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Nicol K, Nugent AP, Woodside JV, Hart KH, Bath SC. Iodine and plant-based diets: a narrative review and calculation of iodine content. Br J Nutr 2024; 131:265-275. [PMID: 37622183 PMCID: PMC10751939 DOI: 10.1017/s0007114523001873] [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: 02/24/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
An increasing number of food-based recommendations promote a plant-based diet to address health concerns and environmental sustainability in global food systems. As the main sources of iodine in many countries are fish, eggs and dairy products, it is unclear whether plant-based diets, such as the EAT-Lancet reference diet, would provide sufficient iodine. This is important as iodine, through the thyroid hormones, is required for growth and brain development; adequate iodine intake is especially important before, and during, pregnancy. In this narrative review, we evaluated the current literature and estimated iodine provision from the EAT-Lancet reference diet. There is evidence that those following a strict plant-based diet, such as vegans, cannot reach the recommended iodine intake from food alone and are reliant on iodine supplements. Using the EAT-Lancet reference diet intake recommendations in combination with iodine values from UK food tables, we calculated that the diet would provide 128 μg/d (85 % of the adult recommendation of 150 μg/d and 51–64 % of the pregnancy recommendation of 200–250 μg/d). However, if milk is replaced with unfortified plant-based alternatives, total iodine provision would be just 54 μg/d (34 % and 22–27 % of the recommendations for adults and pregnancy, respectively). Plant-based dietary recommendations might place consumers at risk of iodine deficiency in countries without a fortification programme and where animal products provide the majority of iodine intake, such as the UK and Norway. It is essential that those following a predominantly plant-based diet are given appropriate dietary advice to ensure adequate iodine intake.
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Affiliation(s)
- Katie Nicol
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Anne P. Nugent
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Northern Ireland, UK
| | - Jayne V. Woodside
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Northern Ireland, UK
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Kathryn H. Hart
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
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2
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Bal-Prylypko L, Nikolaenko M, Volkhova T, Holembovska N, Tyshchenko L, Ivaniuta A, Israelian V, Menchynska A, Shynkaruk O, Melnik V. The study of functional and technological properties of vegetarian ice cream. POTRAVINARSTVO 2023. [DOI: 10.5219/1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
The use perspective and expediency of plant-based milk, enriched with fiber when combined with organic products, biobased products, and sugar substitute products, has been substantiated in the manufacturing process of vegetarian ice cream. When combined with pumpkin fiber, stevia, bananas, pistachios, coconut oil, and coffee beans with different functional and technological properties, rice milk has a purposeful influence on organoleptic and Physico-chemical properties of food products. Accordingly, the expediency of added rice milk (62%) has been determined to optimize vegetarian ice cream's vitamin and mineral composition. The optimal component ratio has been determined employing experimental studies and multi-criteria optimization: for ice cream "Banana & Pistachio": rice milk – 62%, pumpkin fiber – 2.5%, – 0.5%, banana – 16%, pistachio – 6.8%, coconut oil – 12.2%; “Coffee and chocolate”: rice milk – 62%, pumpkin fiber – 4.8%, stevia – 4%, cocoa powder – 7%, coffee beans – 8%, coconut oil – 14.2%, It has been found that the main physicochemical parameters of the vegetarian ice cream depend on the chemical composition of the ice cream mixture and its freezing conditions. Thus, when the fat content increases, the stability of air bubbles increases, but their sizes decrease. The study results make it clear that the increase in the fat amount is good for the ice cream structure and consistency, while the distance between the fat balls decreases, which, in turn, helps to obtain the product with the smaller ice crystals.
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Zaremba A, Gramza-Michalowska A, Pal K, Szymandera-Buszka K. The Effect of a Vegan Diet on the Coverage of the Recommended Dietary Allowance (RDA) for Iodine among People from Poland. Nutrients 2023; 15:nu15051163. [PMID: 36904161 PMCID: PMC10005417 DOI: 10.3390/nu15051163] [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: 02/01/2023] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
The aim of this research was to estimate the effect of a vegan diet on the Recommended Dietary Allowance (RDA) coverage for iodine in people from Poland. It was hypothesized that the problem of iodine deficiency is a concern, especially among vegans. The survey study was conducted in the years 2021-2022 on 2200 people aged 18-80 with omnivore and vegan diets. The exclusion criteria in the study were pregnancy and lactation. The study found that the coverage of RDA for iodine among people with a vegan diet was lower than among people with an omnivore diet (p < 0.05); 90% of the participants with a vegan diet had an iodine intake below 150 µg/day. Plant-based dairy and meat analogs were consumed by vegans frequently and in large portions, but none were fortified with iodine. It was found that iodized salt was each group's primary source of iodine. However, it was observed that the iodine supply from this source was limited among vegans, especially in female subjects, who consumed less salt and smaller portions of meals. That is why consideration should be given to the iodine fortification of plant-based foods commonly consumed by vegans.
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Affiliation(s)
- Agata Zaremba
- Department of Gastronomy Science and Functional Foods, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Anna Gramza-Michalowska
- Department of Gastronomy Science and Functional Foods, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Kunal Pal
- Department of Biotechnology and Medical Engineering, National Institute of Technology, Rourkela 769008, India
| | - Krystyna Szymandera-Buszka
- Department of Gastronomy Science and Functional Foods, Faculty of Food Science and Nutrition, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
- Correspondence:
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Sasidharan Pillai S, Quintos JB. Thyroid function tests of iodine deficiency goiter can mimic thyroid hormone resistance alpha. J Pediatr Endocrinol Metab 2022; 35:1433-1436. [PMID: 36100365 DOI: 10.1515/jpem-2022-0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/29/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Iodine deficiency goiter can develop in children on a restrictive diet and most have normal thyroid function. We report a 6-year-old girl with iodine deficiency goiter with thyroid function studies mimicking thyroid hormone resistance alpha. Thyroid hormones mediate its effects through thyroid hormone receptors alpha and beta. Biochemical picture of low/low-normal T4 and high/high-normal T3 levels, variably reduced reverse T3 and normal TSH is characteristic of thyroid hormone resistance alpha. CASE PRESENTATION A 6-year-old girl, born out of non-consanguineous marriage presented with goiter of 1.5 years duration. She was without symptoms of thyroid dysfunction. The patient was evaluated at one year of age for macrocephaly with cranial ultrasound which was normal. She had normal growth and development. Patient was vegan and was not on any medications or supplements. Laboratory work up showed TSH 5.03 uIU/mL (0.34-5.5), FT4 0.3 ng/dL (0.58-1.2), FT3 5.3 pg/mL (2.5-3.9), total T3 258 ng/dL (94-241), reverse T3 <5.0 ng/dL (8.3-22.9) and negative thyroglobulin antibody and thyroid peroxidase antibody. Thyroglobulin level was 1,098.8 ng/mL (<13 ug/L), and urine iodine 15.8 ug/L (<100 ug/L) confirming a diagnosis of iodine deficiency goiter. Patient was started on iodine supplements, 150 ug daily and repeat work up 3 months later were TSH: 2.717 uIU/mL, T3, total 182 ng/dL, T4, total 9.3 ug/dL, FT 4 2.1 ng/dL. CONCLUSIONS Iodine deficiency goiter may present with low FT 4, elevated T3 and normal TSH mimicking thyroid hormone resistance alpha and should be considered in children on restrictive diet.
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Affiliation(s)
- Sabitha Sasidharan Pillai
- Division of Pediatric Endocrinology, Hasbro Children's Hospital, Providence, USA.,Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jose Bernardo Quintos
- Division of Pediatric Endocrinology, Hasbro Children's Hospital, Providence, USA.,Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Severe Hypothyroidism and Large Goiter due to Iodine Deficiency in an Adolescent Male in the United States: A Case Report and Review of the Literature. Case Rep Endocrinol 2022; 2022:7235102. [PMID: 36387937 PMCID: PMC9646315 DOI: 10.1155/2022/7235102] [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: 08/17/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
Acquired hypothyroidism due to iodine deficiency is extremely rare in the United States due to the introduction of table salt iodization in the 1920s (Leung et al., 2012). We present the case of an adolescent male with a history of mild autism spectrum disorder and an extremely restrictive diet who was found to have iodine deficiency as the etiology for his rapidly enlarging goiter and antibody-negative hypothyroidism. Thyroid-stimulating hormone (TSH) was 416 μIU/mL (0.350–5.500 μIU/mL), free thyroxine (T4) was <0.1 ng/dL (0.80–1.80 ng/dL), and triiodothyronine (T3) was 41 ng/dL (82–213 mg/dL) at diagnosis. The patient's 24-hour urinary iodine was undetectable. He was started on iodine supplementation with rapid visible improvement of goiter within two weeks and normalization of thyroid function tests within four weeks. Thorough dietary history and nutritional screening are important in cases of acquired hypothyroidism and/or goiter. Alternatively, diets that are low in iodized salt, dairy, bread, and seafood should raise concern for iodine deficiency, and patients with suspected or proven iodine deficiency should be screened for hypothyroidism.
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Escobar-Sáez D, Montero-Jiménez L, García-Herrera P, Sánchez-Mata M. Plant-based drinks for vegetarian or vegan toddlers: Nutritional evaluation of commercial products, and review of health benefits and potential concerns. Food Res Int 2022; 160:111646. [DOI: 10.1016/j.foodres.2022.111646] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 01/29/2023]
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Andersson M, Braegger CP. The Role of Iodine for Thyroid Function in Lactating Women and Infants. Endocr Rev 2022; 43:469-506. [PMID: 35552681 PMCID: PMC9113141 DOI: 10.1210/endrev/bnab029] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 12/18/2022]
Abstract
Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.
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Affiliation(s)
- Maria Andersson
- Nutrition Research Unit, University Children's Hospital Zurich, CH-8032 Zürich, Switzerland
| | - Christian P Braegger
- Nutrition Research Unit, University Children's Hospital Zurich, CH-8032 Zürich, Switzerland
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8
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Abstract
Iodine is essential for thyroid hormone synthesis. Individuals adhering to vegan and vegetarian diets have been found to be vulnerable to iodine deficiency. Yet, iodine has not been monitored in these groups across time. This study aims to investigate iodine status, intake and knowledge in vegans, vegetarians and omnivores and determine changes between 2016-2017 and 2019. Dietary intake (µg/d) was estimated by 3-d food diaries and iodine FFQ. Urinary iodine concentration, analysed by inductively coupled plasma mass spectrometry, assessed iodine status according to WHO criteria. Iodine knowledge was scored by an adapted questionnaire. IBM SPSS was used for statistical analysis. Ninety-six adults (18-60 years) were recruited in October 2016-2017 (vegans: 12; vegetarians: 5; omnivores: 43) and June 2019 (vegans: 7; vegetarians: 10;omnivores: 19). Median dietary iodine was below the Reference Nutrient Intake for all groups. Vegans and vegetarians had the lowest iodine intake. Vegans had significantly lower iodine intake than omnivores (2016-2017, P = 0 032; 2019, P = 0 001). Omnivores had the highest iodine status (2016-2017, 79 4 µg/l; 2019, 72 4 µg/l) and vegans the lowest (2016-2017, 31 2 µg/l; 2019, 12 2 µg/l). Iodine knowledge was poor but did not differ between dietary groups (2016-2017, P = 0 219; 2019, P = 0 532). Vegans and vegetarians continue to be at risk of iodine deficiency. Further, iodine intake in the UK is poor independent of dietary choice. Iodine education is needed along with research into improving iodine nutrition at national level.
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Iannuzzo G, Campanozzi A, Trevisani V, Rutigliano I, Abate V, Rendina D, De Filippo G. Iodine Requirements in Pediatrics: From Fetal Life to Adolescence. Front Endocrinol (Lausanne) 2022; 13:929176. [PMID: 35846277 PMCID: PMC9283703 DOI: 10.3389/fendo.2022.929176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
The aim of this mini-review is to present the current knowledge on iodine requirements in developmental age, from conception to adolescence. It is based on the analysis of updated national and international guidelines on iodine intake and the prevention of iodine deficiency. Health policy initiatives carried out in industrialized countries in previous decades have led to a dramatic improvement in nutritional iodine status in the general population. However, the prevention of iodine deficit continues to be a concern, especially for vulnerable categories, like adolescents and pregnant women.
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Affiliation(s)
- Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Angelo Campanozzi
- Pediatrics, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Angelo Campanozzi,
| | - Viola Trevisani
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d’Endocrinologie-Diabétologie, Paris, France
- Post Graduate School of Pediatrics, Departement of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Irene Rutigliano
- Pediatrics, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
- PhD Student, University of Fogggia, Foggia, Italy
| | - Veronica Abate
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d’Endocrinologie-Diabétologie, Paris, France
- French Clinical Research Group in Adolescent Medicine and Health, Paris, France
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Calcaterra V, Mameli C, Rossi V, Massini G, Gambino M, Baldassarre P, Zuccotti G. The Iodine Rush: Over- or Under-Iodination Risk in the Prophylactic Use of Iodine for Thyroid Blocking in the Event of a Nuclear Disaster. Front Endocrinol (Lausanne) 2022; 13:901620. [PMID: 35692388 PMCID: PMC9178126 DOI: 10.3389/fendo.2022.901620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Iodine is an essential element for the production of thyroid hormones (THs). Both deficient and excess iodine intakes may precipitate in adverse thyroidal events. Radioactive iodine (RI) is a common byproduct of nuclear fission processes. During nuclear emergencies RI may be released in a plume, or cloud, contaminating the environment. If inhaled or ingested, it may lead to internal radiation exposure and the uptake of RI mainly by the thyroid gland that absorbs stable iodine (SI) and RI in the same way. A dose of radiation delivered to the thyroid gland is a main risk factor for the thyroid cancer development. The SI prophylaxis helps prevent childhood thyroid cancer. The thyroid gland saturation with prophylactic SI ingestion, reduces the internal exposure of the thyroid by blocking the uptake of RI and inhibiting iodide organification. However, negative impact of inadequate SI intake must be considered. We provide an overview on the recommended iodine intake and the impact of SI and RI on thyroid in children and adolescents, discussing the benefits and adverse effects of the prophylactic SI for thyroid blocking during a nuclear accident. The use of SI for protection against RI may be recommended in cases of radiological or nuclear emergencies, moreover the administration of iodine for prophylactic purposes should be cautious. Benefits and risks should also be considered according to age. Adverse effects from iodine administration cannot be excluded. Precise indications are mandatory to use the iodine for thyroid blocking. Due to this natural adaption mechanism it's possible to tolerate large doses of iodine without clinical effects, however, a prolonged assumption of the iodine when not needed can be dangerous and may precipitate in severe thyroidal and non-thyroidal negative effects.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy
- *Correspondence: Valeria Calcaterra,
| | - Chiara Mameli
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
| | - Virginia Rossi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Giulia Massini
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Mirko Gambino
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, Italy
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Selected Essential and Toxic Chemical Elements in Hypothyroidism-A Literature Review (2001-2021). Int J Mol Sci 2021; 22:ijms221810147. [PMID: 34576309 PMCID: PMC8472829 DOI: 10.3390/ijms221810147] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
Thyroid hormones are known for controlling metabolism of lipids, carbohydrates, proteins, minerals, and electrolytes and for regulating body temperature. Normal thyroid status depends on the chemical/elemental composition of body fluids and tissues, which changes depending on physiological state, lifestyle and environment. A deficiency or excess of certain essential chemical elements (selenium, zinc, copper, iron or fluorine) or exposure to toxic (cadmium or lead) or potentially toxic elements (manganese or chromium) interacts with thyroid hormone synthesis and may disturb thyroid homeostasis. In our review, accessible databases (Scopus, PubMed and Web of Science) were searched for articles from 2001-2021 on the influence of selected chemical elements on the development of hypothyroidism. Our review adopted some of the strengths of a systematic review. After non-eligible reports were rejected, 29 remaining articles were reviewed. The review found that disruption of the physiological levels of elements in the body adversely affects the functioning of cells and tissues, which can lead to the development of disease.
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Hanna LA, Carabine F, Hall M, Craig R, Hanna A. Veganism: Are future pharmacists ready to provide advice? CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:512-519. [PMID: 33795103 DOI: 10.1016/j.cptl.2021.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/24/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION In addition to advising about diets, nutritional deficiencies, and supplements, pharmacists should be confident discussing medicine-related issues that may arise from people adopting veganism, including checking about animal-derived pharmaceutical product excipients, formulation processes, and determining whether vegan-friendly alternatives exist. Thus, this study aimed to investigate pharmacy students' knowledge and views about veganism. METHODS Given veganism's increasing popularity and relevance to pharmacy practice, students enrolled in their last year of the undergraduate master of pharmacy degree program at Queen's University Belfast participated in this voluntary study. The questionnaire was given out at an obligatory workshop (only non-identifiable data were requested). Students were scored on veganism knowledge (22 true/false statements) with other analysis about views being largely descriptive in nature. RESULTS Ninety-two out of 101 (91.1%) completed the questionnaire. Only one reporting being vegan. Mean knowledge score (possible range of 0-22) was 16.59 (±2.43). Only 37% (34/92) reported feeling confident discussing veganism with patients or other healthcare professionals and 40.2% (37/92) deemed they could establish whether a medical product is vegan-friendly. A minority (4.3%) considered they had received adequate training on veganism. A greater proportion of males than females considered that vegans are too forceful with their beliefs (74.2% vs. 51.7%). CONCLUSIONS This study presents the first description of pharmacy students' knowledge and opinions on veganism (from a single institution only). The reported gap in educational provision and lack of confidence needs to be investigated and addressed to enhance patient-centered care.
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Affiliation(s)
- Lezley-Anne Hanna
- Queen's University Belfast School of Pharmacy, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom.
| | - Fiona Carabine
- Queen's University Belfast School of Pharmacy, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom.
| | - Maurice Hall
- Queen's University Belfast School of Pharmacy, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom.
| | - Rebecca Craig
- Queen's University Belfast School of Pharmacy, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom.
| | - Alan Hanna
- Queen's University Belfast Management School, 185 Stranmillis Road, Belfast BT9 5EE, United Kingdom.
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Is There an Ideal Diet to Protect against Iodine Deficiency? Nutrients 2021; 13:nu13020513. [PMID: 33557336 PMCID: PMC7914421 DOI: 10.3390/nu13020513] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/17/2022] Open
Abstract
Iodine deficiency is a global issue and affects around 2 billion people worldwide, with pregnant women as a high-risk group. Iodine-deficiency prevention began in the 20th century and started with global salt iodination programmes, which aimed to improve the iodine intake status globally. Although it resulted in the effective eradication of the endemic goitre, it seems that salt iodination did not resolve all the issues. Currently, it is recommended to limit the consumption of salt, which is the main source of iodine, as a preventive measure of non-communicable diseases, such as hypertension or cancer the prevalence of which is increasing. In spite of the fact that there are other sources of iodine, such as fish, seafood, dairy products, water, and vegetables, the high consumption of processed food with a high content of unionised salt, alternative diets or limited salt intake can still lead to iodine deficiency. Thus, iodine deficiency remains a relevant issue, with new, preventive solutions necessary. However, it appears that there is no diet which would fully cover the iodine requirements, and iodine food supplementation is still required.
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14
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Protudjer JLP, Mikkelsen A. Veganism and paediatric food allergy: two increasingly prevalent dietary issues that are challenging when co-occurring. BMC Pediatr 2020; 20:341. [PMID: 32650748 PMCID: PMC7350184 DOI: 10.1186/s12887-020-02236-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 07/02/2020] [Indexed: 12/16/2022] Open
Abstract
Vegan diets – defined as the exclusion of all foods of animal origin from the diet- are becoming popular. In recent years, the prevalence of food allergy has also increased, and disproportionately affects children. When vegan diets and food allergy co-occur, this combination can be challenging and pose risks of nutritional deficiencies, particularly during childhood. In this paper, we aim to summarise the major concerns regarding vegan diets and food allergy, review the literature on this topic, and provide some suggestions for healthcare providers, particularly dietitians and nutritionists, who work with food allergic, vegan patients and their family. When working with this patient population, a regular and complete medical nutrition history, including screening for any possible nutritional deficiencies, is warranted. Likewise, the routine tracking of serum markers (especially iodine, iron, zinc, calcium, Vitamins B12, D, B2, and A, selected n-3 fatty acids and protein, which are more abundant in animal vs. plant foods) and symptoms of co-morbid diseases, including asthma, is important, as comorbid diseases may increase energy and nutrient requirements. For infants and children, anthropometry ought to be tracked longitudinally at regular intervals to identify any deviations from the child’s previous growth pattern, and to accommodate any increased requirements for growth and development. Correct diagnoses, education and allergy management must be disseminated to the family in a clear and appropriate manner. Children with allergy may have increased nutritional needs due to comorbidity. This is complicated by coincident food allergy and vegan diet as both impose diet restrictions (limiting sources of important nutrients, need for dietary variety and/or increased consumption due to reduced bioavaliability).
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Affiliation(s)
- Jennifer L P Protudjer
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada. .,George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada. .,Children's Hospital Research Institute of Manitoba, Winnipeg, Canada. .,Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada. .,Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
| | - Andrea Mikkelsen
- Paediatric Primary Health Care Clinics of Västra Götaland, Västra Götaland, Sweden.,Research and Development Primary Health Care, Gothenburg and Södra Bohuslän, Region Västra Götaland, Sweden.,Institute of Medicine, Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Redecillas-Ferreiro S, Moráis-López A, Manuel Moreno-Villares J. Position paper on vegetarian diets in infants and children. Committee on Nutrition and Breastfeeding of the Spanish Paediatric Association. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.anpede.2019.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Roseland JM, Somanchi M, Bahadur R, Haytowitz DB, Pehrsson PR. Content and variability of vitamin D and iodine in processed egg products in the United States (U.S.). J Food Compost Anal 2020. [DOI: 10.1016/j.jfca.2019.103379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sakkas H, Bozidis P, Touzios C, Kolios D, Athanasiou G, Athanasopoulou E, Gerou I, Gartzonika C. Nutritional Status and the Influence of the Vegan Diet on the Gut Microbiota and Human Health. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E88. [PMID: 32098430 PMCID: PMC7073751 DOI: 10.3390/medicina56020088] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/15/2020] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
The human gut microbiota is considered a well-known complex ecosystem composed of distinct microbial populations, playing a significant role in most aspects of human health and wellness. Several factors such as infant transitions, dietary habits, age, consumption of probiotics and prebiotics, use of antibiotics, intestinal comorbidities, and even metabolic diseases may continously alter microbiota diversity and function. The study of vegan diet-microbiota interactions is a rapidly evolving field, since plenty of research has been focused on the potential effects of plant-based dietary patterns on the human gut microbiota. It has been reported that well-planned vegan diets and their associated components affect both the bacterial composition and metabolic pathways of gut microbiota. Certain benefits associated with medical disorders but also limitations (including nutritional deficiencies) have been documented. Although the vegan diet may be inadequate in calorific value, it is rich in dietary fiber, polyphenols, and antioxidant vitamins. The aim of the present study was to provide an update of the existing knowledge on nutritional status of vegan diets and the influence of their food components on the human gut microbiota and health.
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Affiliation(s)
- Hercules Sakkas
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (P.B.); (C.G.)
| | - Petros Bozidis
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (P.B.); (C.G.)
| | - Christos Touzios
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Damianos Kolios
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Georgia Athanasiou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Eirini Athanasopoulou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Ioanna Gerou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (C.T.); (D.K.); (G.A.); (E.A.); (I.G.)
| | - Constantina Gartzonika
- Microbiology Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (P.B.); (C.G.)
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Redecilla Ferreiro S, Moráis López A, Moreno Villares JM. [Position paper on vegetarian diets in infants and children. Committee on Nutrition and Breastfeeding of the Spanish Paediatric Association]. An Pediatr (Barc) 2019; 92:306.e1-306.e6. [PMID: 31866234 DOI: 10.1016/j.anpedi.2019.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 10/30/2019] [Indexed: 12/23/2022] Open
Abstract
In the last few years, there are an increased number of families following a vegetarian diet, including their children. In order to guarantee child heath, paediatricians need to know the characteristics of this diet and the main foods that are used. There are few data on the medium and long-term health outcomes when removing all animal foods from the child's diet, especially at younger ages. Nevertheless, new tools have recently become available to facilitate following a vegetarian diet and decreasing the risk of deficiencies. In this document, the group of foods commonly used in vegetarian diets are reviewed, as well as recommendations for each age group. It also mentions the need to use B12 supplements at all ages, as well as other nutrients (iodine, iron, vitaminD3, poly-unsaturated fatty acid n-3), when required. A vegetarian or a vegan diet, as in any other kind of diet, needs to be carefully designed. After reviewing current evidence, even though following a vegetarian diet at any age does not necessarily mean it is unsafe, it is advisable for infant and young children to follow an omnivorous diet or, at least, an ovo-lacto-vegetarian diet.
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Dodd SAS, Cave NJ, Adolphe JL, Shoveller AK, Verbrugghe A. Plant-based (vegan) diets for pets: A survey of pet owner attitudes and feeding practices. PLoS One 2019; 14:e0210806. [PMID: 30645644 PMCID: PMC6333351 DOI: 10.1371/journal.pone.0210806] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 01/02/2019] [Indexed: 11/18/2022] Open
Abstract
People who avoid eating animals tend to share their homes with animal companions, and moral dilemma may arise when they are faced with feeding animal products to their omnivorous dogs and carnivorous cats. One option to alleviate this conflict is to feed pets a diet devoid of animal ingredients-a 'plant-based' or 'vegan' diet. The number of pet owners who avoid animal products, either in their own or in their pets' diet, is not currently known. The objective of this study was to estimate the number of meat-avoiding pet owners, identify concerns regarding conventional animal- and plant-based pet food, and estimate the number of pets fed a plant-based diet. A questionnaire was disseminated online to English-speaking pet owners (n = 3,673) to collect data regarding pet owner demographics, diet, pet type, pet diet, and concerns regarding pet foods. Results found that pet owners were more likely to be vegetarian (6.2%; 229/3,673) or vegan (5.8%; 212/3,673) than previously reported for members of the general population. With the exception of one dog owned by a vegetarian, vegans were the only pet owners who fed plant-based diets to their pets (1.6%; 59/3,673). Of the pet owners who did not currently feed plant-based diets but expressed interest in doing so, a large proportion (45%; 269/599) desired more information demonstrating the nutritional adequacy of plant-based diets. Amongst all pet owners, the concern most commonly reported regarding meat-based pet foods was for the welfare of farm animals (39%; 1,275/3,231). The most common concern regarding strictly plant-based pet foods was regarding the nutritional completeness of the diet (74%; 2,439/3,318). Amongst vegans, factors which predicted the feeding of plant-based diets to their pets were concern regarding the cost of plant-based diets, a lack of concern regarding plant-based diets being unnatural, and reporting no concern at all regarding plant-based diets for pets. Given these findings, further research is warranted to investigate plant-based nutrition for domestic dogs and cats.
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Affiliation(s)
- Sarah A. S. Dodd
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Nick J. Cave
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | | | - Anna K. Shoveller
- Department of Animal Biosciences, University of Guelph, Guelph, Ontario, Canada
| | - Adronie Verbrugghe
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Hunter JD, Crudo DF. Unintended Consequences of Restrictive Diets: Two Case Reports and a Review of Orthorexia. Clin Pediatr (Phila) 2018; 57:1693-1695. [PMID: 30141344 DOI: 10.1177/0009922818795905] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Janel D Hunter
- 1 Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC, USA
| | - David F Crudo
- 1 Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC, USA
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