipid profiles, with less investigation of lipoprotein and inflammatory profiles. Because pro-atherogenic lipid, lipoprotein, and inflammatory processes may facilitate the development of atherosclerosis, understanding the relation between PBDs and these processes is important to inform risk mitigation strategies. Therefore, the objective of this paper was to review the literature on PBDs and lipid, lipoprotein, and inflammatory biomarkers of cardiovascular disease (CVD). A structured literature search was performed, retrieving 752 records, of which 43 articles were included. Plant-based diets generally associated with favourable lipid and lipoprotein profiles, characterised by decreased total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B concentrations, and less low-grade inflammation, characterised by decreased C-reactive protein concentrations. Effect sizes from PBD interventions were greatest compared to habitual dietary patterns, and for non-low-fat vegan and tightly controlled dietary interventions. Associations between PBD indices and the reviewed biomarkers were less consistent. Findings are discussed with reference to the literature on PBDs and PBD indices and CVD risk, the associations between specific plant food groups and CVD outcomes and the reviewed biomarker outcomes, and the potential mechanisms underpinning associations between PBDs and reduced CVD risk.
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Affiliation(s)
- Patrick S. Elliott
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, 4 Dublin, Ireland
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, 4 Dublin, Ireland
| | - Soraeya S. Kharaty
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, 4 Dublin, Ireland
| | - Catherine M. Phillips
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, 4 Dublin, Ireland
- Correspondence:
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Jakše B, Godnov U, Pinter S. Nutritional Status of Slovene Adults in the Post-COVID-19 Epidemic Period. Eur J Investig Health Psychol Educ 2022; 12:1729-1742. [PMID: 36547023 PMCID: PMC9777729 DOI: 10.3390/ejihpe12120122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Monitoring nutritional status data in the adult population is extremely important to mediate their health status. Unfortunately, for Slovenia (2.1 million European Union citizens), data on the body composition status of the general adult population are currently rare or nonexistent in scientific journals. Furthermore, dietary intake was last assessed several years before the COVID-19 epidemic period. Methods: We randomly recruited 844 adult Slovenes from all regions of Slovenia. The primary aim of the cross-sectional study was to examine body composition status (using a medically approved electrical bioimpedance monitor) during the post-COVID-19 epidemic period. In addition, we assessed dietary intake (using a standardized food frequency questionnaire) and compared the obesity propensity for both sexes separately using the body mass index (BMI) and body fat percentage (FAT%) obesity classification of the World Health Organization. Results: Regarding BMI classification, 43% of the whole sample was overweight (28%) or obese (15%), and there were more older adults than adults (64% vs. 42%, p < 0.001). The average FAT% of adult females and males was 26.9% and 19.5% (p < 0.001), respectively, while for older adult females and males, it was 32.7% and 23% (p < 0.001). In addition, a comparison of the proportions of obese people between the two cut-off obesity classifications (BMI vs. FAT%) showed a significantly underestimated proportion of obese female participants based on BMI classification (13% vs. 17%, p = 0.005). In terms of the dietary intake of the assessed nutrients in comparison with the national dietary reference values for energy and nutrient intake, the participants, on average, had lower intake than the recommended values for carbohydrates, fiber, vitamins C, D and E (for males) and calcium, and higher intake than the recommended values for total fat, saturated fatty acids, cholesterol, sodium and chloride (for males). Conclusions: The results urgently call for the need to not only improve the overall national nutritional status but also for regular national monitoring of body composition and dietary intake statuses.
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Affiliation(s)
- Boštjan Jakše
- Independent Researcher, 1230 Domžale, Slovenia
- Correspondence:
| | - Uroš Godnov
- Department of Computer Science, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Stanislav Pinter
- Basics of Movements in Sport, Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia
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21
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Wirnitzer KC, Motevalli M, Tanous DR, Wirnitzer G, Wagner KH, Cocca A, Schätzer M, Kirschner W, Drenowatz C, Ruedl G. Study Protocol of "Sustainably Healthy-From Science 2 Highschool & University"-Prevalence of Mixed, Vegetarian, and Vegan Diets Linked to Sports & Exercise among Austrian Tertiary Students and Lecturers/Academic Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15313. [PMID: 36430039 PMCID: PMC9690980 DOI: 10.3390/ijerph192215313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Healthy lifestyle is the major indicator of individual and public health especially in target populations (e.g., during emerging adulthood). Evidence indicates that unhealthy lifestyle behaviors are strongly associated with the increasing prevalence of chronic diseases. The dual approach of sustainable health (i.e., physical exercise tied to a healthy diet) is an effective lifestyle strategy to control and manage health-related disorders, including overweight/obesity. Based on the evidence on plant-based diets regarding health and considering the growing prevalence of vegans and vegetarians worldwide, limited data exist on the health-related behaviors of those who follow plant-based vs. mixed diets in young adulthood. This multidisciplinary study is the first to examine the association between diet type (mixed, vegetarian, and vegan diets) and various health-related behaviors (primarily physical activity, sport, & exercise) among college/university students and lecturers/academic staff in Austria nationwide. Following a cross-sectional study design and using online questionnaires, 4510 tertiary students and 1043 lecturers/academic staff provided data on sociodemographic characteristics, dietary patterns, physical exercise habits, and other lifestyle behaviors (sleep, alcohol intake, smoking, etc.) along with information on health status and quality of life. While the data will be analyzed based on differentiated sociodemographic and health-related categories, the influence of the COVID-19 pandemic on lifestyle behaviors will also be evaluated. As a study protocol, this article represents comprehensive details of the design, purposes, and associated analytical measures of the present study within the tertiary educational context.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, 6020 Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition—SIPCAN, 5061 Elsbethen, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, 4020 Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
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22
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Wirnitzer KC, Tanous DR, Motevalli M, Göbel G, Wirnitzer G, Drenowatz C, Ruedl G, Cocca A, Kirschner W. Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools. Front Sports Act Living 2022; 4:967915. [PMID: 36249320 PMCID: PMC9554638 DOI: 10.3389/fspor.2022.967915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Georg Göbel
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
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23
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Khalid W, Arshad MS, Ranjha MMAN, Różańska MB, Irfan S, Shafique B, Rahim MA, Khalid MZ, Abdi G, Kowalczewski PŁ. Functional constituents of plant-based foods boost immunity against acute and chronic disorders. Open Life Sci 2022; 17:1075-1093. [PMID: 36133422 PMCID: PMC9462539 DOI: 10.1515/biol-2022-0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Waseem Khalid
- Department of Food Science, Government College University, Faisalabad, 38000, Pakistan
| | - Muhammad Sajid Arshad
- Department of Food Science, Government College University, Faisalabad, 38000, Pakistan
| | | | - Maria Barbara Różańska
- Department of Food Technology of Plant Origin, Poznań University of Life Sciences, 60-624 Poznań, Poland
| | - Shafeeqa Irfan
- Institute of Food Science and Nutrition, University of Sargodha, Sargodha, 40100, Pakistan
| | - Bakhtawar Shafique
- Institute of Food Science and Nutrition, University of Sargodha, Sargodha, 40100, Pakistan
| | - Muhammad Abdul Rahim
- Department of Food Science, Government College University, Faisalabad, 38000, Pakistan
| | | | - Gholamreza Abdi
- Department of Biotechnology, Persian Gulf Research Institute, Persian Gulf University, Bushehr, 75169, Iran
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24
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Termannsen AD, Clemmensen KKB, Thomsen JM, Nørgaard O, Díaz LJ, Torekov SS, Quist JS, Faerch K. Effects of vegan diets on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2022; 23:e13462. [PMID: 35672940 PMCID: PMC9540559 DOI: 10.1111/obr.13462] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/08/2022] [Accepted: 04/27/2022] [Indexed: 11/28/2022]
Abstract
In parallel with an increased focus on climate changes and carbon footprint, the interest in plant-based diets and its potential health effects have increased over the past decade. The objective of this systematic review and meta-analysis was to examine the effect of vegan diets (≥12 weeks) on cardiometabolic risk factors in people with overweight or type 2 diabetes. We identified 11 trials (796 participants). In comparison with control diets, vegan diets reduced body weight (-4.1 kg, 95% confidence interval (CI) -5.9 to -2.4, p < 0.001), body mass index (BMI) (-1.38 kg/m2 , 95% CI -1.96 to -0.80, p < 0.001), glycated hemoglobin (HbA1c ) (-0.18% points, 95% CI -0.29 to -0.07, p = 0.002), total cholesterol (-0.30 mmol/L, 95% CI -0.52 to -0.08, p = 0.007), and low-density lipoprotein cholesterol (-0.24 mmol/L, 95% CI -0.40 to -0.07, p = 0.005). We identified no effect on blood pressure, high-density lipoprotein cholesterol, and triglycerides. We found that adhering to vegan diets for at least 12 weeks may be effective in individuals with overweight or type 2 diabetes to induce a meaningful decrease in body weight and improve glycemia. Some of this effect may be contributed to differences in the macronutrient composition and energy intake in the vegan versus control diets. Therefore, more research is needed regarding vegan diets and cardiometabolic health.
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Affiliation(s)
- Anne-Ditte Termannsen
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen
| | | | - Jonas Mark Thomsen
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev
| | - Ole Nørgaard
- Department of Education, Danish Diabetes Knowledge Center, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Lars Jorge Díaz
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev
| | | | - Jonas Salling Quist
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev
| | - Kristine Faerch
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen
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25
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Hjelmesæth J, Sjöberg A. Human body weight, nutrients, and foods: a scoping review. Food Nutr Res 2022; 66:8814. [PMID: 36035748 PMCID: PMC9396931 DOI: 10.29219/fnr.v66.8814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jøran Hjelmesæth
- Morbid Obesity Centre, Department of Medicine, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Norway
- Jøran Hjelmesæth, Morbid Obesity Centre, Department of Medicine, Vestfold Hospital Trust, Boks 2168, NO-3103 Tønsberg, Norway.
| | - Agneta Sjöberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
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26
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Aldubayan MA, Pigsborg K, Gormsen SMO, Serra F, Palou M, Galmés S, Palou-March A, Favari C, Wetzels M, Calleja A, Rodríguez Gómez MA, Castellnou MG, Caimari A, Galofré M, Suñol D, Escoté X, Alcaide-Hidalgo JM, M Del Bas J, Gutierrez B, Krarup T, Hjorth MF, Magkos F. A double-blinded, randomized, parallel intervention to evaluate biomarker-based nutrition plans for weight loss: The PREVENTOMICS study. Clin Nutr 2022; 41:1834-1844. [PMID: 35839545 DOI: 10.1016/j.clnu.2022.06.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND & AIMS Growing evidence suggests that biomarker-guided dietary interventions can optimize response to treatment. In this study, we evaluated the efficacy of the PREVENTOMCIS platform-which uses metabolomic and genetic information to classify individuals into different 'metabolic clusters' and create personalized dietary plans-for improving health outcomes in subjects with overweight or obesity. METHODS A 10-week parallel, double-blinded, randomized intervention was conducted in 100 adults (82 completers) aged 18-65 years, with body mass index ≥27 but <40 kg/m2, who were allocated into either a personalized diet group (n = 49) or a control diet group (n = 51). About 60% of all food was provided free-of-charge. No specific instruction to restrict energy intake was given. The primary outcome was change in fat mass from baseline, evaluated by dual energy X-ray absorptiometry. Other endpoints included body weight, waist circumference, lipid profile, glucose homeostasis markers, inflammatory markers, blood pressure, physical activity, stress and eating behavior. RESULTS There were significant main effects of time (P < 0.01), but no group main effects, or time-by-group interactions, for the change in fat mass (personalized: -2.1 [95% CI -2.9, -1.4] kg; control: -2.0 [95% CI -2.7, -1.3] kg) and body weight (personalized: -3.1 [95% CI -4.1, -2.1] kg; control: -3.3 [95% CI -4.2, -2.4] kg). The difference between groups in fat mass change was -0.1 kg (95% CI -1.2, 0.9 kg, P = 0.77). Both diets resulted in significant improvements in insulin resistance and lipid profile, but there were no significant differences between groups. CONCLUSION Personalized dietary plans did not result in greater benefits over a generic, but generally healthy diet, in this 10-week clinical trial. Further studies are required to establish the soundness of different precision nutrition approaches, and translate this science into clinically relevant dietary advice to reduce the burden of obesity and its comorbidities. CLINICAL TRIAL REGISTRY ClinicalTrials.gov registry (NCT04590989).
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Affiliation(s)
- Mona A Aldubayan
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark; King Saud bin Abdulaziz University for Health Sciences, College of Applied Medical Sciences, Riyadh, Saudi Arabia
| | - Kristina Pigsborg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
| | | | - Francisca Serra
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Mariona Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Sebastià Galmés
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Andreu Palou-March
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands (UIB), Health Research Institute of the Balearic Islands (IdISBa), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Alimentómica S.L., Spin-off n.1 of the UIB Islands, Spain
| | - Claudia Favari
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Mart Wetzels
- ONMI: Behaviour Change Technology, Eindhoven, the Netherlands
| | - Alberto Calleja
- R&D Department, Food Division, Grupo Carinsa, Sant Quirze del Valles, Barcelona, Spain
| | - Miguel Angel Rodríguez Gómez
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (COS), Joint Unit Universitat Rovira I Virgili-EURECAT, 43204 Reus, Spain
| | - María Guirro Castellnou
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences (COS), Joint Unit Universitat Rovira I Virgili-EURECAT, 43204 Reus, Spain
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | - Mar Galofré
- Eurecat, Centre tecnològic de Catalunya, Digital Health Unit, Carrer de Bilbao, 72, 08005 Barcelona, Spain
| | - David Suñol
- Eurecat, Centre tecnològic de Catalunya, Digital Health Unit, Carrer de Bilbao, 72, 08005 Barcelona, Spain
| | - Xavier Escoté
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | | | - Josep M Del Bas
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | - Biotza Gutierrez
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, Nutrition and Health Unit, Reus, Spain
| | - Thure Krarup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark; Department of Endocrinology, Bispebjerg and Frederiksberg Hospital, Tuborgvej, Hellerup, Denmark
| | - Mads F Hjorth
- Healthy Weight Centre, Novo Nordisk Foundation, Tuborg Havnevej 19, 2900, Hellerup, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark.
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27
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Kumar A, Chidambaram V, Mehta JL. Vegetarianism, Microbiota and Cardiovascular health: Looking back, and forward. Eur J Prev Cardiol 2022; 29:1895-1910. [PMID: 35727958 DOI: 10.1093/eurjpc/zwac128] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022]
Abstract
Cardiovascular diseases (CVD) are the leading cause of death globally, with over 17.9 million attributed deaths in 2019. Unhealthy diet is an often-overlooked major modifiable risk factor for CVD. Global Burden of Disease (GBD) estimates suggest that unhealthy diets account for nearly 26% of all deaths, of which 84% were attributed to CVD. Plant-based diets (PBDs), which are a diverse group of dietary patterns focused on plant produce, with flexibility for varying levels of vegetarianism, have been suggested to decrease the incidence of various cardiovascular and cardiometabolic diseases. In this review, we aim to delve into the spectrum of PBDs, revisit objective definitions and classifications, and compare them with standard non-vegetarian diets. We examine plausible mechanisms underlying the cardiovascular benefits of PBDs with a particular focus on the dietary manipulation of gut microbiota-host interaction and its effect on energy metabolism, and local and systemic inflammation. In addition, we explore the evidence on the impact of PBDs on cardiovascular disease, examine the challenges and limitations associated with dietary intervention studies, and devise strategies to draw valid conclusions. Dietary interventions, such as PBDs are one of the most powerful, attainable, cost-effective tools for health and environmental protection at the population level. We conclude with a clear appreciation for PBDs in environmental sustainability, climate change, and animal welfare.
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Affiliation(s)
- Amudha Kumar
- Department of Internal Medicine, University of Arkansas for Medical Sciences, AR, USA
| | - Vignesh Chidambaram
- Department of Internal Medicine, University of Arkansas for Medical Sciences, AR, USA
| | - Jawahar L Mehta
- Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, AR, USA.,Division of Cardiovascular Medicine, Central Arkansas Veterans Affairs Health Care System, Little Rock, AR
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28
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Nakazeko T, Shobako N, Hirano Y, Nakamura F, Honda K. Novel dietary intervention program “COMB meal program” approaching health and presenteeism: Two pilot studies. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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29
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Sumali B, Yoshimoto J, Kobayashi H, Yamada M, Maeda T, Mitsukura Y. A Study on Legume-Based Noodles as Staple Food for Office Workers. Front Nutr 2022; 9:807350. [PMID: 35360683 PMCID: PMC8963342 DOI: 10.3389/fnut.2022.807350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
This study aims to verify the effects of “legume-based noodles” as a staple food for lunch, specifically: blood glucose, cognitive function tests, Kansei value, work questionnaires, typing, and body weight. The experiment is divided into two groups: the intervention group (legumes-based noodle) and the control group (regular lunch). Both groups have similar menu except the staple food. The intervention group resulted in a statistically significant lower blood glucose area under the curve (AUC) and lower maximum blood glucose levels during the afternoon work hours on weekdays. In addition, the Kansei value “concentration” decreased at the end of the workday in the control group compared to before and after lunch but did not decrease in the intervention group. Furthermore, the number of typing accuracy was higher in the intervention group than in the control group, and the questionnaire responses for “work efficiency” and “motivation” were more positive. These results suggest that eating legume-based noodles may lead to improved performance of office workers.
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Affiliation(s)
- Brian Sumali
- Faculty of Science and Technology, Keio University, Yokohama, Japan
| | - Joto Yoshimoto
- Central Research Institute, Mizkan Holdings Co., Ltd., Handa, Japan
| | - Hiroto Kobayashi
- Central Research Institute, Mizkan Holdings Co., Ltd., Handa, Japan
| | - Mei Yamada
- Central Research Institute, Mizkan Holdings Co., Ltd., Handa, Japan
| | - Tetsuya Maeda
- New Business Development, Mizkan Holdings Co., Ltd., Tokyo, Japan
| | - Yasue Mitsukura
- Faculty of Science and Technology, Keio University, Yokohama, Japan
- *Correspondence: Yasue Mitsukura
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30
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Plant-based diets: a review of the definitions and nutritional role in the adult diet. Proc Nutr Soc 2022; 81:62-74. [DOI: 10.1017/s0029665121003839] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Plant-based (PB) diets are associated with good health and are also recommended for environmental sustainability. The present review aimed to summarise the definitions of PB diets globally and to investigate the nutritional role of PB diets in adults. This review found that there is a wide range of PB definitions ranging from the traditional vegetarian diets (including vegan) to semi-vegetarian/flexitarian diets. Furthermore, other diets which were originally developed due to their associations with positive health outcomes, such as the portfolio, Mediterranean-style, DASH, healthy US-style, planetary health and Nordic-style diets, have been encompassed in PB definitions due to their emphasis on certain PB components. This review has highlighted that those consuming a PB diet are more likely to meet recommended intakes for carbohydrate, dietary fibre and vitamin E and are less likely to meet recommendations for protein, vitamin B12 and iodine compared to omnivores. Regardless of consumer type, neither PB consumers nor omnivores met recommendations for intakes of vitamin D, calcium and sodium. While intakes of protein, n-3, iron and zinc were generally sufficient from the PB diet, it is important to acknowledge the lower bioavailability of these nutrients from PB foods compared to animal-derived products. As dietary patterns shift towards a more PB diet, there is a need for further studies to investigate the role of PB diets for nutritional adequacy and status in populations currently accustomed to consuming a primarily omnivorous diet.
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OUP accepted manuscript. Health Promot Int 2022:6570173. [DOI: 10.1093/heapro/daac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jakše B. Placing a Well-Designed Vegan Diet for Slovenes. Nutrients 2021; 13:4545. [PMID: 34960098 PMCID: PMC8706043 DOI: 10.3390/nu13124545] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 02/06/2023] Open
Abstract
Interest in vegan diets has increased globally as well as in Slovenia. The quantity of new scientific data requires a thorough synthesis of new findings and considerations about the current reserved position of the vegan diet in Slovenia. There is frequently confusion about the benefits of vegetarian diets that are often uncritically passed on to vegan diets and vice versa. This narrative review aims to serve as a framework for a well-designed vegan diet. We present advice on how to maximize the benefits and minimize the risks associated with the vegan diet and lifestyle. We highlight the proper terminology, present the health effects of a vegan diet and emphasize the nutrients of concern. In addition, we provide guidance for implementing a well-designed vegan diet in daily life. We conducted a PubMed search, up to November 2021, for studies on key nutrients (proteins, vitamin B12, vitamin D, omega-3 long chain polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), calcium, iron, zinc, iodine and selenium) in vegan diets. Given the limited amount of scientific evidence, we focus primarily on the general adult population. A well-designed vegan diet that includes a wide variety of plant foods and supplementation of vitamin B12, vitamin D in the winter months and potentially EPA/DHA is safe and nutritionally adequate. It has the potential to maintain and/or to improve health. For physically active adult populations, athletes or individuals with fast-paced lifestyles, there is room for further appropriate supplementation of a conventional vegan diet according to individuals' health status, needs and goals without compromising their health. A healthy vegan lifestyle, as included in government guidelines for a healthy lifestyle, includes regular physical activity, avoidance of smoking, restriction of alcohol and appropriate sleep hygiene.
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Affiliation(s)
- Boštjan Jakše
- Department of Food Science, Biotechnical Faculty, University of Ljubljana, SI-1000 Ljubljana, Slovenia
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Plant-Based Diet as a Strategy for Weight Control. Foods 2021; 10:foods10123052. [PMID: 34945602 PMCID: PMC8701327 DOI: 10.3390/foods10123052] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
According to the World Health Organization, obesity has nearly tripled since the 1970s. Obesity and overweight are major risk factors for cardiovascular diseases, diabetes, inflammatory-mediated diseases, and other serious medical conditions. Moreover, recent data suggest that obesity, overweight, diabetes, and cardiovascular diseases are risk factors for COVID-19-related mortality. Different strategies for weight control have been introduced over the last two decades. Unfortunately, these strategies have shown little effect. At the same time, many studies show that plants might be the key to a successful strategy for weight control. Following the PRISMA guidelines for conducting systematic reviews, a search was conducted in PubMed, Web of Science, Scopus, and Embase using the following keywords: obesity, globesity, vegan, plant-based diet, etc. Our results show that vegan diets are associated with improved gut microbiota symbiosis, increased insulin sensitivity, activation of peroxisome proliferator-activated receptors, and over-expression of mitochondrial uncoupling proteins. The key features of this diet are reduced calorie density and reduced cholesterol intake. The combination of these two factors is the essence of the efficiency of this approach to weight control. Our data suggest that plant-based/vegan diets might play a significant role in future strategies for reducing body weight.
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Craig WJ, Mangels AR, Fresán U, Marsh K, Miles FL, Saunders AV, Haddad EH, Heskey CE, Johnston P, Larson-Meyer E, Orlich M. The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients 2021; 13:4144. [PMID: 34836399 PMCID: PMC8623061 DOI: 10.3390/nu13114144] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 12/13/2022] Open
Abstract
Plant-based diets, defined here as including both vegan and lacto-ovo-vegetarian diets, are growing in popularity throughout the Western world for various reasons, including concerns for human health and the health of the planet. Plant-based diets are more environmentally sustainable than meat-based diets and have a reduced environmental impact, including producing lower levels of greenhouse gas emissions. Dietary guidelines are normally formulated to enhance the health of society, reduce the risk of chronic diseases, and prevent nutritional deficiencies. We reviewed the scientific data on plant-based diets to summarize their preventative and therapeutic role in cardiovascular disease, cancer, diabetes, obesity, and osteoporosis. Consuming plant-based diets is safe and effective for all stages of the life cycle, from pregnancy and lactation, to childhood, to old age. Plant-based diets, which are high in fiber and polyphenolics, are also associated with a diverse gut microbiota, producing metabolites that have anti-inflammatory functions that may help manage disease processes. Concerns about the adequate intake of a number of nutrients, including vitamin B12, calcium, vitamin D, iron, zinc, and omega-3 fats, are discussed. The use of fortified foods and/or supplements as well as appropriate food choices are outlined for each nutrient. Finally, guidelines are suggested for health professionals working with clients consuming plant-based diets.
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Affiliation(s)
- Winston J. Craig
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | | | - Ujué Fresán
- eHealth Group, Instituto de Salud Global Barcelona (ISGlobal), 08036 Barcelona, Spain;
| | - Kate Marsh
- Private Practice, Chatswood, NSW 2067, Australia;
| | - Fayth L. Miles
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Angela V. Saunders
- Nutrition Insights, Sanitarium Health Food Company, Berkeley Vale, NSW 2261, Australia;
| | - Ella H. Haddad
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Celine E. Heskey
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Patricia Johnston
- Center for Nutrition, Healthy Lifestyles, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92354, USA; (F.L.M.); (E.H.H.); (C.E.H.); (P.J.)
| | - Enette Larson-Meyer
- Human Nutrition, Foods, and Exercise Virginia Tech, Blacksburg, VA 24061, USA;
| | - Michael Orlich
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA;
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Melián-Fleitas L, Franco-Pérez Á, Caballero P, Sanz-Lorente M, Wanden-Berghe C, Sanz-Valero J. Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression. Nutrients 2021; 13:3945. [PMID: 34836200 PMCID: PMC8622081 DOI: 10.3390/nu13113945] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health. METHOD This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021. RESULTS A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise. CONCLUSIONS Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).
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Affiliation(s)
- Liliana Melián-Fleitas
- Nutrition Department, University of Granada, 18012 Granada, Spain;
- Geriatric Service, Insular Hospital, Health Services Management of the Health Area of Lanzarote, 35500 Arrecife, Spain
| | - Álvaro Franco-Pérez
- Playa Blanca Health Center, Health Services Management of the Health Area of Lanzarote, 35580 Playa Blanca, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- Center of Public Health, Consellería of Universal Health and Public Health, 46940 Manises, Spain
| | - Carmina Wanden-Berghe
- Health and Biomedical Research Institute of Alicante, University General Hospital, 03010 Alicante, Spain;
| | - Javier Sanz-Valero
- Department of Public Health & History of Science, University Miguel Hernandez, 03550 Alicante, Spain;
- National School of Occupational Medicine, Carlos III Health Institute, 28029 Madrid, Spain
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Storz MA. What makes a plant-based diet? a review of current concepts and proposal for a standardized plant-based dietary intervention checklist. Eur J Clin Nutr 2021; 76:789-800. [PMID: 34675405 PMCID: PMC9187516 DOI: 10.1038/s41430-021-01023-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/23/2021] [Accepted: 09/30/2021] [Indexed: 12/29/2022]
Abstract
Within the last decades, plant-based diets have received increasing interest for their potential benefits to human and environmental health. The concept of plant-based diet, however, varies widely in its definition. Current definitions range from the exclusion of all animal products to diets that include meat, fish, and dairy in varying quantities. Therefore, the main objectives of this review were twofold: (a) to investigate how researchers use the term plant-based diet in nutrition intervention studies and (b) what types of food a plant-based diet may include. Searching two databases, we found that the term “plant-based diet” evokes varying ideas to researchers and clinicians. Fifty percent of the retrieved studies that included a plant-based dietary intervention completely proscribed animal products and used the term plant-based diet interchangeably with a vegan diet. In contrast, an ~33% of trials included dairy products and 20% of dietary interventions emphasized a semi-vegetarian dietary pattern. Based on specific examples, we point out how the usage of the umbrella term “plant-based diet” may cause significant ambiguity. We often encountered incomplete descriptions of plant-based dietary interventions, which makes comparison and reproducibility of studies difficult. As a consequence, we urge others to use the term “plant-based diet” only in conjunction with a detailed dietary description. To facilitate this process, we provide a template of a standardized plant-based intervention reporting checklist. Finally, the present review also highlights the urgent need for a consensus definition of the term plant-based diet and its content.
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Affiliation(s)
- Maximilian Andreas Storz
- Center for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Remde A, DeTurk SN, Almardini A, Steiner L, Wojda T. Plant-predominant eating patterns - how effective are they for treating obesity and related cardiometabolic health outcomes? - a systematic review. Nutr Rev 2021; 80:1094-1104. [PMID: 34498070 DOI: 10.1093/nutrit/nuab060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
CONTEXT The obesity epidemic is a main driver of the chronic disease epidemic; however, present treatment approaches have suboptimal efficacy. OBJECTIVES To assess the efficacy of plant-predominant (vegan, vegetarian, plant-based whole foods [PBWFs]) diets in treating obesity and its main cardiometabolic sequelae: hyperlipidemia (HLD); indices of insulin resistance, glycemic control, and diabetes mellitus type 2 (DM2); and cardiovascular disease (CVD), including hypertension (HTN). DATA SOURCES A systematic search of multiple databases was conducted for articles published between November 2019 and February 2020; databases searched included: PubMed, Medline (Ovid), Cochrane, CENTRAL, and CINAHL. DATA EXTRACTION AND ANALYSIS All interventional trials (randomized controlled trials [RCTs] and trials of non-randomized experimental design) that met the inclusion criteria (English language, duration of at least 4 weeks, primary end point congruent with above objectives, no major flaws in research design that would prevent interpretation) were included in the review. A total of 3135 articles were scanned and 84 were selected. The articles were collated and summarized in 2 evidence tables. Risk of bias for RCTs was assessed using the Cochrane Risk-of-Bias tool 2 as a guide. For non-randomized trials, higher risk of bias was assumed, and the JBI Critical Appraisal tool was used as a guide to determine inclusion. RESULTS Plant-based diets, in general, demonstrated improved weight control and cardiometabolic outcomes related to lipids, cardiovascular end points, blood pressure, insulin sensitivity, A1C, and fasting glucose, and a lower risk of diabetes compared with usual diets and in some cases standard health-oriented diets such as the American Heart Association (AHA), American Diabetic Association (ADA), and Mediterranean diets. Preliminary studies suggest plant-predominant diets practiced as part of healthy lifestyle interventions may stabilize or even reverse DM 2 and CVD. The acceptability and sustainability of plant-predominant diets where measured were generally similar to other health-oriented diets. CONCLUSION Plant-predominant diets can play a major role in reversing the obesity and chronic disease epidemics. In the setting of sustained lifestyle intervention programs, they may arrest or even reverse DM2 and CVD. Further higher-level RCTs are needed to confirm and expand on these findings.
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Affiliation(s)
- Alan Remde
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - Stephen N DeTurk
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - A Almardini
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - Lauren Steiner
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
| | - Thomas Wojda
- A. Remde is with Research and Curriculum, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. S.N. DeTurk is with PGY2 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA. A. Almardini is with PGY1 Family Medicine, SLUHN Family Medicine Residency-Miners Campus, Tamaqua, Pennsylvania, USA. L. Steiner is with Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA. T. Wojda is with PGY3 Family Medicine, SLUHN Family Medicine Residency-Warren, Phillipsburg, New Jersey, USA
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Shobako N. Hypotensive peptides derived from plant proteins. Peptides 2021; 142:170573. [PMID: 34023396 DOI: 10.1016/j.peptides.2021.170573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/29/2021] [Accepted: 05/13/2021] [Indexed: 11/19/2022]
Abstract
Hypertension is a risk factor for arteriosclerosis development and is recognized as a silent killer. Certain processed food materials, digested by protease or through the use of fermentation, have shown exertion of hypotensive effects in human clinical or animal studies, and hypotensive peptides were isolated from them. This review discusses the hypotensive peptides derived from plant proteins, such as grain, soy, vegetables, and seaweeds, and their hypotensive mechanisms. Although angiotensin I-converting enzyme (ACE) inhibition is often noted as one of the mechanisms that may exert antihypertensive effects, ACE inhibitory activity measured by in vitro studies is not associated with the actual hypotensive effect. Thus, this review only highlights the peptide hypotensive effect determined by in vivo studies. This review also discusses the tendency of the amino acid sequence of ACE-inhibitory hypotensive peptides and the possible additional effects of hypotensive peptides independent of ACE inhibition.
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Affiliation(s)
- Naohisa Shobako
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Uji, Kyoto, 611-0011, Japan.
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Pollakova D, Andreadi A, Pacifici F, Della-Morte D, Lauro D, Tubili C. The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review. Nutrients 2021; 13:nu13062123. [PMID: 34205679 PMCID: PMC8235036 DOI: 10.3390/nu13062123] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 12/19/2022] Open
Abstract
A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.
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Affiliation(s)
- Daniela Pollakova
- Diabetes Unit, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy;
- Correspondence:
| | - Aikaterini Andreadi
- Department of Systems Medicine, School of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.P.); (D.D.-M.); (D.L.)
| | - Francesca Pacifici
- Department of Systems Medicine, School of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.P.); (D.D.-M.); (D.L.)
| | - David Della-Morte
- Department of Systems Medicine, School of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.P.); (D.D.-M.); (D.L.)
| | - Davide Lauro
- Department of Systems Medicine, School of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.P.); (D.D.-M.); (D.L.)
- Unit of Endocrinology and Diabetes, University Hospital, Fondazione Policlinico Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Claudio Tubili
- Diabetes Unit, San Camillo Forlanini Hospital, Circonvallazione Gianicolense 87, 00152 Rome, Italy;
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Thorndike AN, McCurley JL, Gelsomin ED, Anderson E, Chang Y, Porneala B, Johnson C, Rimm EB, Levy DE. Automated Behavioral Workplace Intervention to Prevent Weight Gain and Improve Diet: The ChooseWell 365 Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2112528. [PMID: 34097048 PMCID: PMC8185595 DOI: 10.1001/jamanetworkopen.2021.12528] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPORTANCE Personalized interventions that leverage workplace data and environments could improve effectiveness, sustainability, and scalability of employee wellness programs. OBJECTIVE To test an automated behavioral intervention to prevent weight gain and improve diet using employee cafeteria purchasing data. DESIGN, SETTING, AND PARTICIPANTS This individual-level randomized clinical trial of a 12-month intervention with 12 months of follow-up was conducted among employees of a hospital in Boston, Massachusetts, who purchased food at on-site cafeterias that used traffic-light labels (ie, green indicates healthy; yellow, less healthy; red, unhealthy). Participants were enrolled September 2016 to February 2018. Data were analyzed from May to September 2020. INTERVENTIONS For 12 months, participants in the intervention group received 2 emails per week with feedback on previous cafeteria purchases and personalized health and lifestyle tips and 1 letter per month with peer comparisons and financial incentives for healthier purchases. Emails and letters were automatically generated using survey, health, and cafeteria data. Control group participants received 1 letter per month with general healthy lifestyle information. MAIN OUTCOMES AND MEASURES The main outcome was change in weight from baseline to 12 months and 24 months of follow-up. Secondary outcomes included changes in cafeteria purchases, including proportion of green- and red-labeled purchases and calories purchased per day, from baseline (12 months preintervention) to the intervention (months 1-12) and follow-up (months 13-24) periods. Baseline Healthy Eating Index-15 (HEI-15) scores were compared to HEI-15 scores at 6, 12, and 24 months. RESULTS Among 602 employees enrolled (mean [SD] age, 43.6 [12.2] years; 478 [79.4%] women), 299 were randomized to the intervention group and 303 were randomized to the control group. Baseline mean (SD) body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) was 28.3 (6.6) and HEI-15 score was 60.4 (12.4). There were no between-group differences in weight change at 12 (0.2 [95% CI, -0.6 to 1.0] kg) or 24 (0.6 [95% CI, -0.3 to 1.4] kg) months. Compared with baseline, the intervention group increased green-labeled purchases by 7.3% (95% CI, 5.4% to 9.3%) and decreased red-labeled purchases by 3.9% (95% CI, -5.0% to -2.7%) and calories purchased per day by 49.5 (95% CI, -75.2 to -23.9) kcal more than the control group during the intervention period. In the intervention group, differences in changes in green (4.8% [95% CI, 2.9% to 6.8%]) and red purchases (-3.1% [95% CI, -4.3% to -2.0%]) were sustained at the 24-month follow-up. Differences in changes in HEI-15 scores were not significantly different in the intervention compared with the control group at 6 (2.2 [95% CI, 0 to 4.4]), 12 (1.8 [95% CI, -0.6 to 4.1]), and 24 (1.6, 95% CI, -0.7 to 3.8]) months. CONCLUSIONS AND RELEVANCE The findings of this randomized clinical trial suggest that an automated behavioral intervention using workplace cafeteria data improved employees' food choices but did not prevent weight gain over 2 years. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02660086.
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Affiliation(s)
- Anne N. Thorndike
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Jessica L. McCurley
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
| | - Emily D. Gelsomin
- Department of Nutrition and Food Services, Massachusetts General Hospital, Boston
| | - Emma Anderson
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
| | - Yuchiao Chang
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
| | - Bianca Porneala
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
| | | | - Eric B. Rimm
- Departments of Epidemiology and Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Douglas E. Levy
- Harvard Medical School, Boston, Massachusetts
- Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston
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Stolt E, Olsen T, Elshorbagy A, Kožich V, van Greevenbroek M, Øvrebø B, Thoresen M, Refsum H, Retterstøl K, Vinknes KJ. Sulfur amino acid restriction, energy metabolism and obesity: a study protocol of an 8-week randomized controlled dietary intervention with whole foods and amino acid supplements. J Transl Med 2021; 19:153. [PMID: 33858441 PMCID: PMC8051033 DOI: 10.1186/s12967-021-02824-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/09/2021] [Indexed: 01/21/2023] Open
Abstract
Background Dietary sulfur amino acid (SAA) restriction is an established animal model for increasing lifespan and improving metabolic health. Data from human studies are limited. In the study outlined in this protocol, we will evaluate if dietary SAA restriction can reduce body weight and improve resting energy expenditure (REE) and parameters related to metabolic health. Method/design Men and women (calculated sample size = 60), aged 18–45 years, with body mass index of 27–35 kg/m2 will be included in a double-blind 8-week dietary intervention study. The participants will be randomized in a 1:1 manner to a diet with either low or high SAA. Both groups will receive an equal base diet consisting of low-SAA plant-based whole foods and an amino acid supplement free of SAA. Contrasting SAA contents will be achieved using capsules with or without methionine and cysteine (SAAhigh, total diet SAA ~ 50–60 mg/kg body weight/day; SAAlow, total diet SAA ~ 15–25 mg/kg body weight/day). The primary outcome is body weight change. Data and material collection will also include body composition (dual X-ray absorptiometry), resting energy expenditure (whole-room indirect calorimetry) and samples of blood, urine, feces and adipose tissue at baseline, at 4 weeks and at study completion. Measures will be taken to promote and monitor diet adherence. Data will be analyzed using linear mixed model regression to account for the repeated measures design and within-subject correlation. Discussion The strength of this study is the randomized double-blind design. A limitation is the restrictive nature of the diet which may lead to poor compliance. If this study reveals a beneficial effect of the SAAlow diet on body composition and metabolic health, it opens up for new strategies for prevention and treatment of overweight, obesity and its associated disorders. Trial registration ClinicalTrials.gov: NCT04701346, Registration date: January 8th, 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02824-3.
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Affiliation(s)
- Emma Stolt
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannveien 9, 0372, Oslo, Norway
| | - Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannveien 9, 0372, Oslo, Norway.
| | - Amany Elshorbagy
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannveien 9, 0372, Oslo, Norway.,Department of Pharmacology, University of Oxford, Oxford, UK.,Department of Physiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Viktor Kožich
- Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Marleen van Greevenbroek
- Department of Internal Medicine and CARIM School of Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Bente Øvrebø
- Department of Sports Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Magne Thoresen
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannveien 9, 0372, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannveien 9, 0372, Oslo, Norway.,The Lipid Clinic, Oslo University Hospital, Oslo, Norway
| | - Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Sognsvannveien 9, 0372, Oslo, Norway
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Rees K, Al-Khudairy L, Takeda A, Stranges S. Vegan dietary pattern for the primary and secondary prevention of cardiovascular diseases. Cochrane Database Syst Rev 2021; 2:CD013501. [PMID: 33629376 PMCID: PMC8092640 DOI: 10.1002/14651858.cd013501.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets have gained popularity and there is a need to synthesise existing clinical trial evidence for their potential in CVD prevention. OBJECTIVES To determine the effectiveness of following a vegan dietary pattern for the primary and secondary prevention of CVD. SEARCH METHODS We searched the following electronic databases on 4 February 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Web of Science Core Collection. We also searched ClinicalTrials.gov in January 2021. We applied no language restrictions. SELECTION CRITERIA We selected randomised controlled trials (RCTs) in healthy adults and adults at high risk of CVD (primary prevention) and those with established CVD (secondary prevention). A vegan dietary pattern excludes meat, fish, eggs, dairy and honey; the intervention could be dietary advice, provision of relevant foods, or both. The comparison group received either no intervention, minimal intervention, or another dietary intervention. Outcomes included clinical events and CVD risk factors. We included only studies with follow-up periods of 12 weeks or more, defined as the intervention period plus post-intervention follow-up. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion, extracted data and assessed risks of bias. We used GRADE to assess the certainty of the evidence. We conducted three main comparisons: 1. Vegan dietary intervention versus no intervention or minimal intervention for primary prevention; 2. Vegan dietary intervention versus another dietary intervention for primary prevention; 3. Vegan dietary intervention versus another dietary intervention for secondary prevention. MAIN RESULTS Thirteen RCTs (38 papers, 7 trial registrations) and eight ongoing trials met our inclusion criteria. Most trials contributed to primary prevention: comparisons 1 (four trials, 466 participants randomised) and comparison 2 (eight trials, 409 participants randomised). We included only one secondary prevention trial for comparison 3 (63 participants randomised). None of the trials reported on clinical endpoints. Other primary outcomes included lipid levels and blood pressure. For comparison 1 there was moderate-certainty evidence from four trials with 449 participants that a vegan diet probably led to a small reduction in total cholesterol (mean difference (MD) -0.24 mmol/L, 95% confidence interval (CI) -0.36 to -0.12) and low-density lipoprotein (LDL) cholesterol (MD -0.22 mmol/L, 95% CI -0.32 to -0.11), a very small decrease in high-density lipoprotein (HDL) levels (MD -0.08 mmol/L, 95% CI -0.11 to -0.04) and a very small increase in triglyceride levels (MD 0.11 mmol/L, 95% CI 0.01 to 0.21). The very small changes in HDL and triglyceride levels are in the opposite direction to that expected. There was a lack of evidence for an effect with the vegan dietary intervention on systolic blood pressure (MD 0.94 mmHg, 95% CI -1.18 to 3.06; 3 trials, 374 participants) and diastolic blood pressure (MD -0.27 mmHg, 95% CI -1.67 to 1.12; 3 trials, 372 participants) (low-certainty evidence). For comparison 2 there was a lack of evidence for an effect of the vegan dietary intervention on total cholesterol levels (MD -0.04 mmol/L, 95% CI -0.28 to 0.20; 4 trials, 163 participants; low-certainty evidence). There was probably little or no effect of the vegan dietary intervention on LDL (MD -0.05 mmol/L, 95% CI -0.21 to 0.11; 4 trials, 244 participants) or HDL cholesterol levels (MD -0.01 mmol/L, 95% CI -0.08 to 0.05; 5 trials, 256 participants) or triglycerides (MD 0.21 mmol/L, 95% CI -0.07 to 0.49; 5 trials, 256 participants) compared to other dietary interventions (moderate-certainty evidence). We are very uncertain about any effect of the vegan dietary intervention on systolic blood pressure (MD 0.02 mmHg, 95% CI -3.59 to 3.62) or diastolic blood pressure (MD 0.63 mmHg, 95% CI -1.54 to 2.80; 5 trials, 247 participants (very low-certainty evidence)). Only one trial (63 participants) contributed to comparison 3, where there was a lack of evidence for an effect of the vegan dietary intervention on lipid levels or blood pressure compared to other dietary interventions (low- or very low-certainty evidence). Four trials reported on adverse events, which were absent or minor. AUTHORS' CONCLUSIONS Studies were generally small with few participants contributing to each comparison group. None of the included studies report on CVD clinical events. There is currently insufficient information to draw conclusions about the effects of vegan dietary interventions on CVD risk factors. The eight ongoing studies identified will add to the evidence base, with all eight reporting on primary prevention. There is a paucity of evidence for secondary prevention.
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Affiliation(s)
- Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Lena Al-Khudairy
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrea Takeda
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
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Naicker A, Shrestha A, Joshi C, Willett W, Spiegelman D. Workplace cafeteria and other multicomponent interventions to promote healthy eating among adults: A systematic review. Prev Med Rep 2021; 22:101333. [PMID: 33732606 PMCID: PMC7937753 DOI: 10.1016/j.pmedr.2021.101333] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 12/18/2022] Open
Abstract
The objective of this review is to evaluate evidence for the effectiveness of workplace cafeteria and other supporting multicomponent interventions to promote healthy eating and reductions in health risks among adults. We conducted an electronic search in EMBASE, CINAHL, EconLit, Ovid, Cochrane, Web of Science and PubMed for English-language articles published from 1985 to July 2019. Studies were original articles reporting the results of workplace cafeteria interventions to promote healthy eating and reduction in health risks. Outcomes were classified as changes in fruit and vegetable intake, health risk indicators, dietary intake, and food sales. Interventions were categorized as interventions targeting food quality or quantity, targeting price, targeting food choice at point of purchase, targeting improved supply, targeting client's information, education or motivation and targeting organization policies. Behavioral change conditions used in interventions were identified using the COM-B system of behavioral change. Results were presented in a narrative summary. A total of 55 studies out of 6285 articles were identified for this review. Several studies used multicomponent interventions and the most featured interventions included interventions targeting food quality or quantity, targeting client's information, education or motivation and targeting food choice at point of purchase. There is evidence that workplace cafeteria and other supporting multicomponent interventions resulted in higher intake of fruit and vegetables, improved dietary intake, improved health outcomes and healthy food sales. The findings of this review have the potential to inform future cafeteria-based and other supporting multicomponent workplace health interventions. The review protocol was not registered in a repository.
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Affiliation(s)
- Ashika Naicker
- Department of Food and Nutrition, Durban University of Technology, Durban, South Africa.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Archana Shrestha
- Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health, New Haven, USA
| | | | - Walter Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Donna Spiegelman
- Center for Methods on Implementation and Prevention Science (CMIPS) Yale School of Public Health, New Haven, USA
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Gibbs J, Gaskin E, Ji C, Miller MA, Cappuccio FP. The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials. J Hypertens 2021; 39:23-37. [PMID: 33275398 DOI: 10.1097/hjh.0000000000002604] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The consumption of strict vegetarian diets with no animal products is associated with low blood pressure (BP). It is not clear whether less strict plant-based diets (PBDs) containing some animal products exert a similar effect. The main objective of this meta-analysis was to assess whether PBDs reduce BP in controlled clinical trials. METHODS We searched Cumulative Index to Nursing and Allied Health Literature, Medline, Embase, and Web of Science to identify controlled clinical trials investigating the effect of PBDs on BP. Standardized mean differences in BP and 95% confidence intervals were pooled using a random effects model. Risk of bias, sensitivity, heterogeneity, and publication bias were assessed. RESULTS Of the 790 studies identified, 41 clinical trials met the inclusion criteria (8416 participants of mean age 49.2 years). In the pooled analysis, PBDs were associated with lower SBP [Dietary Approach to Stop Hypertension -5.53 mmHg (95% confidence intervals -7.95,-3.12), Mediterranean -0.95 mmHg (-1.70,-0.20), Vegan -1.30 mmHg (-3.90,1.29), Lacto-ovo vegetarian -5.47 mmHg (-7.60,-3.34), Nordic -4.47 mmHg (-7.14,-1.81), high-fiber -0.65 mmHg (-1.83,0.53), high-fruit and vegetable -0.57 mmHg (-7.45,6.32)]. Similar effects were seen on DBP. There was no evidence of publication bias and some heterogeneity was detected. The certainty of the results is high for the lacto-ovo vegetarian and Dietary Approach to Stop Hypertension diets, moderate for the Nordic and Mediterranean diets, low for the vegan diet, and very low for the high-fruit and vegetable and high-fiber diets. CONCLUSION PBDs with limited animal products lower both SBP and DBP, across sex and BMI.
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Affiliation(s)
- Joshua Gibbs
- University of Warwick, World Health Organization Collaborating Centre for Nutrition, Warwick Medical School, Division of Health Sciences
| | - Eleanor Gaskin
- University of Warwick, World Health Organization Collaborating Centre for Nutrition, Warwick Medical School, Division of Health Sciences
| | - Chen Ji
- University of Warwick, World Health Organization Collaborating Centre for Nutrition, Warwick Medical School, Division of Health Sciences
| | - Michelle A Miller
- University of Warwick, World Health Organization Collaborating Centre for Nutrition, Warwick Medical School, Division of Health Sciences
| | - Francesco P Cappuccio
- University of Warwick, World Health Organization Collaborating Centre for Nutrition, Warwick Medical School, Division of Health Sciences
- University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
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45
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Nugent SJ, Rogerson D, Ranchordas MK, Broom DR. Vegan diet for adults with overweight or obesity. Hippokratia 2020. [DOI: 10.1002/14651858.cd013828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Shane J Nugent
- Health and Wellbeing, Academy of Sport and Physical Activity; Sheffield Hallam University; Sheffield UK
| | - David Rogerson
- Department of Sport; Sheffield Hallam University; Sheffield UK
| | | | - David R Broom
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences; Coventry University; Coventry UK
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46
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Vodovotz Y, Barnard N, Hu FB, Jakicic J, Lianov L, Loveland D, Buysse D, Szigethy E, Finkel T, Sowa G, Verschure P, Williams K, Sanchez E, Dysinger W, Maizes V, Junker C, Phillips E, Katz D, Drant S, Jackson RJ, Trasande L, Woolf S, Salive M, South-Paul J, States SL, Roth L, Fraser G, Stout R, Parkinson MD. Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit. Front Med (Lausanne) 2020; 7:585744. [PMID: 33415115 PMCID: PMC7783318 DOI: 10.3389/fmed.2020.585744] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022] Open
Abstract
Declining life expectancy and increasing all-cause mortality in the United States have been associated with unhealthy behaviors, socioecological factors, and preventable disease. A growing body of basic science, clinical research, and population health evidence points to the benefits of healthy behaviors, environments and policies to maintain health and prevent, treat, and reverse the root causes of common chronic diseases. Similarly, innovations in research methodologies, standards of evidence, emergence of unique study cohorts, and breakthroughs in data analytics and modeling create new possibilities for producing biomedical knowledge and clinical translation. To understand these advances and inform future directions research, The Lifestyle Medicine Research Summit was convened at the University of Pittsburgh on December 4–5, 2019. The Summit's goal was to review current status and define research priorities in the six core areas of lifestyle medicine: plant-predominant nutrition, physical activity, sleep, stress, addictive behaviors, and positive psychology/social connection. Forty invited subject matter experts (1) reviewed existing knowledge and gaps relating lifestyle behaviors to common chronic diseases, such as cardiovascular disease, diabetes, many cancers, inflammatory- and immune-related disorders and other conditions; and (2) discussed the potential for applying cutting-edge molecular, cellular, epigenetic and emerging science knowledge and computational methodologies, research designs, and study cohorts to accelerate clinical applications across all six domains of lifestyle medicine. Notably, federal health agencies, such as the Department of Defense and Veterans Administration have begun to adopt “whole-person health and performance” models that address these lifestyle and environmental root causes of chronic disease and associated morbidity, mortality, and cost. Recommendations strongly support leveraging emerging research methodologies, systems biology, and computational modeling in order to accelerate effective clinical and population solutions to improve health and reduce societal costs. New and alternative hierarchies of evidence are also be needed in order to assess the quality of evidence and develop evidence-based guidelines on lifestyle medicine. Children and underserved populations were identified as prioritized groups to study. The COVID-19 pandemic, which disproportionately impacts people with chronic diseases that are amenable to effective lifestyle medicine interventions, makes the Summit's findings and recommendations for future research particularly timely and relevant.
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Affiliation(s)
- Yoram Vodovotz
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Neal Barnard
- Department of Medicine, George Washington University School of Medicine, Washington, DC, United States
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - John Jakicic
- School of Education, University of Pittsburgh, Pittsburgh, PA, United States
| | - Liana Lianov
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | | | - Daniel Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eva Szigethy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Toren Finkel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States
| | - Paul Verschure
- Institute for Bioengineering of Catalunya, Barcelona Institute of Science and Technology, Catalan Institute of Advanced Studies, Barcelona, Spain
| | - Kim Williams
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | | | | | - Victoria Maizes
- Department of Internal Medicine, University of Arizona, Tucson, AZ, United States
| | - Caesar Junker
- United States Air Force, Washington, DC, United States
| | - Edward Phillips
- Department of Physical Medicine and Rehabilitation, Veterans Administration Boston Healthcare System, Boston, MA, United States
| | - David Katz
- True Health Initiative, Derby, CT, United States
| | - Stacey Drant
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Richard J Jackson
- Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Leonardo Trasande
- Department of Pediatrics and Environmental Medicine, New York University, New York, NY, United States
| | - Steven Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Marcel Salive
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, Bethesda, MD, United States
| | - Jeannette South-Paul
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah L States
- Phipps Conservatory and Botanical Gardens, Pittsburgh, PA, United States
| | - Loren Roth
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gary Fraser
- Department of Medicine, Preventive Medicine and Public Health, Loma Linda University, Loma Linda, CA, United States
| | - Ron Stout
- Ardmore Institute of Health, Ardmore, OK, United States
| | - Michael D Parkinson
- University of Pittsburgh Medical Center Health Plan/WorkPartners, Pittsburgh, PA, United States
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Do vegetarians feel bad? Examining the association between eating vegetarian and subjective well-being in two representative samples. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.104018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Storz MA. Adherence to Low-Fat, Vegan Diets in Individuals With Type 2 Diabetes: A Review. Am J Lifestyle Med 2020; 16:300-310. [DOI: 10.1177/1559827620964755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022] Open
Abstract
Low-fat, vegan diets seem to be particularly effective for glycemic control and may significantly lower hemoglobin A1c levels in individuals with type 2 diabetes. However, health care providers report low levels of practice and argue that this diet is hard to follow. This controversy on the acceptability of low-fat vegan diets appears to be a significant barrier to its broader clinical implementation. This review investigated dropout and adherence rates in intervention studies using a low-fat vegan diet in individuals with type 2 diabetes. In contrast to the common belief that this diet is poorly accepted, this review suggests different findings. Dietary adherence appears to be good with approximately 50% of individuals meeting the criteria for high adherence in most studies. Adherence to a low-fat vegan diet was higher than adherence to conventional diets in several studies. Group support and regular supervision improve adherence. Moreover, relatively low dropout rates were found—indirectly indicating good acceptance and high patient interest in this particular dietary modification. Although this review has several important limitations, it appears inappropriate to associate low-fat, vegan diets with poor adherence in individuals with type 2 diabetes. With good and regular support, adherence rates are more than solid and physicians should advocate for this diet more frequently.
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Bowman SA. A Vegetarian-Style Dietary Pattern Is Associated with Lower Energy, Saturated Fat, and Sodium Intakes; and Higher Whole Grains, Legumes, Nuts, and Soy Intakes by Adults: National Health and Nutrition Examination Surveys 2013-2016. Nutrients 2020; 12:nu12092668. [PMID: 32882973 PMCID: PMC7551258 DOI: 10.3390/nu12092668] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/25/2020] [Accepted: 08/29/2020] [Indexed: 12/30/2022] Open
Abstract
Consumer demand for plant-based foods is increasing though the reasons may vary. Plant foods are sole sources of dietary fiber, vitamin C, and flavonoids and good sources of vitamin B1, folic acid, potassium, and magnesium. They are low in saturated fat, and do not contain cholesterol and vitamin B12. Plant foods are associated with better body weight and healthy blood lipid profile. This cross-sectional study used nationally representative National Health and Nutrition Examination Survey 2013-2016 data and compared nutrient and food pattern food group intakes of adults eating a vegetarian-style diet with adults eating a nonvegetarian diet. Adults 20+ years (N = 10,064) were grouped using the Dietary Guidelines for Americans 2015-2020 definition of vegetarian-style diet, which is modelled as lacto-ovo-vegetarian diet. Trained dietary interviewers collected self-reported dietary intake data using a 24-h recall and an automated multi-pass method. Means were compared using linear contrasts (p < 0.01). On average, the vegetarians ate an estimated 419 fewer kilocalories, 7 g less saturated fat, and 1274 mg less sodium. The vegetarian-style diet was higher in micronutrient density, except for vitamin B12 and zinc. The vegetarians ate more whole grains, legumes, nuts, and soy products. Fruit, vegetables, and dairy intakes were similar for both groups. A vegetarian-style diet may be advocated to control energy, saturated fat, and sodium intakes.
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Affiliation(s)
- Shanthy A Bowman
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USA, U.S. Department of Agriculture, 10300 Baltimore Ave, Beltsville, MD 20705, USA
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50
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Abstract
Hospitalization is an unparalleled opportunity for physicians to educate patients about the interconnection between poor dietary choices and the occurrence of many chronic diseases. For those patients who are ready to embrace nutrition as an essential part of the healing process, however, it is oftentimes difficult to find healthy menus at hospitals. Meat-based entrées, sugar-sweetened beverages and candy appear to be omnipresent in cafeterias and restaurants at U.S. hospitals. On the other hand, healthy plant-based menus are still the exception rather than the rule. Some states undertook considerable efforts to change this and made plant-based meals the law. Upon request by a patient, hospitals in New York are now required by law to provide plant-based options at every meal. This recent development triggered a controversial discussion within the medical community whether other states should follow this example and make plant-based hospital menus the law as well. This editorial illuminates why mandatory plant-based hospital menus could be a win-win situation for many involved stakeholders, including patients, hospitals and food services. This step is not a loss-marking venture for hospitals but rather a chance to save money and to improve corporate brand marketing at the same time. The introduction of mandatory plant-based menus in hospitals at a large scale represents a unique opportunity at the nexus of health, innovative corporate strategies and economics. Adequate framework conditions are necessary to ensure that all individuals can make healthy and affordable dietary choices while being hospitalized.
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