Potential health hazards of eating red meat

Mediterranean and standard American diet consumption in psychosis and non-psychosis affective disorders groups: Symptoms and cognition

Research supports an association between diet and health, and emerging evidence suggests that diet is associated with neuropsychiatric symptoms. However, no human study has examined an anti-inflammatory diet across rigorously defined psychiatric diagnoses and its associations with symptom severity and cognition. As inflammation is implicated in mental illness, we investigated adherence to the Mediterranean diet (MD), an anti-inflammatory diet, and the standard American diet (SAD), and examined cross-sectional relationships with psychiatric symptoms and cognition.

METHOD

Participants included 54 individuals with psychotic disorders, 30 with non-psychosis affective disorders and 40 healthy controls. Participants underwent diagnostic interviews, PANSS symptom ratings, and MATRICS cognitive assessments. The self-report GBAQ was used to assess adherence to the MD versus SAD.

RESULTS

The psychosis group was significantly more likely to consume the SAD than healthy controls (p = 0.007), with MD adherence predicting better working memory (r = 0.461, p < 0.001). In the non-psychosis affective disorders group, MD adherence predicted slower processing speed (r = -0.376, p = 0.049). In the non-psychosis affective disorders group, MD predicted reduced PANSS General Psychopathology scale (r = -0.449, p = 0.013), as well as the Activation (r = -0.362, p = 0.049), and Dysphoric Mood factors (r = -0.403, p = 0.027).

DISCUSSION

This first-of-its kind study identified poor dietary choices in persons with psychosis, showing significantly lower symptoms and better cognition in association with the MD in transdiagnostic analyses. It supports the study of dietary interventions for prevention and treatment of psychiatric conditions.

Total, unprocessed, and processed red meat intake in relation to the risk of pancreatic cancer: A systematic review and dose-response meta-analysis of prospective cohort studies

Data on the association between red meat from both processed and unprocessed sources and risk of pancreatic cancer is controversial. Therefore, this study summarized current evidence on the relationship between red and processed red meat intake and pancreatic cancer risk through a meta-analysis. A systematic search was conducted on PubMed, ISI Web of Science and Scopus for prospective cohorts up to October 2024. Hazard ratio (HR) and 95 % confidence intervals (CIs) for the highest vs. the lowest category of the exposures were combined using random-effects models. Dose-response relations were explored by one-stage weighted mixed effects meta-analysis. 19 studies involving 4,291,065 participants with 13,820 pancreatic cancer cases were included. The highest intake of total red meat was positively related to risk of pancreatic cancer (Pooled HR: 1.12, 95%CIs: 1.01, 1.24; I2: 36.5 %, PQ-test: 0.10). Such association was not significant for unprocessed (Pooled HR: 1.05, 95%CIs: 0.88, 1.24; I2: 66.6 %, PQ-test: 0.002) and processed (Pooled HR: 1.02, 95%CIs: 0.86, 1.21; I2: 66.0 %, PQ-test: 0.001) red meat intake. No significant association was observed between each 3 serving/wk of total, unprocessed, and processed red meat and risk of pancreatic cancer. Also, no evidence for a nonlinear association was found for all associations. This meta-analysis suggests a positive relation between the highest consumption of total red meat and pancreatic cancer. However, this relation was not substantial in terms of unprocessed and processed red meat.

A randomized controlled cross-over trial of differences in acute effects on serum metabolites from isocaloric meals based on red meat, fatty fish, or soy protein

PURPOSE

Reducing red meat intake in the Western diet is beneficial for health and the environment. However, red meat is nutrient-rich, so understanding the impact of substituting it with other protein sources such as fish or plant-based proteins is essential, especially for vulnerable groups like the elderly and those with chronic diseases. The purpose of this study was to study the postprandial response in serum metabolites in women with Rheumatoid Arthritis (RA) after intake of red meat, fatty fish, and soy protein.

METHODS

Women with RA (n = 24) consumed isocaloric meals that included burgers made from either red meat, fatty fish, or soy protein in a crossover design. Blood samples were taken in fasting state before the meal (0 h) and at intervals up to 5 h after eating. Nuclear Magnetic Resonance (NMR) analysis quantified serum metabolites, and multivariate models and univariate statistics were applied to compare postprandial metabolite changes across protein sources.

RESULTS

Postprandial metabolite patterns varied significantly by protein type. The fatty fish meal led to a faster and higher increase in metabolites, including creatinine, isoleucine, valine, and trimethylamine N-oxide, compared to red meat. Unidentified lipids also differed. However, metabolite patterns after soy protein were similar to those after red meat.

CONCLUSION

This postprandial crossover trial found that intake of fatty fish lead to a quicker and more pronounced increase in key blood concentrations of metabolites compared to red meat. However, metabolite profiles in serum based on NMR-analysis were similar after intake of soy protein compared to red meat.

TRIAL REGISTRATION

The PIRA (Postprandial Inflammation in Rheumatoid Arthritis) trial is Registered at Clinicaltrials.gov (NCT04247009).

Reasoning to Justify Eating Animals Varies With Age

The present study examined the justifications used by children, adolescents, and adults to justify eating animals. Children (n = 100, Mage = 9.82, SD = 0.77, female n = 49) as compared to adolescents (n = 76, Mage = 14.0, SD = 1.62, female n = 36) and adults (n = 113, Mage = 44.1, SD = 14.4, female n = 54) were more ambivalent or opposed to eating animals, and they showed a distinct reasoning pattern. Children relied less on arguments about meat eating being natural or with to humane slaughter practices. These findings align with recent theoretical perspectives that reasoning may be used to counter cognitive dissonance arising from knowledge of food production systems.

Effect of a portion-size default nudge on meat consumption and diner satisfaction: controlled experiments in Stanford University dining halls

Reducing meat consumption, especially in high-intake countries such as the United States, is crucial in mitigating the climate and biodiversity crises and improving public health and animal welfare. Choice-architecture interventions or nudges in the food domain, such as choice defaults (e.g., reduced default portion sizes), can be powerful levers of behavior change. However, evidence remains limited in large-scale, real-life settings, and little is known about potential effects on diner satisfaction and backfiring effects that reduce or even reverse the desired behavior. These uncertainties have posed substantial barriers to scalability and wider adoption by the food service industry. In our single-blinded, quasi-experimental, pre-registered field interventions in Stanford University dining halls with staff-served portions, a 25% reduction in the serving spoon size (Study 1, 24 days, 364 diners, made-to-order burritos) produced a non-significant trend of 18% less meat served per day without reducing overall diner satisfaction (p = 0.059, d = 0.64) but with a wide CI that included the null (- 49.2, 1.07). A more substantial 50% reduction in serving spoon size (Study 2, 29 days, 1802 diners, varying menu items) did not reduce the amount of meat served (p = 0.60, d = 0.20), triggered backfiring effects, and significantly decreased diner satisfaction. Combining the two studies, the intervention did not significantly reduce meat consumption. While the trends in our findings are consistent with the 'norm range model'-i.e., that moderate portion reductions may decrease intake but drastic reductions may prompt compensatory eating-key differences and contextual nuances between the two studies help explain the mixed results. Future studies on the 'norm range' of default portion size nudges to reduce meat consumption across different menu items and food service models is suggested to increase our understanding of effective and scalable interventions that facilitate collective shifts towards more sustainable dietary behaviors.

Associations between national plant-based vs animal-based protein supplies and age-specific mortality in human populations

Transitions to sustainable food systems require shifts in food production and availability, particularly the replacement of animal-based protein with plant-based protein. To explore how this transition may relate to demographic patterns, we undertake an ecological analysis of global associations between age-specific mortality, total national macronutrient distributions, and protein substitution. Our dataset includes per capita daily food supply and demographic data for 101 countries from 1961-2018. After adjusting for time, population size, and economic factors, we find associations between low total protein supplies and higher mortality rates across all age groups. Early-life survivorship improves with higher animal-based protein and fat supplies, while later-life survival improves with increased plant-based protein and lower fat supplies. Here, we show that the optimal balance of protein and fat in national food supplies, which correlates with minimal mortality, varies with age, suggesting that reductions in dietary protein, especially from animal sources, may need to be managed with age-specific redistributions to balance health and environmental benefits.

Trends in the burden of chronic kidney disease related to high red meat intake from 1990 to 2021

OBJECTIVE

To systematically examine global trends and spatial distribution of the burden of chronic kidney disease associated with high red meat intake from 1990 to 2021 using data from the Global Burden of Disease 2021 study, providing scientific evidence for targeted prevention strategies.

METHODS

We assessed disease burden using age-standardized death rate and age-standardized disability-adjusted life year rate. Disease burden was analyzed by sex, age, region, and Socio-demographic Index level, while estimated annual percentage change was calculated to evaluate temporal trends.For the analysis of future trends in chronic kidney disease burden, we utilized both the Age-Period-Cohort model and the Bayesian Age-Period-Cohort model.

RESULTS

From 1990 to 2021, age-standardized death rate and disability-adjusted life year rates of chronic kidney disease linked to high red meat intake increased, with EAPCs of 1.33% and 1.07%, respectively. Males consistently exhibited a higher disease burden than females, with mortality peaking in the 85-89 age group. The age-standardized disability-adjusted life year rate in high-SDI groups (6.59 per 100,000) was significantly higher than in low-SDI groups (2.38 per 100,000). A temporary decline occurred between 2016 and 2018, and disease burden decreased among individuals over 95 years old between 2018 and 2021.

CONCLUSION

The chronic kidney disease burden associated with high red meat intake demonstrated significant demographic and regional disparities, characterized by an overall increasing trend with some period-specific exceptions. These findings suggest the need for targeted public health interventions, particularly dietary guidance for high-risk populations such as males and residents of high-SDI groups. Future research should focus on elucidating the underlying biological mechanisms and social determinants that drive these disparities.

Association of red and processed meat consumption with cancer incidence and mortality: An umbrella review protocol

BACKGROUND

Many meta-analyses have reported the associations between red and processed meat consumption and cancer outcomes, but few have assessed the credibility of the evidence. In addition, the results of dose-effect analyses of the association between red and processed meat consumption and cancer outcomes were inconsistently reported in different articles. Here we propose a protocol for an umbrella review (UR) that be designed to assess these associations and explore the potential dose-response relationships.

METHODS

We will independently search five electronic databases and two registers from inception to July 2024 for systematic reviews with meta-analysis concerning the associations of red and processed meat consumption with cancer incidence and mortality. We will conduct the statistical analysis between August 2024 and December 2024. Also, an up-to-date search for additional primary studies of cancer outcomes that were not included in previously published meta-analyses will be conducted. The main outcomes will include the incidence and mortality of any cancer related to red and processed meat exposure. A series of unique associations will be created based on the cancer outcome, exposure, and clinical or population setting. For each association, we will update the meta-analysis by combining studies included in prior meta-analyses and new studies that were not included in prior meta-analyses, and re-perform the meta-analysis using the random-effects models. According to the credibility of the evidence assessment, all associations with a P value of ≤  0.05 will be categorized as convincing, highly suggestive, suggestive, or weak evidence. All analyses will be performed in R (version 4.2.3).

RESULTS

The results of this UR are planned to be submitted to a peer-reviewed journal.

CONCLUSION

The main aim of protocol publication is to get feed back from the reviewers to develop a standard protocol before its publication and after publication, it should guide this protocol to take up similar research by any researcher(s) by following meticulously this standard protocol.

REGISTRATION

PROSPERO CRD42023414550.

Machine Learning Models Integrating Dietary Indicators Improve the Prediction of Progression from Prediabetes to Type 2 Diabetes Mellitus

Background: Diet plays an important role in preventing and managing the progression from prediabetes to type 2 diabetes mellitus (T2DM). This study aims to develop prediction models incorporating specific dietary indicators and explore the performance in T2DM patients and non-T2DM patients. Methods: This retrospective study was conducted on 2215 patients from the Henan Rural Cohort. The key variables were selected using univariate analysis and the least absolute shrinkage and selection operator (LASSO). Multiple predictive models were constructed separately based on dietary and clinical factors. The performance of different models was compared and the impact of integrating dietary factors on prediction accuracy was evaluated. Receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the predictive performance. Meanwhile, group and spatial validation sets were used to further assess the models. SHapley Additive exPlanations (SHAP) analysis was applied to identify key factors influencing the progression of T2DM. Results: Nine dietary indicators were quantitatively collected through standardized questionnaires to construct dietary models. The extreme gradient boosting (XGBoost) model outperformed the other three models in T2DM prediction. The area under the curve (AUC) and F1 score of the dietary model in the validation cohort were 0.929 [95% confidence interval (CI) 0.916-0.942] and 0.865 (95%CI 0.845-0.884), respectively. Both were higher than the traditional model (AUC and F1 score were 0.854 and 0.779, respectively, p < 0.001). SHAP analysis showed that fasting plasma glucose, eggs, whole grains, income level, red meat, nuts, high-density lipoprotein cholesterol, and age were key predictors of the progression. Additionally, the calibration curves displayed a favorable agreement between the dietary model and actual observations. DCA revealed that employing the XGBoost model to predict the risk of T2DM occurrence would be advantageous if the threshold were beyond 9%. Conclusions: The XGBoost model constructed by dietary indicators has shown good performance in predicting T2DM. Emphasizing the role of diet is crucial in personalized patient care and management.

Sociodemographic and behavioural determinants of vegetarian main dish selection in a French university cafeteria: A three-month observational study with repeated measures

Reducing meat consumption is crucial for improving population and planetary health. Millions of students regularly eat at university cafeterias, which offer a unique opportunity to promote meat-free meals to new generations by addressing barriers such as accessibility, price, and cooking skills. This study aimed to analyse the individual characteristics associated with the proportion of vegetarian main dish choices in a university cafeteria and to determine whether this behaviour influenced the nutritional quality and environmental impact of student meals. A sample of 257 French students who ate regularly at a large university cafeteria took part in an observational study with repeated measures. They took pictures of their meal trays each time they ate at the cafeteria for three months. They completed an online questionnaire to assess their sociodemographic characteristics and various behavioural determinants of the choice of a vegetarian main dish based on the Capability, Opportunity, Motivation Behaviour (COM-B) framework. Being a woman was the only sociodemographic characteristic significantly associated with more frequent vegetarian main dish selection. The proportion of vegetarian choices was negatively associated with attachment to meat (p < 0.001, η2 = 0.189) and positively associated with environmental knowledge (p = 0.034, η2 = 0.018) and the following food choice motives: animal welfare (p < 0.001, η2 = 0.062), health (p < 0.001, η2 = 0.044), ethics (p = 0.002, η2 = 0.039), natural content (p = 0.010, η2 = 0.026), religion (p = 0.014, η2 = 0.025), and mood (p = 0.022, η2 = 0.020). Students who chose vegetarian main dishes more frequently composed healthier (p = 0.023, η2 = 0.020) and more environmentally friendly meal trays (p < 0.001, η2 = 0.349). These findings highlight the variability in the students' propensity to choose vegetarian main dishes in a university cafeteria and its association with motivational factors in a food environment bound by design.

The Role of the Planetary Diet in Managing Metabolic Syndrome and Cardiovascular Disease: A Narrative Review

Introduction: The planetary health diet, introduced by the EAT-Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, including prevention and management of abdominal obesity, carbohydrate metabolism disorders, dyslipidemia, and elevated blood pressure. These metabolic disorders are components of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Objectives: This narrative review aims to gather the most recent findings on the impact of the planetary diet on individual components of metabolic syndrome and on the prevention and treatment of cardiovascular disease. Methods: The available research on the topic was identified via searches in PubMed, Scopus, and Google Scholar. Results: Abdominal obesity, a major risk factor for a range of chronic diseases, can be effectively mitigated by adhering to plant-based dietary patterns, which have been shown to reduce waist circumference and improve overall cardiometabolic health. Furthermore, the planetary diet plays a crucial role in reducing the risk of type-2 diabetes and improving glycemic control, with specific dietary components such as whole grains and fiber, demonstrating positive effects on blood glucose levels. This diet is additionally associated with favorable lipid profiles, including lower levels of LDL cholesterol and total cholesterol, which are critical in the prevention of atherosclerosis and cardiovascular diseases. Conclusions: These multiple benefits highlight that the planetary diet may be an effective strategy for managing and preventing metabolic syndrome and cardiovascular disease. However, further research is needed to confirm its long-term efficacy and applicability across diverse populations.

Rheological and Gelling Properties of Chicken-Mushroom Hybrid Gel for Flexitarian-Friendly Functional Food Applications

Hybrid gels combining chicken and mushroom offer innovative functional food choices, catering to the growing demand for flexitarian-friendly products. These gels reduce meat content while enhancing dietary fiber, bioactive compounds, and sustainability. This study examined the effects of split gill mushroom (Schizophyllum commune) powder (SGM) substitution (0%, 25%, 50%, and 75%, w/w) for Ligor chicken meat in hybrid gels, focusing on rheological and gelling properties. The 25% SGM gel demonstrated optimal performance in terms of rheology, texture, microstructure, pH, water-holding capacity, and color. At this level, hybrid gels exhibited superior gelation properties, demonstrating elasticity dominance, as indicated by a higher storage modulus (G') than loss modulus (G″), along with stable cohesiveness and unaffected springiness (p > 0.05). However, hardness, gumminess, and chewiness were significantly lower than the control (p < 0.05). Higher SGM levels (50-75%) markedly weakened the gels, reducing viscoelasticity, increasing porosity and water release, and causing discoloration. These findings highlight 25% SGM as an optimal level for hybrid meat gels, maintaining product quality while promoting sustainability in the meat industry.

Determination of Polar Heterocyclic Aromatic Amines in Meat Thermally Treated in a Roasting Bag with Dried Fruits

Frequent consumption of processed meat has been classified as carcinogenic to humans by the International Agency for Research on Cancer (Group 1), while red meat has been classified as probably carcinogenic (Group 2A). Mutagenic and carcinogenic compounds formed by heating in protein-rich food include, among others, heterocyclic aromatic amines (HAAs). Modifying the heat treatment of meat and using natural additives with antioxidant properties can lead to a reduction in their formation. The aim of this study was to determine polar HAAs (imidazoquinolines, IQ and MeIQ; imidazoquinoxalines, 8-MeIQx and 4,8-DiMeIQx; and phenylimidazopyridine, PhIP) in pork loin prepared without additives and with three types of dried fruit (apricots, cranberries, and prunes), baked in a roasting bag. HAAs were isolated from meat samples by solid-phase extraction. Quantitative analysis was performed by high-performance liquid chromatography with fluorescence detection (FLD) and a diode array detector (DAD). Only two HAAs, 8-MeIQx and PhIP, were detected in extracts isolated from meat samples. The total content of these compounds in meat roasted without additives was 5.9 ng/g. Using a dried fruit stuffing content of 200 g/kg of meat reduced these concentrations in dishes prepared with prunes, apricots, and cranberries by 42%, 47%, and 77%, respectively.

Public Health Risks Associated with Food Process Contaminants - A Review

The increasing complexity of food production and processing has raised concerns regarding food process contaminants, which pose significant public health risks. Food process contaminants can be introduced during diverse phases of food processing such as drying, heating, grilling, and fermentation, resulting in the synthesis of harmful chemicals including acrylamide (AA), advanced glycation end products (AGEs), heterocyclic aromatic amines (HAAs), furan and its naturally occurring derivatives, polycyclic aromatic hydrocarbons (PAHs), N-nitroso compounds (NOCs), 2-chloropropane-1,2-diol esters (2-MCPDE), and 3-chloropropane-1,2-diol esters (3-MCPDE), ethyl carbamate (EC), glycidyl esters (GE), and 4-methylimidazole (4-MEI), all of these are harmful to human health. Although these compounds can be somewhat prevented during processing, eliminating them can often be challenging due to their unknown formation mechanism. Moreover, prolonged exposure to these dangerous compounds might harm human health. There is limited understanding of the sources, formation processes, and hazards of food processing contaminants, and a lack of knowledge of the mechanisms involved in how to control their generation. In this review, we provide a comprehensive overview of the harmful effects associated with food process contaminants generated during thermal processing and fermentation, alongside elemental process contaminants and their potential threats to human health. Furthermore, this study identifies existing knowledge gaps proposes avenues for future inquiry and emphasizes the necessity of employing a multi-disciplinary approach to alleviate the public health risks posed by food process contaminants, advocating for cooperative initiatives among food scientists, public health officials, and regulatory entities to enhance food safety and protect consumer health.

The willingness to transition to a more plant-based diet among omnivores: Determinants and socioeconomic differences

Plant-based diets benefit individual health and the environment, yet most people eat omnivorous diets. We aim to (1) assess the role of multiple determinants for transitioning to more plant-based diets in a sample of omnivorous respondents, such as recommendations from doctors, scientists and politicians; lower costs; and increased availability, and to (2) identify which subpopulations are most receptive to which determinants. Using data from a survey on the use and acceptance of Traditional, Complementary and Integrative Medicine in Germany (N = 4065; N omnivorous = 3419; 84%), we find that the overall willingness to change to a more plant-based diet is low (mean = 2.25 on a scale of 1-4). Respondents are most willing based on doctors' recommendations (mean = 2.61), and if prices for plant-based products were lower (mean = 2.55), and least willing based on scientists' and politicians' recommendations (mean = 1.86). Regression analyses reveal that men, the baby boomer cohort, and respondents with lower levels of education have a significantly lower willingness to transition to more plant-based diets. Further, recommendations from doctors, scientists, and politicians appear to be promising interventions for addressing the dietary behavior of men and older cohorts. Interventions by doctors and lower prices for plant-based products have the highest potential to induce dietary change even among the reluctant, reducing health inequalities and promoting environmentally friendly behavior.

In Situ Conversion of Atherosclerotic Plaques' Iron into Nanotheranostics

The presence of a substantial necrotic core in atherosclerotic plaques markedly heightens the risk of rupture, a consequence of elevated iron levels that exacerbate oxidative stress and lipid peroxidation, thereby sustaining a detrimental cycle of ferroptosis and inflammation. Concurrently targeting both ferroptosis and inflammation is crucial for the effective treatment of vulnerable plaques. In this study, we introduce gallium hexacyanoferrate nanoabsorption catalysts (GaHCF NACs) designed to disrupt this pathological cycle. GaHCF NACs function as highly efficient iron chelators with robust antiferroptosis properties. Through in situ capture of iron within atherosclerotic plaques, these catalysts enhance reactive oxygen species scavenging, initiating an amplified therapeutic response. GaHCF NACs significantly advance plaque regression, stabilization, and vascular functional recovery by inhibiting MAPK13 (p38-δ MAPK) signaling, a key mediator of inflammation and cell death. Importantly, the in situ iron capture process generates a detectable photoacoustic signal, offering a notable diagnostic advantage that allows real-time monitoring of plague status. This multifunctional nanocatalytic platform in situ transforms toxic iron within atherosclerotic plaques into both a therapeutic and diagnostic agent, adapting dynamically to the microenvironment and representing a promising strategy for reducing plaque vulnerability and preventing rupture.

Knowledge, attitudes, and use of the Mediterranean diet in practice among dietitians in the United Arab Emirates: a cross-sectional study

Dietitians are uniquely positioned to promote the Mediterranean Diet (MedDiet), a diet recognized for its health benefits and sustainability. This study aimed to assess the knowledge and attitudes regarding the MedDiet among dietitians in the United Arab Emirates (UAE), and to examine the frequency and correlates of using this diet in clinical practice. Practicing dietitians (n = 220) completed a 44-item web-based questionnaire, verified for face, content and construct validity, as well as internal and parallel form reliability. Total scores were computed as sum of items for knowledge and attitudes. The mean knowledge score was 6.48 ± 1.85 out of 10, with gaps related to MedDiet's benefits and nutrient composition. Despite positive attitudes, many dietitians did not agree that it is easy to encourage patients to decrease red meat (68%) and increase fruits/vegetables intake (70%). In clinical practice, 35% of dietitians rarely/never used the MedDiet. Dietitians were more likely to recommend the MedDiet if they had a Mediterranean country of origin (p = 0.037), higher knowledge (p = 0.022) and attitude (p = 0.013) scores, and acquired information about the MedDiet through university education (p = < 0.001) or conferences/seminars/workshops (p = 0.002). Using the findings of this study, evidence-based interventions can be developed to support the role of dietitians in promoting adherence to the MedDiet.

A Study on Production of Canned Minced Chicken and Pork and Formation of Heterocyclic Amines During Processing

Toxic compounds such as heterocyclic amines (HAs) are formed during the processing of protein-rich foods, especially meat products. This study aims to investigate the formation of HAs during the canning of chicken and pork by using an ultra-performance liquid chromatograph coupled with tandem mass spectrometer (UPLC-MS/MS). Minced samples of both chicken and pork were separately subjected to marinating, stir-frying and degassing for subsequent canning and sterilization for 60 min at 115 °C (low temperature–long time, LL–ST) or 25 min at 125 °C (high temperature–short time, HS–ST) and analyzed for HAs. The results showed that both marinating and sterilization could significantly affect the HA formation in canned minced chicken and pork, with the LL–ST treatment being more liable to total HA formation than the HS–ST treatment, and the total HAs (especially, Harman and Norharman) was produced at a higher level in canned minced pork than in canned minced chicken under the same sterilization treatment. A reduction in reducing sugar, creatine, and amino acid contents resulted in HA formation in canned minced chicken and pork during processing. The results were confirmed by principal component analysis and showed that HAs were formed at significant levels in canned minced chicken and pork, with the level of major HA content following the order of Harman > Trp-P-1 > Norharman > DMIP. Although the presence of non-mutagenic HAs (Harman, Norharman and DMIP) and possibly carcinogenic HA (Trp-P-1) contributed to 95.8% of total HAs formed in both canned pork and chicken in this study, it is imperative to reduce the HA exposure to humans for improved public health by decreasing the consumption of processed meat and increasing the intake of fruits and vegetables, as well as incorporating natural antioxidant-rich ingredients into foods during processing to minimize the formation of HAs.

Tailoring meat products for the elderly: A comprehensive review

The population of the elderly is projected to grow significantly in most of the developed countries in the near future. This should earn this demographic the title of 'Consumer of the future'. Meat has high quality proteins and essential vitamins which are important for all demographics but more so for the elderly due to their susceptibility to sarcopenia. This review explored the landscape of meat research and product development that meets the distinctive requirements of the elderly, drawing from published refereed articles, industry reports, and unpublished grey literature. The review emphasised the importance of understanding the evolving dietary and sensory requirements associated with ageing and how they intersect with meat consumption. One notable aspect observed is the diversity within the elderly population, which underscores the necessity for tailored approaches in meat product development to cater to the varying preferences and nutritional needs of different individuals. This review also highlights the ongoing efforts in developing meat-based products that span a spectrum of consistencies, ranging from solid to liquid forms, to accommodate the diverse needs of elderly consumers. Despite these advancements, the review found a discrepancy between the pace of meat product development for the elderly and the rapid advancements in kitchen-level technologies and suggests that further research is needed to bridge this gap and align product innovation with emerging technological trends.

Red Meat Consumption and its Relationship With Cardiovascular Health: A Review of Pathophysiology and Literature

Red meat is the muscle meat of mammals like beef, lamb, and pork that is red due to the abundance of myoglobin pigment and becomes even darker when cooked. The global average per capita consumption of meat and the total amount of meat consumed is rising, and there has been a particularly marked increase in the global consumption of chicken and pork. The consumption of red meat has always been a contentious issue, with data suggesting benefits in terms of nutritional value and at the same time linking its consumption to major health disorders such as endocrine abnormalities, gastrointestinal issues, cancers, and cardiovascular diseases (CVDs). Despite being normalized by major food franchises, red meat consumption may lead to adverse cardiovascular outcomes such as atherosclerosis, ischemic heart disease, stroke, and cardiac failure. Given the evidence that indicates the consumption of red and processed meat as a risk factor for cardiovascular diseases and all-cause mortality, it is important to review the effects of red meat on the risk of cardiovascular diseases.

The Gut-Heart Axis: Effects of Intestinal Microbiome Modulation on Cardiovascular Disease-Ready for Therapeutic Interventions?

Recent reports demonstrate an association between distinct bacteria or bacteria-derived metabolites originating from the gut microbiome and the onset or progression of cardiovascular disease (CVD). This raises the opportunity to modulate the gut microbiome to prevent or treat CVD. To investigate whether intestinal microbiome modulation can prevent or treat CVD, this systematic literature review includes all randomized clinical trials on microbiome modulation and its effects on CVD risk published between August 2018 and August 2023. Within this review, we report the modulation of the gut microbiome by a variety of interventions and their effects on CVD, focusing on cardiovascular risk factors and risk markers of CVD. Beneficial effects were observed upon lifestyle intervention and probiotics use. The most promising diets for reducing risk factors of CVD were the Mediterranean diet, high-fiber diets, polyphenol-rich diets, and diets containing polyunsaturated fatty acids. Among drug interventions, only empagliflozin showed beneficial effects on CVD risk factors. Many dietary interventions were less conclusive because of the heterogeneity of study populations, small sample sizes, and short intervention windows or follow-up. Diet, lifestyle, probiotics, or drug interventions can modulate the gut microbiome and decrease risk markers or risk factors related to CVD. Yet, their effects on clinical endpoints remain to be determined.

Association between plasma trimethylamine N-oxide and cerebral white matter hyperintensity: a cross-sectional study

Background

Cerebral white matter hyperintensity (WMH) is a pivotal imaging feature of cerebral small vessel disease (CSVD), closely correlated with an elevated risk of ischemic stroke (IS). Trimethylamine N-oxide (TMAO), a metabolite of gut microbiota, is increasingly associated with IS and atherosclerosis. However, the intricate relationship between TMAO and WMH remains ambiguous. This study aimed to study the connection between plasma TMAO and WMH. Furthermore, it assessed the potential of TMAO as a risk evaluation instrument for WMH.

Methods

In this cross-sectional study, we categorized WMH into periventricular WMH (P-WMH) and deep WMH (D-WMH), based on its locations. The severity of WMH was assessed and grouped according to the Fazekas scale. Plasma TMAO levels were quantitatively determined. We established the correlation between plasma TMAO levels and WMH severity using a Logistic regression model. Additionally, we employed ROC curves to evaluate the diagnostic efficacy of plasma TMAO concentration in distinguishing the severity of WMH.

Results

A higher plasma TMAO tertile was significantly linked to a higher Fazekas score, encompassing the overall score, P-WMH score, and D-WMH score (p < 0.001). A logical regression analysis revealed that plasma TMAO levels were independently associated with overall moderate and severe WMH, compared to overall non-mild WMH, in the unadjusted model (OR = 1.373, 95%CI 1.183-1.594 for moderate; OR = 1.384, 95%CI 1.192-1.607 for severe), the adjusted model a (OR = 1.436, 95%CI 1.214-1.669 for moderate; OR = 1.446, 95%CI 1.222-1.711 for severe) and the adjusted model b (OR = 1.490, 95%CI 1.234-1.800 for moderate; OR = 1.494, 95%CI 1.237-1.805 for severe). The analysis also showed an independent correlation between plasma TMAO levels and WMH severity, irrespective of the unadjusted model, adjusted model a, or adjusted model b, when considering P-WMH and D-WMH severity. The ROC indicated that, in overall WMH and P-WMH, the area under curve (AUC) for non-mild and severe WMH were both>0.5, while the AUC for moderate WMH was<0.5. In contrast, in D-WMH, the AUC for non-mild, moderate, and severe WMH were all>0.5.

Conclusion

Plasma TMAO levels exhibited a significant correlation with both overall and region-specific WMH severity. Furthermore, the plasma TMAO levels displayed robust predictive capability for D-WMH.

The role of dietary modification in the prevention and management of metabolic dysfunction-associated fatty liver disease: An international multidisciplinary expert consensus

Metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD), has become the leading cause of chronic liver disease worldwide. Optimal dietary intervention strategies for MAFLD are not standardized. This study aimed to achieve consensus on prevention of MAFLD through dietary modification. A multidisciplinary panel of 55 international experts, including specialists in hepatology, gastroenterology, dietetics, endocrinology and other medical specialties from six continents collaborated in a Delphi-based consensus development process. The consensus statements covered aspects ranging from epidemiology to mechanisms, management, and dietary recommendations for MAFLD. The recommended dietary strategies emphasize adherence to a balanced diet with controlled energy intake and personalized nutritional interventions, such as calorie restriction, high-protein, or low-carbohydrate diets. Specific dietary advice encouraged increasing the consumption of whole grains, plant-based proteins, fish, seafood, low-fat or fat-free dairy products, liquid plant oils, and deeply colored fruits and vegetables. Concurrently, it advised reducing the intake of red and processed meats, saturated and trans fats, ultra-processed foods, added sugars, and alcohol. Additionally, maintaining the Mediterranean or DASH diet, minimizing sedentary behavior, and engaging in regular physical activity are recommended. These consensus statements lay the foundation for customized dietary guidelines and proposing avenues for further research on nutrition and MAFLD.

Ultra-processed plant-based analogs: Addressing the challenging journey toward health and safety

Currently, plant-based analogs are presented as healthier alternatives to the products they are intended to replace. However, the processing to which ultra-processed plant-based analogs are subjected to acquire the characteristics of animal-derived products might result in the opposite effect, producing unhealthy ultra-processed foods. In the present review, a list of strategies widely known and already employed in animal-derived products is suggested to achieve healthier, safer, and tastier ultra-processed plant-based analogs: fermentation, employment of probiotics and postbiotics, NaCl replacement or substitution, addition of antioxidants, and fatty profile enhancement. In general, these strategies are not yet applied to the plant-based products available on the market; thus, this research paper might induce new investigation pathways for researchers and producers to develop actually healthier alternatives.

Association between plant and animal protein and biological aging: findings from the UK Biobank

PURPOSE

This study aimed to evaluate the relationship between plant protein, animal protein and biological aging through different dimensions of biological aging indices. Then explore the effects of substitution of plant protein, animal protein, and their food sources on biological aging.

METHODS

The data came from 79,294 participants in the UK Biobank who completed at least two 24-h dietary assessments. Higher Klemera-Doubal Method Biological Age (HKDM-BA), higher PhenoAge (HPA), higher allostatic load (HAL), and longer telomere length (LTL) were estimated to assess biological aging. Logistic regression was used to estimate protein-biological aging associations. Substitution model was performed to assess the effect of dietary protein substitutions.

RESULTS

Plant protein intake was inversely associated with HKDM-BA, HPA, HAL, and positively associated with LTL (odds ratios after fully adjusting and comparing the highest to the lowest quartile: 0.83 (0.79-0.88) for HKDM-BA, 0.86 (0.72-0.94) for HPA, 0.90 (0.85-0.95) for HAL, 1.06 (1.01-1.12) for LTL), while animal protein was not correlated with the four indices. Substituting 5% of energy intake from animal protein with plant protein, replacing red meat or poultry with whole grains, and replacing red or processed meat with nuts, were negatively associated with HKDM-BA, HPA, HAL and positively associated with LTL. However, an inverse association was found when legumes were substituted for yogurt. Gamma glutamyltransferase, alanine aminotransferase, and aspartate aminotransferase mediated the relationship between plant protein and HKDM-BA, HPA, HAL, and LTL (mediation proportion 11.5-24.5%; 1.9-6.7%; 2.8-4.5%, respectively).

CONCLUSION

Higher plant protein intake is inversely associated with biological aging. Although there is no association with animal protein, food with animal proteins displayed a varied correlation.

Making Sense of the Relationship Between Ultra-Processed Foods, Obesity, and Other Chronic Diseases

Ultra-processed foods (UPFs) is a food category within the NOVA system. The key feature of UPFs are foods that have been highly processed and contain various additives, especially those that are industrially produced. It is claimed that UPFs are inherently unhealthy. The classification system is highly controversial. This paper critically evaluates the evidence. In stark contrast to conventional systems for food classification, the NOVA system disregards the nutritional values of foods. As a result, many foods generally considered to be healthy are included as UPFs, whereas many unhealthy foods are excluded. Epidemiological studies, mainly prospective cohort studies, have consistently reported an association between the intake of UPFs and risk of obesity, cardiovascular disease (CVD), type 2 diabetes, common mental disorders (especially depression), and all-cause mortality. A similar association has been reported for cancer and hypertension, but the supporting evidence is weaker. The most plausible explanation for this is that the associations are largely due to a limited number of unhealthy foods, such as processed meat and sugar-sweetened beverages. Studies of the relationship between UPFs and obesity present a different picture. There is much evidence that suggests that UPFs play a major causal role in obesity. The high contents of fat, sugar, carbohydrates, and sodium commonly present in UPFs makes these foods hyperpalatable. In addition, UPFs typically have a high energy density. As a result of these two features of UPFs, most people consume an excessive energy intake when presented with UPFs. Because UPFs include a wide range of foods, many of which are healthy, it is likely that while many UPFs are obesogenic, many others are not.

Dietary patterns and diabetic microvascular complications risk: a Mendelian randomization study of European ancestry

Purpose

Previous observational studies about the link between dietary factors and diabetic microvascular complications (DMCs) is controversial. Thus, we systemically assessed the potential causal relationship between diet and DMCs risk using Mendelian randomization (MR) methods.

Methods

We used genome-wide association studies (GWAS) statistics to estimate the causal effects of 17 dietary patterns on three common DMCs in European. Summary statistics on dietary intakes were obtained from the UK biobank, and data on DMCs [diabetic retinopathy (DR), diabetic nephropathy (DN), and diabetic neuropathy (DNP)] were obtained from the FinnGen Consortium. A two-sample MR (TSMR) was conducted to explore the causal relationships of dietary habits with DMCs. In addition, multivariable MR analysis (MVMR) was performed to adjust for traditional risk factors for eating habits, and evaluated the direct or indirect effects of diet on DMCs.

Results

TSMR analysis revealed that salad/raw vegetable intake (odd ratio [OR]: 2.830; 95% confidence interval [CI]: 1.102-7.267; p = 0.0306) and fresh fruit intake (OR: 2.735; 95% CI: 1.622-4.611; p = 0.0002; false discovery rate [FDR] = 0.0082) increased the risk of DR, whereas cheese intake (OR: 0.742; 95% CI: 0.563-0.978; p = 0.0339) and cereal intake (OR: 0.658; 95% CI: 0.444-0.976; p = 0.0374) decreased the risk of DR. Salad/raw vegetable (OR: 6.540; 95% CI: 1.061-40.300; p = 0.0430) and fresh fruit consumption (OR: 3.573; 95% CI: 1.263-10.107; p = 0.0164) are risk factors for DN, while cereal consumption (OR: 0.380; 95% CI: 0.174-0.833; p = 0.0156) is the opposite. And genetically predicted higher pork intake increased the risk of DNP (OR: 160.971; 95% CI: 8.832-2933.974; p = 0.0006; FDR = 0.0153). The MVMR analysis revealed that cheese intake may act as an independent protective factor for DR development. Moreover, fresh fruit intake, salad/raw vegetable intake and pork intake may be independent risk factors for DR, DN and DNP, respectively. Other causal associations between dietary habits and DMCs risk may be mediated by intermediate factors.

Conclusion

This causal relationship study supports that specific dietary interventions may reduce the risk of DMCs.

Influence of a robotic companion on women's food choices: Evidence from an imaginary task

Previous research has demonstrated the influence of commensal dining between humans on food choices, whereas we conducted two studies to examine how the presence of a robot might influence people's choices between meat-heavy and vegetable-forward meals in imaginary scenarios. In Study 1, participants were instructed to choose three desirable dishes from a set of two meat and two vegetable dishes while they imagined eating alone, with a human, or with a robot. Although the meat dishes were rated as more palatable and pleasant, the female participants chose fewer meat-heavy meals when eating alone or with a robot than when eating with a human, whereas no such effect was observed for the male participants. We also replicated these patterns in Study 2, as the female participants chose fewer meat-heavy meals when eating with a robot and a human than when eating with two humans. Collectively, these findings provide empirical evidence regarding how the presence of a certain robot can influence female consumers' food choices in imaginary scenarios, which has direct implications for the practice of promoting sustainable food choices.

Electrospun fibers of zein and pea protein to create high-quality fibrous structures in meat analogs

Introduction

The importance of developing plant-based meat similar to animal meat lies in the fact that sensory similarity is a crucial factor in encouraging consumers to adopt this alternative.

Methodology

The present study reports the morphology, hydrophilicity, and thermal analysis of different fibers obtained by the electrospinning method. In the first step of this work, zein and zein/poly(ethylene oxide) (PEO) in 80% aqueous ethanol solution with varying concentrations of these polymers were investigated.

Results and Discussion

It was observed that the diameters of the electrospun fibers are related to the concentration and viscosity of the solutions. Moreover, the addition of small percentages of PEO makes the fibers more hydrophilic and leads to an increase in the polymeric solution viscosity. Because of its low toxicity, PEO is used in various edible products. In the second step of this work, an ideal zein/PEO combination was found to allow the pea protein (PP) to be electrospun. Adding PP to the zein/PEO blend (20:1) leads to a more hydrophilic fiber and improves thermal stability. The results suggest that the zein/PEO and zein/PEO/PP blends can offer an innovative solution to enhance the texture and appearance of plant-based meats. These simulated electrospun fibers can mimic the fibers in animal meat and are a potential alternative to provide a sensory experience as close to animal meat as possible.

Intersecting perspectives: Advocating for sustainable family meals across generations

Adolescents in Germany eat fewer animal products than their parents, often for sustainability reasons. We investigated how adolescents differ from their parents' generation in sustainability food-choice motives, consumption of animal products, and corresponding behaviors such as advocating for and influencing decisions towards more sustainable family meals. In an online questionnaire, an educationally diverse sample of 500 adolescents (M = 17.9 years, range = 15-20) and 500 adults of their parents' generation (M = 52.2 years, range = 45-60) reported food-choice motives, their own and their family's diet style, how they advocate for sustainable food decisions at family meals (e.g., less meat), and how they influence different steps in family meal planning (e.g., grocery shopping). The two generations did not differ in sustainable food motives and mean consumption frequency of meat and animal products, but adolescents reported three times more often than their parents' generation to never eat meat. At shared family meals they advocated for eating plant-based substitutes (d = 0.27, p < 0.001) and other animal products (β = -0.15, p = 0.02) more often than their parents' generation, but not for eating less meat. Adolescents advocated more frequently for sustainable food decisions at shared meals the more important sustainability motives were to them (β = 0.53, p < 0.001), and the less meat (β = -0.35, p < 0.001) and fewer other animal products (β = -0.11, p = 0.015) they consumed. Adolescents motivated towards sustainability have the potential to impact the family's dietary choices through reverse socialization processes. These findings challenge current theories that suggest only parents influence their children, neglecting the role of adolescents as potential agents of change for improved family and planetary health.

Children and their being "carnivorous": is visceral adiposity protection or promotion?

BACKGROUND

Environmental factors and, in particular, diet, could represent potentially modifiable risk factors for the treatment of childhood obesity. The association between red meat consumption and obesity is demonstrated in adulthood. On the other hand, the association between red meat consumption and obesity is not as clear in children and adolescents. The aim of this study is to test the hypothesis that children and adolescents with obesity are consuming higher quantities of red meat, while still taking into account the appropriate consumption and the overall benefits of red meat itself.

METHODS

A cross-sectional study was conducted by using a sample including 41 children and adolescent affected by obesity. Anthropometric measures and eating habits, including red meat consumption, were collected at baseline using a structured and detailed questionnaire. The amount of red meat intake was estimated in portions per week (for clarity, the term portion is equivalent to about 150 grams of red meat).

RESULTS

Red meat consumption correlates with Body Mass Index (BMI) (P<0.01). Waist circumference (WC) values are also directly proportional to the consumption of red meat (P<0.05).

CONCLUSIONS

This study demonstrates that red meat consumption correlates with BMI and WC in pediatric age. Considering the opposite results from other study, the association between red meat consumption and obesity seems less clear in pediatric age rather than adulthood. On the other hand, the current state of art emphasizes that there should be more attention in obese and overweight children and adolescents in conjunction with appropriate lifestyle changes in order to achieve adequate waist circumference, BMI and related cardiovascular health. Benefits and risks associated with red meat consumption would seem balanced if consumed in moderate quantities as part of balanced diets with a high intake of vegetables and fruits. Even for the topic "red meat," the right balance would seem to lie in the middle.

The Impact of Storytelling about an Innovative and Sustainable Organic Beef Production System on Product Acceptance, Preference, and Satisfaction

Food labels and storytelling are marketing tools used by the food industry to highlight and communicate important product characteristics to consumers. By using these tools, food companies can influence consumers' attitudes toward the product and potentially the likelihood of purchase. In the present study, we investigated how storytelling about an innovative and sustainable organic beef production system influenced participants' preference and acceptance of a veal steak product and, further, if some information characteristics were more important than others for consumer satisfaction. Without being aware that the samples were identical, participants (n = 224) tasted two veal steak samples: one steak sample was presented with information about the production system, and the other without information. Results showed that when the steak sample was presented with product information, compared to without information, it received significantly higher hedonic ratings (overall liking, liking of flavor, and liking of texture). This was likewise reflected in a greater preference for the steak sample when presented with product information. Furthermore, product information was found to positively impact the participants' satisfaction with the steak sample regardless of their preference. Overall, our results suggest that the use of storytelling about the innovative and sustainable product system for veal steaks can positively influence consumers' attitudes toward the product.

Consumption of different types of meat and the risk of chronic limb-threatening ischemia: the Singapore Chinese Health Study

BACKGROUND

Although red meat consumption has been associated with risk of atherosclerotic coronary artery disease and stroke, no prospective study has examined this with the risk of chronic limb-threatening ischemia (CLTI).

METHODS

In a prospective study of 63,257 Chinese in Singapore, who were aged 45-74 years old at recruitment, diet was assessed via a validated semi-quantitative food frequency questionnaire. Incident CLTI cases were ascertained via linkage with nationwide hospital records for lower extremity amputation or angioplasty for peripheral arterial disease. Multivariable Cox models were used to examine associations between quartiles of meat intake and CLTI risk.

RESULTS

After a mean follow-up of 18.8 years, there were 1069 cases of CLTI. Higher intake of red meat intake was associated with increased risk of CLTI in a stepwise manner. Comparing extreme quartiles of red meat intake, the hazard ratio (HR) for the association with CLTI risk was 1.24 [95% confidence interval (CI) = 1.03-1.49; P-trend = 0.02]. In stratified analysis, red meat intake had a stronger association with CLTI risk among those without diabetes [HR (95% CI) comparing extreme quartiles = 1.41 (1.10-1.80); P-trend = 0.03] than among those with diabetes at baseline [HR (95% CI) comparing extreme quartiles = 1.04 (0.79-1.38); P-trend = 0.05] (P-interaction = 0.03). Otherwise, the associations were not different by sex, BMI, smoking status, hypertension, alcohol consumption, or history of cardiovascular diseases. Using a theoretical model in substitution analysis that substituted three servings per week of red meat with poultry or fish/shellfish, the relative risk of CLTI was reduced by 13-14%.

CONCLUSIONS

Consumption of red meat was associated with higher CLTI risk in this Asian cohort. Substituting red meat with poultry or fish/shellfish may reduce this risk.

Association between processed red meat intake and cardiovascular risk factors in patients with type 2 diabetes: a cross-sectional study from China

Aim

To explore the association between Processed red meat (PRM) consumption and cardiovascular risk factors in Chinese adults with type 2 diabetes mellitus (T2DM).

Methods

Dietary survey, physical measurement, and blood biochemical examination were conducted on 316 patients with type 2 diabetes in Bengbu, China from May to July 2019. Possible confounding factors were identified by comparing between-group variability in the baseline table. To eliminate the effect of confounding factors, subgroup analysis was used to explore whether there were differences in the correlation between PRM intake status and the indicators in cardiovascular disease risk factors. A logistic regression model was used to analyze the association between PRM and the risk of abnormal levels of cardiovascular risk factors in T2DM patients. Restricted cubic spline plots were used to analyze the dose-response relationship between PRM intake and the indicators of cardiovascular disease risk factors.

Results

A total of 316 subjects were included in the study, of whom 139 (44.0%) were male and 177 (56.0%) were female. In the multiplicative interaction, there was an effect modifier for smoking (Pinteraction = 0.033) on the association between PRM intake and the risk of substandard FPG level control; sex (Pinteraction = 0.035), smoking status (Pinteraction = 0.017), and alcohol consumption (Pinteraction = 0.046) had effect modifying effects on the association between PRM intake and risk of abnormal systolic blood pressure. Sex (Pinteraction = 0.045) had an effect modifier on the association of PRM intake status with the risk of diastolic blood pressure abnormality. In addition, age had an effect modifier on the association of PRM intake status with risk of abnormal triglyceride index (Pinteraction = 0.004) and risk of abnormal HDL index (Pinteraction = 0.018). After adjusting for potential confounding variables, logistic regression showed that the OR for substandard HbA1c control in patients in the highest PRM intake group, T3 (3.4 ~ 57.2 g/d), was 1.620-fold higher than in the lowest intake, i.e., the no-intake group, T1 (0.0 ~ 0.0 g/d; OR = 2.620; 95% CI 1.198 ~ 5.732; p = 0.016). Whereas the OR for abnormal control of systolic blood pressure levels was 1.025 times higher (OR = 2.025; 95% CI 1.033 ~ 3.968; p = 0.040) in patients in the PRM low intake group T2 (0.1 ~ 3.3 g/d) than in the non-intake group T1 (0.0 ~ 0.0 g/d), the OR for substandard control of systolic blood pressure in patients in the highest group T3 (3.4 ~ 57.2 g/d) was 1.166 times higher than in the no-intake group T1 (OR = 2.166; 95% CI 1.007 ~ 4.660; p = 0.048). The OR for abnormal TG levels in patients in the highest PRM intake group T3 (3.4 ~ 57.2 g/d) was 1.095 times higher than in the no-intake group T1 (OR = 2.095; 95% CI 1.076 ~ 4.078; p = 0.030). Restricted cubic spline plots presented a nonlinear dose-response relationship between PRM intake and risk of substandard HbA1c and SBP control (P nonlinear <0.05), and an atypical inverted U-shaped association between PRM intake and TC and LDL-C levels (P nonlinear <0.05). The strength of the associations between PRM intake and the control levels of FPG, DBP, HDL-C, and TG were not statistically significant (p > 0.05).

Conclusion

PRM intake was generally low in patients with T2DM, but a nonlinear dose-response relationship between PRM intake and the risk of suboptimal control of HbA1c and SBP, with an atypical inverted U-shaped association with TC and LDL-C levels, was observed. Appropriate control of PRM intake may be important for tertiary prevention of T2DM and cardiovascular disease prevention. We need to better understand these relationships to promote improved cardiometabolism and global health.

Exercise, Dialysis, and Environment: A Narrative Review in an Ecological Perspective

BACKGROUND

Patient empowerment and environmental sustainability may contribute to creating efficient and resilient healthcare models. Chronic kidney diseases call for a sustainable approach aimed at improving physical function and mental health of patients and possibly contributing to the slowing down of the evolution toward the end stage of renal disease (ESRD) with a reduction of the environmental and economic impact.

SUMMARY

Multidisciplinary interventions should be implemented particularly, at the final stages when patients are exposed to sedentariness, reduced health-related quality of life (HR-QoL), high cardiovascular morbidity and mortality, and the healthcare services to high costs, and participation in environmental pollution. Ecological strategies based on specific nutritional approaches, exercise, and environment should be designed and tested. In particular, the introduction to physical exercise represents a useful replacement therapy to counteract the hazards derived from the sedentary behavior of ESRD patients, with low physical function associated with poor clinical outcomes. A more active and healthy lifestyle, particularly in the natural environment, could impact HR-QoL, mental and physical well-being but also on socialization, with lower anxiety and fatigue stress levels. Otherwise, combining sustainable exercise models into the patient's daily routine can be enhanced by the biophilic design called to reproduce a natural environment in the dialysis center. Finally, the involvement of the personnel and the health professionals in properly managing the exercise interventions and the related factors (location, modality, dose, intensity, and duration) might improve the patients' participation. In particular, ecological programs should be broadly inclusive and aimed to target the lowest performing populations through minimal feasible doses of exercise.

KEY MESSAGES

Moving toward an ecological framework of lifestyle change in the very advanced stages of kidney disease, the potential synergies between environment, diet, and exercise may improve the physical and mental health of the patients and reduce the impact of dialysis.

Spatial metabolomics using mass-spectrometry imaging to decipher the impact of high red meat diet on the colon metabolome in rat

Colorectal cancer (CRC) is the third most common cancer in the world with a higher prevalence in the developed countries, mainly caused by environmental and lifestyle factors such as diet, particularly red meat consumption. The metabolic impact of high red meat consumption on the epithelial part of the colon was investigated using Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging (MSI), to specifically analyze the epithelial substructure. Ten colons from rats fed for 100 days high red or white meat diet were subjected to untargeted MSI analyses using two spatial resolutions (100 μm and 10 μm) to evaluate metabolite changes in the epithelial part and to visualize the distribution of metabolites of interest within the epithelium crypts. Our results suggest a specific effect of red meat diet on the colonic epithelium metabolism, as evidenced by an increase of purine catabolism products or depletion in glutathione pool, reinforcing the hypothesis of increased oxidative stress with red meat diet. This study also highlighted cholesterol sulfate as another up-regulated metabolite, interestingly localized at the top of the crypts. Altogether, this study demonstrates the feasibility and the added value of using MSI to decipher the effect of high red meat diet on the colonic epithelium.

In Healthy Pathways of Dietary Changes, a Very Rapid Reduction of Red Meat Is Possible, but Specific Diet Changes Are Required for Full Reduction-A Graph-Based Analysis

BACKGROUND

Although reducing meat consumption is becoming increasingly popular in Western countries, such a transition to a sustainable diet may pose some nutritional risks.

OBJECTIVES

We aim to analyze the pathways for reaching a low-meat healthy diet and the changes in other food categories needed to rapidly decrease total red meat consumption.

METHODS

We used a recently developed method based on graph theory to represent all possible pathways of stepwise changes that avoid nutritional deficiencies toward a target healthy diet. Initial and target diets were defined as the daily consumption of 33 food groups. For each sex, 3 initial diets were taken from the French representative survey third individual and national study on food consumption survey as the mean observed diet and low (first quintile) and high (fifth quintile) meat consumption. Target diets were identified using multicriteria optimization to minimize the long-term health risk (HR) of chronic diseases while ensuring nutritional adequacy. The Dijkstra algorithm was used to identify the optimal pathways between the initial and target diets, with the aim of reducing meat consumption as quickly as possible and thus minimizing long-term HRs.

RESULTS

Unprocessed red meat was easily minimized in the first steps of the pathways regardless of sex and initial level of meat consumption. However, processed meat could only be decreased later and required prior changes such as increases in fruit, vegetables, and oily fish. During total red meat minimization in females, securing adequate intakes of bioavailable iron had the most substantial impact on the other dietary changes needed.

CONCLUSIONS

Immediate reduction of red meat consumption is possible on the pathway to a healthy diet that avoids any nutrient deficiency. However, early increases in fruit, vegetables, and fish are required before minimizing total red meat early in the diet.

Meat consumption and the risk of hip fracture in women and men: two prospective Swedish cohort studies

PURPOSE

To study the association between meat intake (predominantly red and processed meats) and the risk of hip fracture, as well as the association between meat intake and biomarkers of inflammation, oxidative stress, bone turnover, body composition, and bone mineral density (BMD).

METHODS

Data from the Swedish Mammography Cohort and the Cohort of Swedish men (n = 83,603, 54% men) with repeated investigations and their respective clinical sub-cohorts was utilised. Incident hip fractures were ascertained through individual linkage to registers. Associations were investigated using multivariable Cox and linear regression analyses.

RESULTS

During up to 23 years of follow-up (mean 18.2 years) and 1,538,627 person-years at risk, 7345 participants (2840 men) experienced a hip fracture. Each daily serving of meat intake conferred a hazard ratio (HR) of 1.03 (95% confidence interval [CI] 1.00; 1.06) for hip fracture. In quintile 5, compared to quintile 2, the HR was 1.11 (95% CI 1.01; 1.21) among all participants. In the sub-cohorts, meat intake was directly associated with circulating levels of interleukin-6, C-reactive protein, leptin, ferritin, parathyroid hormone, and calcium.

CONCLUSION

A modest linear association was found between a higher meat intake and the risk of hip fractures. Our results from the sub-cohorts further suggest that possible mechanisms linking meat intake and hip fracture risk may be related to the regulation of bone turnover, subclinical inflammation, and oxidative stress. Although estimates are modest, limiting red and processed meat intake in a healthy diet is advisable to prevent hip fractures.

Associations between Long-Term Dietary Coenzyme Q10 Intake and New-Onset Hypertension in Adults: Insights from a Nationwide Prospective Cohort Study

Coenzyme Q10 (CoQ10) supplementation appears to be associated with a lower blood pressure. Nevertheless, it remains unclear whether food-sourced CoQ10 will affect new-onset hypertension in general adults. This study investigated the relationship between dietary CoQ10 intake and new-onset hypertension among the general population. Participants without hypertension at baseline from the China Health and Nutrition Survey (CHNS) prospective cohort study were included (n = 11,428). Dietary CoQ10 intake was collected by validated dietary recalls and the food weighing method. Linear and non-linear relationships between dietary CoQ10 intake and new-onset hypertension were analyzed using multivariable Cox proportional hazards models and restricted cubic splines. During follow-up (median: 6 years), 4006 new-onset hypertension cases were documented. Compared with non-consumers, the hazard ratio (HR) and 95% confidence interval (CI) from quintile 2 to 4 total dietary CoQ10 were 0.83 (0.76, 0.91), 0.86 (0.78, 0.94) and 1.01 (0.92, 1.11); total plant-derived CoQ10 were 0.80 (0.73, 0.88), 1.00 (0.91, 1.09) and 1.10 (1.00, 1.20); and animal-derived CoQ10 were 0.65 (0.59, 0.71), 0.58 (0.53, 0.64) and 0.68 (0.62, 0.75). The lowest risk was found at moderate intake, with a non-linear relationship (P nonlinearity < 0.05). Furthermore, the overall inverse association was stronger among individuals without alcohol consumption or eating a low-fat diet. Moderate long-term dietary CoQ10 intake might be protective against new-onset hypertension. However, it follows a non-linear relationship and excessive intake may increase the risk of new-onset hypertension in the Chinese population.

Impact of Substituting Meats with Plant-Based Analogues on Health-Related Markers: A Systematic Review of Human Intervention Studies

The growing drive towards more sustainable dietary patterns has led to an increased demand for and availability of plant-based meat analogues (PBMAs). This systematic review aims to summarize the currently available evidence from human intervention studies investigating the impact of substituting animal meat (AM) with PBMAs in adults. A total of 19 studies were included. Overall, an increase in satiety following PBMA intake was reported, albeit to different extents and not always accompanied by changes in leptin and ghrelin. PBMAs generally resulted in lower protein bioavailability and a smaller increase in plasma essential amino acids in comparison to AM. However, muscle protein synthesis and physical performance were not affected. Finally, conflicting results have been reported for other outcomes, such as pancreatic and gastrointestinal hormones, oxidative stress and inflammation, vascular function, and microbiota composition. In conclusion, we documented that the impact of substituting AM with PBMA products has been scarcely investigated. In addition, the heterogeneity found in terms of study design, population, outcomes, and findings suggests the need for additional high-quality intervention trials, particularly long-term ones, to better clarify the advantages and potential critical issues of such substitutions within sustainable healthy diets.

Health Benefits of Vegetarian Diets: An Insight into the Main Topics

Vegetarian diets are plant-based diets including all the edible foods from the Plant Kingdom, such as grains, legumes, vegetables, fruits, nuts, and seeds. Dairy and eggs can be added in small amounts in the lacto-ovo-vegetarian subtype, or not at all in the vegan subtype. The abundance of non-processed plant foods-typical of all well-planned diets, including vegetarian ones-can provide the body with numerous protective factors (fiber, phytocompounds), while limiting the intake of harmful nutrients like saturated fats, heme-iron, and cholesterol. The beneficial effects on health of this balance have been reported for many main chronic diseases, in both observational and intervention studies. The scientific literature indicates that vegetarians have a lower risk of certain types of cancer, overall cancer, overweight-obesity, type 2 diabetes, dyslipidemia, hypertension, and vascular diseases. Since the trend of following a vegetarian diet is increasing among citizens of developed countries, the knowledge in the field will benefit from further studies confirming the consistency of these findings and clarifying the effects of vegetarian diets on other controversial topics.

Choline consumption reduces CVD risk via body composition modification

Despite extensive research on the relationship between choline and cardiovascular disease (CVD), conflicting findings have been reported. We aim to investigate the relationship between choline and CVD. Our analysis screened a retrospective cohort study of 14,663 participants from the National Health and Nutrition Examination Survey conducted between 2013 and 2018. Propensity score matching and restricted cubic splines was used to access the association between choline intake and the risk of CVD. A two-sample Mendelian randomization (MR) analysis was conducted to examine the potential causality. Additionally, sets of single cell RNA-sequencing data were extracted and analyzed, in order to explore the role of choline metabolism pathway in the progression and severity of the CVD and the underlying potential mechanisms involved. The adjusted odds ratios and 95% confidence intervals for stroke were 0.72 (0.53-0.98; p = 0.035) for quartile 3 and 0.54 (0.39-0.75; p < 0.001) for quartile 4. A stratified analysis revealed that the relationship between choline intake and stroke varied among different body mass index and waist circumference groups. The results of MR analysis showed that choline and phosphatidylcholine had a predominantly negative causal effect on fat percentage, fat mass, and fat-free mass, while glycine had opposite effects. Results from bioinformatics analysis revealed that alterations in the choline metabolism pathway following stroke may be associated with the prognosis. Our study indicated that the consumption of an appropriate quantity of choline in the diet may help to protect against CVD and the effect may be choline-mediated, resulting in a healthier body composition. Furthermore, the regulation of the choline metabolism pathway following stroke may be a promising therapeutic target.

Global burden and cross-country inequalities in stroke and subtypes attributable to diet from 1990 to 2019

DATA SOURCES

The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019.

BACKGROUND

To describe burden, and to explore cross-country inequalities according to socio-demographic index (SDI) for stroke and subtypes attributable to diet.

METHODS

Death and years lived with disability (YLDs) data and corresponding estimated annual percentage changes (EAPCs) were estimated by year, age, gender, location and SDI. Pearson correlation analysis was performed to evaluate the connections between age-standardized rates (ASRs) of death, YLDs, their EAPCs and SDI. We used ARIMA model to predict the trend. Slope index of inequality (SII) and relative concentration index (RCI) were utilized to quantify the distributive inequalities in the burden of stroke.

RESULTS

A total of 1.74 million deaths (56.17% male) and 5.52 million YLDs (55.27% female) attributable to diet were included in the analysis in 2019.Between 1990 and 2019, the number of global stroke deaths and YLDs related to poor diet increased by 25.96% and 74.76% while ASRs for death and YLDs decreased by 42.29% and 11.34% respectively. The disease burden generally increased with age. The trends varied among stroke subtypes, with ischemic stroke (IS) being the primary cause of YLDs and intracerebral hemorrhage (ICH) being the leading cause of death. Mortality is inversely proportional to SDI (R = -0.45, p < 0.001). In terms of YLDs, countries with different SDIs exhibited no significant difference (p = 0.15), but the SII changed from 38.35 in 1990 to 45.18 in 2019 and the RCI showed 18.27 in 1990 and 24.98 in 2019 for stroke. The highest ASRs for death and YLDs appeared in Mongolia and Vanuatu while the lowest of them appeared in Israel and Belize, respectively. High sodium diets, high red meat consumption, and low fruit diets were the top three contributors to stroke YLDs in 2019.

DISCUSSION

The burden of diet-related stroke and subtypes varied significantly concerning year, age, gender, location and SDI. Countries with higher SDIs exhibited a disproportionately greater burden of stroke and its subtypes in terms of YLDs, and these disparities were found to intensify over time. To reduce disease burden, it is critical to enforce improved dietary practices, with a special emphasis on mortality drop in lower SDI countries and incidence decline in higher SDI countries.

Protein transition: focus on protein quality in sustainable alternative sources

The current consumption trends, combined with the expected demographic growth in the coming years, call for a protein transition, i.e., the partial substitution of animal protein-rich foods with foods rich in proteins produced in a more sustainable way. Here, we have discussed some of the most common and promising protein sources alternative to animal proteins, namely: legumes, insects, and microorganisms (including microalgae and fungi). The primary objective was to assess their nutritional quality through the collection of digestible indispensable amino acid score (DIAAS) values available in the scientific literature. Protein digestibility corrected amino acid score (PDCAAS) values have been used where DIAAS values were not available. The ecological impact of each protein source, its nutritional quality and the potential applications in traditional foods or novel food concepts like meat analogues are also discussed. The data collected show that DIAAS values for animal proteins are higher than all the other protein sources. Soybean proteins, mycoproteins and proteins of some insects present relatively high DIAAS (or PDCAAS) values and must be considered proteins of good quality. This review also highlights the lack of DIAAS values for many potentially promising protein sources and the variability induced by the way the proteins are processed.

Silicon as a Functional Meat Ingredient Improves Jejunal and Hepatic Cholesterol Homeostasis in a Late-Stage Type 2 Diabetes Mellitus Rat Model

Silicon included in a restructured meat (RM) matrix (Si-RM) as a functional ingredient has been demonstrated to be a potential bioactive antidiabetic compound. However, the jejunal and hepatic molecular mechanisms by which Si-RM exerts its cholesterol-lowering effects remain unclear. Male Wistar rats fed an RM included in a high-saturated-fat high-cholesterol diet (HSFHCD) combined with a low dose of streptozotocin plus nicotinamide injection were used as late-stage type 2 diabetes mellitus (T2DM) model. Si-RM was included into the HSFHCD as a functional food. An early-stage TD2M group fed a high-saturated-fat diet (HSFD) was taken as reference. Si-RM inhibited the hepatic and intestinal microsomal triglyceride transfer protein (MTP) reducing the apoB-containing lipoprotein assembly and cholesterol absorption. Upregulation of liver X receptor (LXRα/β) by Si-RM turned in a higher low-density lipoprotein receptor (LDLr) and ATP-binding cassette transporters (ABCG5/8, ABCA1) promoting jejunal cholesterol efflux and transintestinal cholesterol excretion (TICE), and facilitating partially reverse cholesterol transport (RCT). Si-RM decreased the jejunal absorptive area and improved mucosal barrier integrity. Consequently, plasma triglycerides and cholesterol levels decreased, as well as the formation of atherogenic lipoprotein particles. Si-RM mitigated the dyslipidemia associated with late-stage T2DM by Improving cholesterol homeostasis. Silicon could be used as an effective nutritional approach in diabetic dyslipidemia management.

Dietary diversity score and the acceleration of biological aging: a population-based study of 88,039 participants

OBJECTIVES

Our study aimed to investigate the association of dietary diversity score (DDS), as reflected by five dietary categories, with biological age acceleration.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

This study included 88,039 individuals from the UK Biobank.

METHODS

Biological age (BA) was assessed using Klemerae-Doubal (KDM) and PhenoAge methods. The difference between BA and chronological age represents the age acceleration (AgeAccel), termed as "KDMAccel" and "PhenoAgeAccel". AgeAccel > 0 indicates faster aging. Generalized linear regression models were performed to assess the associations of DDS with AgeAccel. Similar analyses were performed for the five dietary categories.

RESULTS

After adjusting for multiple variables, DDS was inversely associated with KDMAccel (βHigh vs Low= -0.403, 95%CI: -0.492 to -0.314, P < 0.001) and PhenoAgeAccel (βHigh vs Low= -0.545, 95%CI: -0.641 to -0.450, P < 0.001). Each 1-point increment in the DDS was associated with a 4.4% lower risk of KDMAccel and a 5.6% lower risk of PhenoAgeAccel. The restricted cubic spline plots demonstrated a non-linear dose-response association between DDS and the risk of AgeAccel. The consumption of grains (βKDMAccel = -0.252, βPhenoAgeAccel = -0.197), vegetables (βKDMAccel = -0.044, βPhenoAgeAccel = -0.077) and fruits (βKDMAccel = -0.179, βPhenoAgeAccel = -0.219) was inversely associated with the two AgeAccel, while meat and protein alternatives (βKDMAccel = 0.091, βPhenoAgeAccel = 0.054) had a positive association (All P < 0.001). Stratified analysis revealed stronger accelerated aging effects in males, smokers, and drinkers. A strengthening trend in the association between DDS and AgeAccel as TDI quartiles increased was noted.

CONCLUSIONS

This study suggested that food consumption plays a role in aging process, and adherence to a higher diversity dietary is associated with the slowing down of the aging process.

Self-reported consumption frequency of meat and fish products among young adults in Kazakhstan

Background: Meat and dairy products are important ingredients in Kazakhstan, although there are indications that high consumption of red and processed meat is associated with a risk of several non-communicable diseases and has an adverse impact on the environment. Aim: The aim of this study was to investigate the dietary habits of young adults in Kazakhstan, particularly meat and fish consumption frequency among university students in five regions of Kazakhstan. Methods: The assessment of meat and fish consumption was based on the food frequency questionnaire. Region of residence, age, sex, weight, height and parental education were also self-reported. Results: Meat consumption among the participants was lower than recommended consumption of 1500 g per week in Kazakhstan but almost two-fold higher than the World Cancer Research Fund recommendations of 500 g per week. Approximately 24% of the participants reported to consume meat every day. Only 8.6% of the participants reported fish consumption in line with the recommendation of approximately 270 g per week in Kazakhstan. Meat and fish consumption was fairly homogeneous across regions and sex. Conclusion: The results from this study contribute to the relatively limited information on meat and fish consumption in Kazakhstan. Further knowledge on dietary habits and probably improved nutrition recommendations on meat consumption in Kazakhstan are needed to protect public health and the environment.

Tyrosine nitration of glucagon impairs its function: Extending the role of heme in T2D pathogenesis

New studies raise the possibility that the higher glucagon (GCG) level present in type 2 diabetes (T2D) is a compensatory mechanism to enhance β-cell function, rather than induce dysregulated glucose homeostasis, due to an important role for GCG that acts directly within the pancreas on insulin secretion by intra-islet GCG signaling. However, in states of poorly controlled T2D, pancreatic α cell mass increases (overproduced GCG) in response to insufficient insulin secretion, indicating decreased local GCG activity. The reason for this decrease is not clear. Recent evidence has uncovered a new role of heme in cellular signal transduction, and its mechanism involves reversible binding of heme to proteins. Considering that protein tyrosine nitration in diabetic islets increases and glucose-stimulated insulin secretion (GSIS) decreases, we speculated that heme modulates GSIS by transient interaction with GCG and catalyzing its tyrosine nitration, and the tyrosine nitration may impair GCG activity, leading to loss of intra-islet GCG signaling and markedly impaired insulin secretion. Data presented here elucidate a novel role for heme in disrupting local GCG signaling in diabetes. Heme bound to GCG and induced GCG tyrosine nitration. Two tyrosine residues in GCG were both sensitive to the nitrating species. Further, GCG was also demonstrated to be a preferred target peptide for tyrosine nitration by co-incubation with BSA. Tyrosine nitration impaired GCG stimulated cAMP-dependent signaling in islet β cells and decreased insulin release. Our results provided a new role of heme for impaired GSIS in the pathological process of diabetes.

Consumption of red, white, and processed meat and odds of developing kidney damage and diabetic nephropathy (DN) in women: a case control study

Diabetic nephropathy (DN) is one of the most prevalent and severe complications of diabetes mellitus (DM) and is associated with increased morbidity and mortality. We aimed to investigate the associations between red, processed, and white meat consumption and the odds of developing kidney damage and DN in women. We enrolled 105 eligible women with DN and 105 controls (30-65 years). A validated and reliable food frequency questionnaire (FFQ) was used to evaluate the consumption of red, processed, and white meat. Biochemical variables and anthropometric measurements were assessed for all patients using pre-defined protocols. Binary logistic regression was conducted to examine possible associations. The results of the present study showed that there was a direct significant association between high consumption of red meat and processed meats and odds of microalbuminuria (red meat 2.30, 95% CI 1.25, 4.22; P-value = 0.007, processed meat: OR 2.16, 95% CI 1.18, 3.95; P-value = 0.01), severe albuminuria (red meat OR 3.25, 95% CI 1.38, 7.46; P-value = 0.007, processed meat: OR 2.35, 95% CI 1.01, 5.49; P-value = 0.04), BUN levels (red meat: OR 2.56, 95% CI 1.10, 5.93; P-value = 0.02, processed meat: OR 2.42, 95% CI 1.04, 5.62; P-value = 0.03), and DN (red meat 2.53, 95% CI 1.45, 4.42; P-value = 0.001, processed meat: OR 2.21; 95% CI 1.27, 3.85; P-value = 0.005). In summary, our study suggests that higher consumption of red and processed meat sources may be associated with microalbuminuria, severe albuminuria, higher BUN level, and higher odds of DN.

Circular food system approaches can support current European protein intake levels while reducing land use and greenhouse gas emissions

Protein transition and circular food system transition are two proposed strategies for supporting food system sustainability. Here we model animal-sourced protein to plant-sourced protein ratios within a European circular food system, finding that maintaining the current animal-plant protein share while redesigning the system with circular principles resulted in the largest relative reduction of 44% in land use and 70% in greenhouse gas (GHG) emissions compared with the current food system. Shifting from a 60:40 to a 40:60 ratio of animal-sourced proteins to plant-sourced proteins yielded a 60% reduction in land use and an 81% GHG emission reduction, while supporting nutritionally adequate diets. Differences between current and recommended total protein intake did not substantially impact minimal land use and GHG emissions. Micronutrient inadequacies occurred with less than 18 g animal protein per capita per day. Redesigning the food system varied depending on whether land use or GHG emissions were reduced-highlighting the need for a food system approach when designing policies to enhance human and planetary health.