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Herter J, Stübing F, Lüth V, Zimmermann J, Lederer AK, Hannibal L, Huber R, Storz MA. Bowel health, defecation patterns and nutrient intake following adoption of a vegan diet: a randomized-controlled trial. Ann Med 2024; 56:2305693. [PMID: 38327148 PMCID: PMC10854443 DOI: 10.1080/07853890.2024.2305693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND The beneficial effects of a plant-based diet on gut microbiota diversity are well documented, however, its impact on clinical bowel health and defecation patterns are less well understood. Vegetarian diets have been associated with a higher bowel movement (BM) frequency as well as softer stools in cross-sectional studies. The effects of the de-novo adoption of a vegan diet on bowel health, however, have never been investigated in a randomized-controlled trial. MATERIALS AND METHODS The present study examined bowel health and defecation patterns in relation to diet and nutrient intake in a young and healthy sample of n = 65 physically-active German university students who were randomly assigned to either a vegan or a meat-rich diet for eight weeks. Bowel health assessment included the Bristol Stool Form Scale (BSFS), the Gastrointestinal Quality of Life Index (GIQLI) and the Cleveland Clinic Fecal Incontinence Score (CCFIS). Nutrient intake was assessed using weighed food diaries. The study was prospectively registered at the German Clinical Trial Register (DRKS00031541). RESULTS Weekly BM frequency slightly increased in vegans, whereas it remained unaltered in participants assigned to a meat-rich diet. Fiber intake increased significantly in vegans (34.89 (18.46) g/d) whereas it decreased in those assigned to the meat-rich group (22.79 (12.5) g/d). No significant intergroup differences in BSFS and CCFIS patterns were observed. Adoption of a vegan diet neither resulted in a transient increase in abdominal discomfort nor in a decreased gastrointestinal quality of life, which was comparable across the diet groups. CONCLUSIONS The short-term de-novo adoption of a vegan diet did not negatively affect markers of bowel health in this study.
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Affiliation(s)
- Julian Herter
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frieda Stübing
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volker Lüth
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Zimmermann
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ann-Kathrin Lederer
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luciana Hannibal
- Laboratory of Clinical Biochemistry and Metabolism, Department of General Pediatrics, Adolescent Medicine and Neonatology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Roman Huber
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Andreas Storz
- Department of Internal Medicine II, Centre for Complementary Medicine, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Hosseini Y, Hadi Sichani P, Moslemi E, Nouri M, Rajabzadeh-Dehkordi M, Jalali S, Heidari Z, Shateri Z, Rashidkhani B. Pro-vegetarian dietary pattern and risk of breast cancer: a case-control study. Breast Cancer Res Treat 2024; 205:395-402. [PMID: 38416331 DOI: 10.1007/s10549-024-07243-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/02/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND There are a few conflicting results from studies assessing the association between plant-based diets, particularly pro-vegetarian dietary pattern (PDP), and breast cancer (BC) incidence. Therefore, this study aimed to investigate the association between PDP and BC odds in the Iranian population. METHODS This case-control study was conducted on 134 women with BC and 265 without cancer (control). Participants were selected from two referral hospitals in Tehran, Iran. Also, a validated food frequency questionnaire was used to collect food information. Logistic regression was used to assess the association between PDP and BC and the association between PDP and BC by menopausal status. RESULTS It was observed that in two models of logistic regression, the chance of BC was lower in the second and last tertile (T) than in the first tertile of PDP (model 1-T2: odds ratio (OR) = 0.39; 95% confidence interval (CI): 0.23-0.67; P = 0.001, and T3: OR = 0.43; 95% CI: 0.26-0.73; P = 0.002-model 2: T2: OR = 0.42; 95% CI: 0.24-0.74; P = 0.003, and T3: OR = 0.49; 95% CI: 0.27-0.88; P = 0.017). Also, according to menopausal status, the odds of developing BC in post-menopausal women in the second and last tertile of PDP was significantly lower than the first tertile in both logistic regression models. CONCLUSIONS The findings revealed that Iranian women who followed PDP had a lower chance of developing BC. Also, we found that a diet high in plant-based foods and low in animal products is beneficial for reducing BC odds, particularly for post-menopausal women.
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Affiliation(s)
- Yasaman Hosseini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Hadi Sichani
- Department of Community Nutrition, School of Nutrition and Food Sciences, Nutrition and Food Security Research Center, Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Moslemi
- Faculty of Nutrition and Food Sciences, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehran Nouri
- Cancer Research Center, Health Research Institute, Babol University of Medical sciences, Babol, Iran
| | - Milad Rajabzadeh-Dehkordi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saba Jalali
- Human Nutrition, Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Zeinab Heidari
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Bassin SR, Ferreira De Carvalho J, Gulati M. A Review of Plant-Based Diets for Obesity Management. Endocr Pract 2024:S1530-891X(24)00513-5. [PMID: 38729570 DOI: 10.1016/j.eprac.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/03/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Obesity is the most prevalent chronic disease in the United States with over 70% of the American population suffering from overweight/obesity. Recently, the popularity of plant-based diets has grown, with individuals adopting these diets for ethical, health and environmental reasons. Our aim is to evaluate the effect of a plant-based diet (PBD) on weight loss among patients who are overweight or obese. METHODS A literature review of PBDs for the treatment of obesity was conducted using PubMed and Scopus. Our search yielded 27 intervention trials (3361 participants) and six metanalyses (9168 participants, 61 trials). RESULTS Among the intervention trials evaluated, 75% showed a significant decrease in weight loss in the intervention group, on average -5.0kg (range -1.8 to -12.1kg). Other outcomes included energy intake (-420 Kcal/day), systolic blood pressure (-3.78 mmHg), fasting plasma glucose (-2.0 mmol/L), HbA1c (-0.5%, -3.4 mmol/L), total cholesterol (-0.40 mmol/L), low-density lipoprotein (-0.38 mmol/L), triglyceride levels (+0.13 mmol/L), and fiber intake (+10.8 g/day). The six meta-analyses showed weight loss (average -2.9 kg , range -2.02 kg to -4.1 kg), BMI reduction, and improvements in HbA1c, LDL, and total cholesterol. CONCLUSION PBDs result in significant weight loss and improve metabolic outcomes. PBDs offer a sustainable approach to long-term weight loss maintenance. Healthcare providers should encourage open discussions with their patients regarding their dietary habits to assist them in setting feasible lifestyle goals and consider shared medical appointments to support patients in transitioning to PBDs.
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Affiliation(s)
| | | | - Mahima Gulati
- Department of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University
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Amir S, Kim H, Hu EA, Ricardo AC, Mills KT, He J, Fischer MJ, Pradhan N, Tan TC, Navaneethan SD, Dobre M, Anderson CAM, Appel LJ, Rebholz CM. Adherence to Plant-Based Diets and Risk of CKD Progression and All-Cause Mortality: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 2024; 83:624-635. [PMID: 38103719 PMCID: PMC11034716 DOI: 10.1053/j.ajkd.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/15/2023] [Accepted: 09/18/2023] [Indexed: 12/19/2023]
Abstract
RATIONALE & OBJECTIVE Studies have shown that generally healthy individuals who consume diets rich in plant foods have a lower risk of incident chronic kidney disease (CKD) and cardiovascular disease. This study investigated the prospective associations of plant-based diets with the risk of CKD progression and all-cause mortality in individuals with CKD. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS 2,539 participants with CKD recruited between 2003-2008 into the Chronic Renal Insufficiency Cohort (CRIC) Study. EXPOSURE Responses on the Diet History Questionnaire were used to calculate scores for the overall plant-based diet index, healthy plant-based diet index, and unhealthy plant-based diet index. OUTCOME (1) CKD progression defined as≥50% estimated glomerular filtration rate decline from baseline or kidney replacement therapy (dialysis, transplant) and (2) all-cause mortality. ANALYTICAL APPROACH Cox proportional hazards models to compute hazard ratios and 95% confidence intervals adjusting for lifestyle, socioeconomic, and clinical covariates. RESULTS There were 977 CKD progression events and 836 deaths during a median follow-up period of 7 and 12 years, respectively. Participants with the highest versus lowest adherence to overall plant-based diets and healthy plant-based diets had 26% (HR, 0.74 [95% CI, 0.62-0.88], P trend<0.001) and 21% (HR, 0.79 [95% CI, 0.66-0.95], P trend=0.03) lower risks of all-cause mortality, respectively. Each 10-point higher score of unhealthy plant-based diets was modestly associated with a higher risk of CKD progression (HR, 1.14 [95% CI, 1.03-1.25) and all-cause mortality (HR, 1.11 [95% CI, 1.00-1.23). LIMITATIONS Self-reported diet may be subject to measurement error. CONCLUSIONS Adherence to an overall plant-based diet and a healthy plant-based diet is associated with a reduced risk of all-cause mortality among individuals with CKD. An unhealthy plant-based was associated with an elevated risk of CKD progression and all-cause mortality. PLAIN-LANGUAGE SUMMARY Plant-based diets are healthful dietary patterns that have been linked to a lower risk of chronic diseases. However, the impact of plant-based diets on clinical outcomes in patients with chronic kidney disease (CKD) is not well established. In 2,539 individuals with CKD, we examined the associations of adherence to 3 different types of plant-based diets with the risks of CKD progression and all-cause mortality. We found that following an overall plant-based diet and a healthy plant-based diet was associated with a lower risk of all-cause mortality. By contrast, following an unhealthy plant-based diet was associated with a higher risk of CKD progression and all-cause mortality. These results suggest that the quality of plant-based diets may be important for CKD management.
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Affiliation(s)
- Saira Amir
- Department of Medicine, UNC Health Southeastern, Lumberton, North Carolina; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Hyunju Kim
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Ana C Ricardo
- Division of Nephrology, Department of Medicine, University of Illinois, Chicago, Illinois
| | - Katherine T Mills
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Jiang He
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Michael J Fischer
- Division of Nephrology, Department of Medicine, University of Illinois, Chicago, Illinois
| | - Nishigandha Pradhan
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Thida C Tan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | | | - Mirela Dobre
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Cheryl A M Anderson
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California-San Diego, San Diego, California
| | - Lawrence J Appel
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
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Liu VN, Van Blarigan EL, Zhang L, Graff RE, Loeb S, Langlais CS, Cowan JE, Carroll PR, Chan JM, Kenfield SA. Plant-Based Diets and Disease Progression in Men With Prostate Cancer. JAMA Netw Open 2024; 7:e249053. [PMID: 38691361 PMCID: PMC11063803 DOI: 10.1001/jamanetworkopen.2024.9053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/01/2024] [Indexed: 05/03/2024] Open
Abstract
Importance Plant-based diets are associated with many health and environmental benefits, including primary prevention of fatal prostate cancer, but less is known about postdiagnostic plant-based diet patterns in individuals with prostate cancer. Objective To examine whether postdiagnostic plant-based dietary patterns are associated with risk of prostate cancer progression and prostate cancer-specific mortality. Design, Setting, and Participants This longitudinal observational cohort study included men with biopsy-proven nonmetastatic prostate cancer (stage ≤T3a) from the diet and lifestyle substudy within the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) enrolled at 43 urology practices across the US from 1999 to 2018. Participants completed a comprehensive diet and lifestyle questionnaire (including a validated food frequency questionnaire [FFQ]) between 2004 and 2016. Data were analyzed from August 2022 to April 2023. Exposures Overall plant-based diet index (PDI) and healthful plant-based diet index (hPDI) scores were calculated from the FFQ. Main Outcomes and Measures The primary outcome was prostate cancer progression (recurrence, secondary treatment, bone metastases, or prostate cancer-specific mortality). The secondary outcome was prostate cancer-specific mortality. Results Among 2062 participants (median [IQR] age, 65.0 [59.0-70.0] years), 61 (3%) identified as African American, 3 (<1%) identified as American Indian or Alaska Native, 9 (<1%) identified as Asian or Pacific Islander, 15 (1%) identified as Latino, and 1959 (95%) identified as White. Median (IQR) time from prostate cancer diagnosis to FFQ was 31.3 (15.9-62.0) months after diagnosis. During a median (IQR) follow-up of 6.5 (1.3-12.8) years after the FFQ, 190 progression events and 61 prostate cancer-specific mortality events were observed. Men scoring in the highest vs lowest quintile of PDI had a 47% lower risk of progression (HR, 0.53; 95% CI, 0.37-0.74; P for trend = .003). The hPDI was not associated with risk of progression overall. However, among 680 individuals with Gleason grade 7 or higher at diagnosis, the highest hPDI quintile was associated with a 55% lower risk of progression compared with the lowest hPDI quintile (HR 0.45; 95% CI, 0.25-0.81; P for trend = .01); no association was observed in individuals with Gleason grade less than 7. Conclusions and Relevance In this cohort study of 2062 men with prostate cancer, higher intake of plant foods after prostate cancer diagnosis was associated with lower risk of cancer progression. These findings suggest nutritional assessment and counseling may be recommended to patients with prostate cancer to help establish healthy dietary practices and support well-being and overall health.
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Affiliation(s)
- Vivian N. Liu
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Menwell Limited, London, England, United Kingdom
| | - Erin L. Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Urology, University of California, San Francisco
| | - Li Zhang
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Medicine, University of California, San Francisco
| | - Rebecca E. Graff
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York
| | - Crystal S. Langlais
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Real World Solutions, IQVIA, Durham, North Carolina
| | - Janet E. Cowan
- Department of Urology, University of California, San Francisco
| | | | - June M. Chan
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Urology, University of California, San Francisco
| | - Stacey A. Kenfield
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Urology, University of California, San Francisco
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Oncina-Cánovas A, Torres-Collado L, García-de-la-Hera M, Compañ-Gabucio LM, González-Palacios S, Signes-Pastor AJ, Vioque J. Pro-vegetarian dietary patterns and mortality by all-cause and specific causes in an older Mediterranean population. J Nutr Health Aging 2024; 28:100239. [PMID: 38643602 DOI: 10.1016/j.jnha.2024.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE Pro-vegetarian (PVG) dietary patterns have shown health benefits, although the evidence concerning their association with mortality is scarce, particularly in older populations. We investigated the effect of three defined PVG patterns on all-cause, cardiovascular disease (CVD) and cancer mortality risk in an older Mediterranean population. METHODS We analysed baseline data from 597 adults aged 65 and older who participated in a population-based cross-sectional study, and mortality during a 12-year period. We used a validated food frequency questionnaire to estimate the adherence in tertiles to three evidence-based PVG dietary patterns: a general PVG pattern (gPVG) and two specific variations (healthful -hPVG, and unhealthful -uPVG). The gPVG pattern incorporated data from 12 food groups, consisting of 7 plant-based and 5 animal-based. The hPVG and uPVG versions included information from 18 food groups (4 food groups added and the splitting of 2 food groups). We used Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for relevant covariates. RESULTS After the 12-years follow-up period, moderate adherence to hPVG pattern was associated with lower all-cause and CVD mortality whereas greater adherence to uPVG pattern was associated with higher all-cause and CVD mortality. Compared with those in the lowest tertile, participants in the second tertile of adherence to the hPVG pattern showed a significant lower risk of all-cause mortality (HR = 0.59; 95%CI: 0.43, 0.82) and CVD mortality (HR = 0.47; 0.28, 0.78). Participants in the highest tertile of adherence to the uPVG showed an increased mortality risk of all-cause (HR = 1.53; 1.07, 2.19) and CVD (HR = 2.10; 1.19, 3.70). No significant associations were found between adherence to any of the PVG dietary patterns and cancer mortality. CONCLUSION Moderate adherence to a healthy PVG pattern reduced the long-term mortality risk for all-cause and CVD in an older Mediterranean population, while higher adherence to an unhealthy PVG pattern increased the risk of all-cause and CVD mortality.
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Affiliation(s)
- Alejandro Oncina-Cánovas
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Laura Torres-Collado
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain.
| | - Manuela García-de-la-Hera
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Laura María Compañ-Gabucio
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Sandra González-Palacios
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Antonio J Signes-Pastor
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
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Wilcox NS, Amit U, Reibel JB, Berlin E, Howell K, Ky B. Cardiovascular disease and cancer: shared risk factors and mechanisms. Nat Rev Cardiol 2024:10.1038/s41569-024-01017-x. [PMID: 38600368 DOI: 10.1038/s41569-024-01017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
Cardiovascular disease (CVD) and cancer are among the leading causes of morbidity and mortality globally, and these conditions are increasingly recognized to be fundamentally interconnected. In this Review, we present the current epidemiological data for each of the modifiable risk factors shared by the two diseases, including hypertension, hyperlipidaemia, diabetes mellitus, obesity, smoking, diet, physical activity and the social determinants of health. We then review the epidemiological data demonstrating the increased risk of CVD in patients with cancer, as well as the increased risk of cancer in patients with CVD. We also discuss the shared mechanisms implicated in the development of these conditions, highlighting their inherent bidirectional relationship. We conclude with a perspective on future research directions for the field of cardio-oncology to advance the care of patients with CVD and cancer.
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Affiliation(s)
- Nicholas S Wilcox
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Uri Amit
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacob B Reibel
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eva Berlin
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kendyl Howell
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bonnie Ky
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Toh DWK, Fu AS, Mehta KA, Lam NYL, Haldar S, Henry CJ. Plant-Based Meat Analogs and Their Effects on Cardiometabolic Health: An 8-Week Randomized Controlled Trial Comparing Plant-Based Meat Analogs With Their Corresponding Animal-Based Foods. Am J Clin Nutr 2024:S0002-9165(24)00396-4. [PMID: 38599522 DOI: 10.1016/j.ajcnut.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND With the growing popularity of plant-based meat analogs (PBMAs), an investigation of their effects on health is warranted in an Asian population. OBJECTIVES This research investigated the impact of consuming an omnivorous animal-based meat diet (ABMD) compared with a PBMAs diet (PBMD) on cardiometabolic health among adults with elevated risk of diabetes in Singapore. METHODS In an 8-wk parallel design randomized controlled trial, participants (n = 89) were instructed to substitute habitual protein-rich foods with fixed quantities of either PBMAs (n = 44) or their corresponding animal-based meats (n = 45; 2.5 servings/d), maintaining intake of other dietary components. Low-density lipoprotein (LDL) cholesterol served as primary outcome, whereas secondary outcomes included other cardiometabolic disease-related risk factors (e.g. glucose and fructosamine), dietary data, and within a subpopulation, ambulatory blood pressure measurements (n = 40) at baseline and postintervention, as well as a 14-d continuous glucose monitor (glucose homeostasis-related outcomes; n = 37). RESULTS Data from 82 participants (ABMD: 42 and PBMD: 40) were examined. Using linear mixed-effects model, there were significant interaction (time × treatment) effects for dietary trans-fat (increased in ABMD), dietary fiber, sodium, and potassium (all increased in PBMD; P-interaction <0.001). There were no significant effects on the lipid-lipoprotein profile, including LDL cholesterol. Diastolic blood pressure (DBP) was lower in the PBMD group (P-interaction=0.041), although the nocturnal DBP dip markedly increased in ABMD (+3.2% mean) and was reduced in PBMD (-2.6%; P-interaction=0.017). Fructosamine (P time=0.035) and homeostatic model assessment for β-cell function were improved at week 8 (P time=0.006) in both groups. Glycemic homeostasis was better regulated in the ABMD than PBMD groups as evidenced by interstitial glucose time in range (ABMD median: 94.1% (Q1:87.2%, Q3:96.7%); PBMD: 86.5% (81.7%, 89.4%); P = 0.041). The intervention had no significant effect on the other outcomes examined. CONCLUSIONS An 8-wk PBMA diet did not show widespread cardiometabolic health benefits compared with a corresponding meat based diet. Nutritional quality is a key factor to be considered for next generation PBMAs. This trial was registered at https://clinicaltrials.gov/as NCT05446753.
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Affiliation(s)
- Darel Wee Kiat Toh
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore.
| | - Amanda Simin Fu
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Kervyn Ajay Mehta
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Nicole Yi Lin Lam
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore
| | - Sumanto Haldar
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore; Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Christiani Jeyakumar Henry
- Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore; Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
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9
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Austin G, Ferguson JJA, Eslick S, Oldmeadow C, Wood LG, Garg ML. Cardiovascular Disease Risk in Individuals Following Plant-Based Dietary Patterns Compared to Regular Meat-Eaters. Nutrients 2024; 16:1063. [PMID: 38613096 PMCID: PMC11013900 DOI: 10.3390/nu16071063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Plant-based diets (PBDs) have been associated with a lower risk of cardiovascular disease (CVD). The aim was to investigate the predicted 5-year and 10-year risk of developing CVD in individuals following PBDs compared to regular meat-eating diets. This cross-sectional study included n = 240 middle-aged adults habitually consuming dietary patterns for ≥6 months: vegan, lacto-ovo vegetarian (LOV), pesco-vegetarian (PV), semi-vegetarian (SV) or regular meat-eater (RME) (n = 48 per group). Predicted 5-year and 10-year CVD risks were quantified using the Framingham Risk Equation and the Australian Absolute CVD risk calculator, respectively. Multivariable regression analysis was used to adjust for age, sex, smoking status, physical activity, alcohol use and BMI. Over three-quarters of the participants were women, mean age of 53.8 yrs. After adjustments for potential confounders, there was no difference in the predicted risk of CVD between regular-meat diets and PBDs, although crude analyses revealed that vegans had a lower 5-year and 10-year predicted risk of CVD compared to RMEs. SVs, PVs and LOVs had lower CVD risk scores, however, not significantly. Vegans had a favourable cardiometabolic risk profile including significantly lower serum lipid levels, fasting blood glucose and dietary fats and higher dietary fibre intake compared to RMEs. This was the first study to purposefully sample Australians habitually following PBDs. We found that PBDs do not independently influence the predicted risk of CVD, although PBDs tended to have lower risk and vegans had significantly lower cardiometabolic risk factors for CVD.
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Affiliation(s)
- Grace Austin
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Jessica J. A. Ferguson
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- School of Health Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Shaun Eslick
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Macquarie Medical School, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Lisa G. Wood
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Manohar L. Garg
- School of Biomedical Sciences & Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia (S.E.); (L.G.W.)
- Macquarie Medical School, Macquarie University, Macquarie Park, NSW 2109, Australia
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10
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Oncina-Cánovas A, Vioque J, Riutort-Mayol G, Soler-Blasco R, Irizar A, Barroeta Z, Fernández-Somoano A, Tardón A, Vrijheid M, Guxens M, Carey M, Meharg C, Ralphs K, McCreanor C, Meharg A, Signes-Pastor AJ. Pro-vegetarian dietary patterns and essential and heavy metal exposure in children of 4-5-years from the INfancia y medio Ambiente cohort (INMA). Int J Hyg Environ Health 2024; 257:114344. [PMID: 38430670 DOI: 10.1016/j.ijheh.2024.114344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
Dietary patterns provide a comprehensive assessment of food consumption, including essential nutrients and potential exposure to environmental contaminants. While pro-vegetarian (PVG) dietary patterns have shown health benefits in adults, their effects on children are less well studied. This study aims to explore the association between children's adherence to the most common PVG dietary patterns and their exposure to metals, assessed through urine concentration. In our study, we included a population of 723 children aged 4-5-years from the INfancia y Medio Ambiente (INMA) cohort in Spain. We calculated three predefined PVG dietary patterns, namely general (gPVG), healthful (hPVG), and unhealthful (uPVG), using dietary information collected through a validated Food Frequency Questionnaire. Urinary concentrations of various essential and heavy metals (Co, Cu, Zn, Se, Mo, Pb, and Cd) were measured using mass spectrometry. Additionally, urinary arsenic speciation, including arsenobetaine (AsB), dimethylarsinic acid (DMA), monomethylarsonic acid (MMA), and inorganic arsenic (iAs), was measured. The sum of urinary MMA and iAs was used to assess iAs exposure. We estimated primary (PMI) and secondary iAs methylation (SMI) indices. To explore the association between PVG dietary patterns in quintiles and metal exposure, we utilized multiple-adjusted linear regression models and the quantile g-computation approach. Compared with the lowest quintile, participants in the highest quintile of gPVG showed a 22.7% lower urinary Co (95% confidence interval (CI): -38.7; -1.98) and a 12.6% lower Se (95%CI: -22.9; -1.00) concentrations. Second quintile of adherence to hPVG was associated with a 51.7% lower urinary iAs + MMA concentrations (95%CI: -74.3; -8.61). Second quintile of adherence to an uPVG was associated with a 13.6% lower Se levels (95%CI: -22.9; -2.95) while the third quintile to this pattern was associated with 17.5% lower Mo concentrations (95%CI: -29.5; -2.95). The fourth quintile of adherence to gPVG was associated with a 68.5% higher PMI and a 53.7% lower SMI. Our study showed that adherence to a gPVG dietary pattern in childhood may modestly reduce the intakes of some essential metals such as Co and Se. Further investigations are warranted to explore any potential health implications.
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Affiliation(s)
- Alejandro Oncina-Cánovas
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain.
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain
| | - Gabriel Riutort-Mayol
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain
| | - Raquel Soler-Blasco
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Valencia, Spain; Department of Nursing, Universitat de València, Valencia, Spain
| | - Amaia Irizar
- Health Research Institute, Biodonostia, Donostia-San Sebastian, Spain
| | - Ziortza Barroeta
- Health Research Institute, Biodonostia, Donostia-San Sebastian, Spain
| | - Ana Fernández-Somoano
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Institute of Health Research of the Principality of Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain
| | - Adonina Tardón
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julián Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Institute of Health Research of the Principality of Asturias (ISPA), Roma Avenue s/n, 33001, Oviedo, Spain
| | - Martine Vrijheid
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Mònica Guxens
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain; ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Manus Carey
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Caroline Meharg
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Kathryn Ralphs
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Coalain McCreanor
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Andrew Meharg
- Biological Sciences, Institute for Global Food Security, Queen's University Belfast, 19 Chlorine Gardens, Belfast, BT9 5DL, Northern Ireland, UK
| | - Antonio J Signes-Pastor
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010, Alicante, Spain; Unidad de Epidemiología de la Nutrición, Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550, Alicante, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034, Madrid, Spain.
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11
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Zhou L, Zhang R, Yang H, Zhang S, Zhang Y, Li H, Chen Y, Maimaitiyiming M, Lin J, Ma Y, Wang Y, Zhou X, Liu T, Yang Q, Wang Y. Association of plant-based diets with total and cause-specific mortality across socioeconomic deprivation level: a large prospective cohort. Eur J Nutr 2024; 63:835-846. [PMID: 38194192 DOI: 10.1007/s00394-023-03317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Current evidence on the association between plant-based diet indices (PDIs) and mortality is inconsistent. We aimed to investigate the association of PDIs with all-cause and cause-specific mortality and to examine whether such associations were modified by socioeconomic deprivation level. METHODS A total of 189,003 UK Biobank participants with at least one 24-h dietary assessment were included. All food items were categorised into three groups, including healthy plant foods, less healthy plant foods, and animal foods. Three PDIs, including the overall PDI (positive scores for all plant-based food intake and inverse scores for animal-based foods), the healthful PDI (hPDI) (positive scores only for healthy plant food intake and inverse scores for others), and the unhealthful PDI (uPDI) (positive scores only for less healthy plant food intake and inverse scores for others), were calculated according to the quantities of each food subgroup in three categories. The Townsend deprivation index was used as the indicator of socioeconomic deprivation level. Cox proportional hazard models were used to estimate the hazard ratios (HRs) of PDIs for all-cause and cause-specific mortality. The modification effects of socioeconomic deprivation levels on these associations were evaluated. RESULTS During a median follow-up of 9.6 years, 9335 deaths were documented. Compared with the lowest quintile, the highest quintile of overall PDI was associated with adjusted HRs of 0.87 (95% CI 0.81-0.93) for all-cause mortality and 0.77 (0.66-0.91) for cardiovascular mortality. Compared with the lowest quintile, the highest quintile of hPDI was associated with lower risks of all-cause mortality (0.92, 0.86-0.98), and death caused by respiratory disease (0.63, 0.47-0.86), neurological disease (0.65, 0.48-0.88), and cancer (0.90, 0.82-0.99). Compared with the lowest quintile, the highest quintile of uPDI was associated with an HR of 1.29 (1.20-1.38) for all-cause mortality, 1.95 (1.40-2.73) for neurological mortality, 1.54 (1.13-2.09) for respiratory mortality, and 1.16 (1.06-1.27) for cancer mortality. The magnitudes of associations of hPDI and uPDI with mortality were larger in the most socioeconomically deprived participants (the highest tertile) than in the less deprived ones (p-values for interaction were 0.039 and 0.001, respectively). CONCLUSIONS This study showed that having a high overall PDI and hPDI were related to a reduced risk of death, while the uPDI was linked to a higher risk of death. Sticking to a healthy plant-based diet may help decrease mortality risks across socioeconomic deprivation levels, especially for those who are the most socioeconomically deprived.
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Affiliation(s)
- Lihui Zhou
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Ran Zhang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yuan Zhang
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Huiping Li
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yanchun Chen
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Maiwulamujiang Maimaitiyiming
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Jing Lin
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yue Ma
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yuan Wang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Xin Zhou
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tong Liu
- Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Simsek M, Whitney K. Examination of Primary and Secondary Metabolites Associated with a Plant-Based Diet and Their Impact on Human Health. Foods 2024; 13:1020. [PMID: 38611326 PMCID: PMC11011468 DOI: 10.3390/foods13071020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
The consumption of plant-based diets has become a burgeoning trend, and they are increasingly consumed globally owing to their substantial energy intensity and dietetic advantages. Plants possess numerous bioactive components that have been recognized to exhibit manifold health-promoting assets. Comprehension of the synthesis of these primary and secondary metabolites by plants and their method of action against several chronic illnesses is a significant requirement for understanding their benefits to human health and disease prevention. Furthermore, the association of biologically active complexes with plants, humans, disease, medicine, and the underlying mechanisms is unexplored. Therefore, this review portrays various bioactive components derived from plant sources associated with health-promoting traits and their action mechanisms. This review paper predominantly assembles proposed plant-derived bioactive compounds, postulating valuable evidence aimed at perceiving forthcoming approaches, including the selection of potent bioactive components for formulating functional diets that are effective against several human disorders. This meticulous evidence could perhaps provide the basis for the advanced preemptive and therapeutic potential promoting human health. Hence, delivery opens possibilities for purchasers to approach the lucrative practice of plants as a remedy, produce novel products, and access new marketplaces.
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Affiliation(s)
- Miray Simsek
- Department of Biochemistry, Purdue University, West Lafayette, IN 47907, USA
| | - Kristin Whitney
- Department of Food Science and Whistler Center for Carbohydrate Research, Purdue University, West Lafayette, IN 47907, USA
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13
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Rickerby A, Green R. Barriers to Adopting a Plant-Based Diet in High-Income Countries: A Systematic Review. Nutrients 2024; 16:823. [PMID: 38542734 PMCID: PMC10975979 DOI: 10.3390/nu16060823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/01/2024] Open
Abstract
Adopting a plant-based diet (PBD) has been shown to reduce the risk of developing certain diseases and is linked to environmental benefits. This review synthesises the evidence on the barriers adults aged 18 to 65 living in high-income countries (HIC) may experience when adopting a PBD. A systematic literature review was conducted using four search databases: Medline, Embase, Global Health, and Web of Science. Barriers were mapped to behaviour change strategies using the COM-B model. Ten studies were included in the final review, including 1740 participants. Five were qualitative, four were cross-sectional, and one was a pre- and-post-intervention study. In total, 40 barriers were identified and synthesised into 11 themes: financial, lack of knowledge, emotional, health, convenience, social, enjoyment of meat, environmental, accessibility, personal ability, and media. Of the 40 barriers, nutritional intake/requirements (categorised into the "health" theme) had the most evidence. This barrier encompassed concerns around being able to meet nutritional needs if an individual were to adopt a PBD. Habits (in the "personal ability" theme), which included established eating habits and habitual behaviours relating to animal-source foods, had the second most evidence alongside the barrier of not knowing what to eat as part of a PBD (in the "lack of knowledge" theme). Education interventions and communication/marketing policies were the behaviour change mechanisms mapped onto these barriers. Future interventions should focus on informing individuals about what to consume as part of a nutritionally balanced PBD and facilitating habitual dietary change.
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Affiliation(s)
- Alice Rickerby
- Department of Population Health, LSHTM Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, Keppel St, London W1CE 7HT, UK
| | - Rosemary Green
- Department of Population Health, LSHTM Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, Keppel St, London W1CE 7HT, UK
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14
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Glover A, Hayes HE, Ni H, Raikos V. A comparison of the nutritional content and price between dairy and non-dairy milks and cheeses in UK supermarkets: A cross sectional analysis. Nutr Health 2024; 30:157-165. [PMID: 35695231 PMCID: PMC10924701 DOI: 10.1177/02601060221105744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Non-Dairy (ND) food consumption is rapidly increasing in the UK and for many consumers plant-based diets are presumed to be healthier than standard diets. ND alternatives have different nutritional compositions, and their consumption could present challenges on a public-health level. Aim: To compare the price and nutritional composition of dairy and ND milks and cheeses in UK supermarkets. Methods: Macro and micronutrient data was recorded from Alpro's website and the 6 leading UK grocers for their own-label ND milks and cheeses. For missing micronutrient values the McCance & Widdowson's dataset was used. 99 total products were extracted: 57 ND milks, 7 dairy milks, 10 dairy cheeses and 25 ND cheeses. Dairy milk and cheese were used as control against which all ND products were compared. Results: Soya and coconut milks had lower values of carbohydrates, sugars, calcium, iodine, and potassium (p < 0.01) than dairy. Almond milk had lower values of carbohydrates (p = 0.01), sugars, calcium, iodine, and potassium (p < 0.01) compared to dairy milk. Protein was significantly (p < 0.01) lower for all ND except soya. Dairy cheeses had higher values for energy, protein, iodine, potassium, riboflavin, vitamin B12 and calcium (p < 0.01) than ND. Median prices were similar between dairy and ND milks, whereas ND cheeses were significantly more expensive compared to dairy (p < 0.01). Conclusions: ND alternatives fall short in several key nutrients compared to dairy. Fortification, accurate labelling and nutrition education are needed to help consumers make healthy and informed choices.
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Affiliation(s)
- Alex Glover
- Rowett Institute, University of Aberdeen, Aberdeen, Scotland, UK
| | - Helen E. Hayes
- Rowett Institute, University of Aberdeen, Aberdeen, Scotland, UK
| | - He Ni
- Guangdong Provincial Key Lab of Biotechnology for Plant Development, School of Life Sciences, South China Normal University, Guangzhou, China
| | - Vassilios Raikos
- Rowett Institute, University of Aberdeen, Aberdeen, Scotland, UK
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Shen X, Tilves C, Kim H, Tanaka T, Spira AP, Chia CW, Talegawkar SA, Ferrucci L, Mueller NT. Plant-based diets and the gut microbiome: findings from the Baltimore Longitudinal Study of Aging. Am J Clin Nutr 2024; 119:628-638. [PMID: 38218318 PMCID: PMC10972708 DOI: 10.1016/j.ajcnut.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Mounting evidence indicates that although some plant-based diets are healthful, others are not. Changes in the gut microbiome and microbiome-dependent metabolites, such as trimethylamine N-oxide (TMAO), may explain differential health effects of plant-based diets. However, human data are sparse on whether qualitatively distinct types of plant-based diets differentially affect gut microbiome diversity, composition, particularly at the species level, and/or metabolites. OBJECTIVES We aimed to examine cross-sectional associations of different plant-based indices with adult gut microbiome diversity, composition, and the metabolite TMAO. METHODS We studied 705 adults in the Baltimore Longitudinal Study of Aging with data for diet, fecal microbiome (shotgun metagenomic sequencing), and key covariates. We derived healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI) using data from food frequency questionnaires. We examined plant-based diet indices with microbiome α-diversity (richness and evenness measures), β-diversity (Bray-Curtis and UniFrac measures), composition (species level), and plasma TMAO. We used regression models to determine associations before and after adjustment for age, sex, education, physical activity, smoking status, body mass index, and total energy intake. RESULTS The analytic sample (mean age, 71.0 years, SD = 12.8 years) comprised 55.6% female and 67.5% non-Hispanic White participants. hPDI was positively and uPDI negatively associated with microbiome α-diversity, driven by microbial evenness (Pielou P < 0.05). hPDI was also positively associated with relative abundance of 3 polysaccharide-degrading bacterial species (Faecalibacterium prausnitzii, Eubacterium eligens, and Bacteroides thetaiotaomicron) and inversely associated with 6 species (Blautia hydrogenotrophica, Doreasp CAG 317, Eisenbergiella massiliensis, Sellimonas intestinalis, Blautia wexlerae, and Alistipes shahii). Furthermore, hPDI was inversely associated with TMAO. Associations did not differ by age, sex, or race. CONCLUSIONS Greater adherence to a healthful plant-based diet is associated with microbiome features that have been linked to positive health; adherence to an unhealthful plant-based diet has opposing or null associations with these features.
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Affiliation(s)
- Xinyi Shen
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Tufts University School of Medicine, Tufts University, Boston, MA, United States
| | - Curtis Tilves
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Hyunju Kim
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, United States
| | - Toshiko Tanaka
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, United States
| | - Chee W Chia
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Sameera A Talegawkar
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health at the George Washington University, Washington, DC, United States
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, United States; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States.
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16
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Kokkorou M, Spinelli S, Dinnella C, Monteleone E. Interventions based on sensory-hedonic strategies and on nudging to facilitate vegetable and pulses consumption in the school environment. Compr Rev Food Sci Food Saf 2024; 23:e13312. [PMID: 38462822 DOI: 10.1111/1541-4337.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024]
Abstract
Childhood and adolescence shape lifelong taste preferences and dietary habits, making them crucial periods for promoting healthy and sustainable eating. As students consume up to half of their daily energy intake at school, school interventions can have a significant impact on promoting plant-based diets. Although the benefits of promoting plant-based diets on children's and adolescents' health and environmental sustainability are well established and various studies report promising effects of interventions based on sensory-hedonic strategies and on nudging in promoting vegetables and pulses in schools, a comprehensive collection of those reports is lacking. Therefore, this systematic review aims to collect published literature on the above interventions in schools that focus on promoting the consumption of vegetables and pulses to children and adolescents. Three databases-PubMed, Scopus, and Web of Science-were searched over all years until March 2022 using pre-specified terms. From the 10.488 studies identified, a total of 57 studies reporting sensory-hedonic (e.g., manipulating food sensory properties or their hedonic value) or nudging (e.g., changing the presentation) interventions targeting children and/or adolescents in schools and aiming at promoting vegetables and/or pulses were included. Overall, interventions based on sensory-hedonic strategies (either enhancing the perception of well-accepted flavor and texture or manipulating their hedonic value) and on nudging (through incentives and prompts) are effective in promoting vegetables and pulses. A gap in the literature was identified for interventions targeting adolescents and promoting pulses. Finally, multicomponent interventions, rather than using one strategy alone, could be more successful.
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Affiliation(s)
- Margarita Kokkorou
- European Commission, Joint Research Centre (JRC), Ispra, Italy
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Sara Spinelli
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Caterina Dinnella
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
| | - Erminio Monteleone
- Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence, Italy
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17
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Jacquier EF, van de Wouw M, Nekrasov E, Contractor N, Kassis A, Marcu D. Local and Systemic Effects of Bioactive Food Ingredients: Is There a Role for Functional Foods to Prime the Gut for Resilience? Foods 2024; 13:739. [PMID: 38472851 DOI: 10.3390/foods13050739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
Scientific advancements in understanding the impact of bioactive components in foods on the gut microbiota and wider physiology create opportunities for designing targeted functional foods. The selection of bioactive ingredients with potential local or systemic effects holds promise for influencing overall well-being. An abundance of studies demonstrate that gut microbiota show compositional changes that correlate age and disease. However, navigating this field, especially for non-experts, remains challenging, given the abundance of bioactive ingredients with varying levels of scientific substantiation. This narrative review addresses the current knowledge on the potential impact of the gut microbiota on host health, emphasizing gut microbiota resilience. It explores evidence related to the extensive gut health benefits of popular dietary components and bioactive ingredients, such as phytochemicals, fermented greens, fibres, prebiotics, probiotics, and postbiotics. Importantly, this review distinguishes between the potential local and systemic effects of both popular and emerging ingredients. Additionally, it highlights how dietary hormesis promotes gut microbiota resilience, fostering better adaptation to stress-a hallmark of health. By integrating examples of bioactives, this review provides insights to guide the design of evidence-based functional foods aimed at priming the gut for resilience.
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Affiliation(s)
| | - Marcel van de Wouw
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
| | | | | | - Amira Kassis
- Neat Science, 1618 Chatel-Saint-Denis, Switzerland
| | - Diana Marcu
- School of Molecular Biosciences, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
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18
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Bruins A, Keeley J, Uhley V, Anyadike K, Kemp K. White Blood Cell and C-Reactive Protein Levels Are Similar in Obese Hispanic White Women Reporting Adherence to a Healthy Plant, Unhealthy Plant, or Animal-Based Diet, unlike in Obese Non-Hispanic White Women. Nutrients 2024; 16:556. [PMID: 38398880 PMCID: PMC10891662 DOI: 10.3390/nu16040556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
While modifying dietary patterns can reduce the effects of inflammation in obesity, less is known about the impact of dietary patterns on inflammation levels in women of different ethnicities. This study investigated the link between dietary patterns and mediators associated with inflammation, such as C-reactive protein (CRP) and white blood cells (WBCs), among obese Hispanic and Non-Hispanic White women. CRP and WBC counts were extracted from the National Health and Nutrition Examination Survey conducted between 2003 and 2010. Based on their recorded responses to two 24 h recall interviews, individuals were grouped into one of three dietary patterns: healthy plant-based, less healthy plant-based, or animal-based. Comparisons were run between obese Hispanic and Non-Hispanic women assigned to the same dietary pattern groups and between dietary pattern groups within ethnic groups. CRP and WBCs increased in obese Non-Hispanics as dietary patterns moved from healthy plant-based to animal-based (pCRP = 0.002 and pWBC = 0.017). Regardless of the dietary pattern, CRP and WBC expression were similar in Hispanic women. In addition, WBCs were higher in Hispanics compared to Non-Hispanics when both populations adhered to healthy plant and less healthy plant dietary patterns. The results indicate that dietary patterns may influence Hispanics' inflammation differently than Non-Hispanics.
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Affiliation(s)
- Anna Bruins
- Trinity Health Grand Rapids Family Medicine Residency, 200 Jefferson Ave SE, Grand Rapids, MI 49503, USA;
| | - Jacob Keeley
- Department of Research, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
| | - Virginia Uhley
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
- Department of Family Medicine and Community Health, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Kimberly Anyadike
- Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
| | - Kyeorda Kemp
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA;
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19
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Wathanavasin W, Kittiskulnam P, Johansen KL. Plant-based diets in patients with chronic kidney disease. ASIAN BIOMED 2024; 18:2-10. [PMID: 38515633 PMCID: PMC10954082 DOI: 10.2478/abm-2024-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Dietary protein restriction has been considered to be a nutritional-related strategy to reduce risk for end-stage kidney disease among patients with non-dialysis-dependent chronic kidney disease (CKD). However, there is insufficient evidence to recommend a particular type of protein to slow down the CKD progression. Recently, various plant-based diets could demonstrate some additional benefits such as a blood pressure-lowering effect, a reduction of metabolic acidosis as well as hyperphosphatemia, and gut-derived uremic toxins. Furthermore, the former concerns about the risk of undernutrition and hyperkalemia observed with plant-based diets may be inconsistent in real clinical practice. In this review, we summarize the current evidence of the proposed pleiotropic effects of plant-based diets and their associations with clinical outcomes among pre-dialysis CKD patients.
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Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok10330, Thailand
| | - Piyawan Kittiskulnam
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok10330, Thailand
- Division of Internal Medicine-Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok10330, Thailand
- Special Task Force for Activating Research in Renal Nutrition (Renal Nutrition Research Group), Office of Research Affairs, Chulalongkorn University, Bangkok10330, Thailand
| | - Kirsten L. Johansen
- Division of Nephrology, Hennepin Healthcare, Minneapolis, MN55415, USA
- Division of Nephrology, University of Minnesota, Minneapolis, MN55415, USA
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20
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Burghardt K, Craven T, Sardar NA, Pearce JM. Towards Sustainable Protein Sources: The Thermal and Rheological Properties of Alternative Proteins. Foods 2024; 13:448. [PMID: 38338583 PMCID: PMC10855059 DOI: 10.3390/foods13030448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Reducing meat consumption reduces carbon emissions and other environmental harms. Unfortunately, commercial plant-based meat substitutes have not seen widespread adoption. In order to enable more flexible processing methods, this paper analyzes the characteristics of commercially available spirulina, soy, pea, and brown rice protein isolates to provide data for nonmeat protein processing that can lead to cost reductions. The thermal and rheological properties, as well as viscosity, density, and particle size distribution, were analyzed for further study into alternative protein-based food processing. The differential scanning calorimetry analysis produced dry amorphous-shaped curves and paste curves with a more distinct endothermic peak. The extracted linear temperature ranges for processing within food production were 70-90 °C for spirulina, 87-116 °C for soy protein, 67-77 °C for pea protein, and 87-97 °C for brown rice protein. The viscosity analysis determined that each protein material was shear-thinning and that viscosity increased with decreased water concentration, with rice being an exception to the latter trend. The obtained viscosity range for spirulina was 15,100-78,000 cP, 3200-80,000 cP for soy protein, 1400-32,700 cP for pea protein, and 600-3500 cP for brown rice protein. The results indicate that extrusion is a viable method for the further processing of protein isolates, as this technique has a large temperature operating range and variable screw speed. The data provided here can be used to make single or multi-component protein substitutes.
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Affiliation(s)
- Kaitlyn Burghardt
- Department of Chemical & Biochemical Engineering, Western University, London, ON N6A 5B9, Canada
| | - Tierney Craven
- Department of Chemical & Biochemical Engineering, Western University, London, ON N6A 5B9, Canada
| | | | - Joshua M Pearce
- Department of Electrical & Computer Engineering and Ivey Business School, Western University, London, ON N6A 5B9, Canada
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21
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Ross FC, Mayer DE, Horn J, Cryan JF, Del Rio D, Randolph E, Gill CIR, Gupta A, Ross RP, Stanton C, Mayer EA. Potential of dietary polyphenols for protection from age-related decline and neurodegeneration: a role for gut microbiota? Nutr Neurosci 2024:1-19. [PMID: 38287652 DOI: 10.1080/1028415x.2023.2298098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Many epidemiological studies have shown the beneficial effects of a largely plant-based diet, and the strong association between the consumption of a Mediterranean-type diet with healthy aging including a lower risk of cognitive decline. The Mediterranean diet is characterized by a high intake of olive oil, fruits and vegetables and is rich in dietary fiber and polyphenols - both of which have been postulated to act as important mediators of these benefits. Polyphenols are large molecules produced by plants to protect them from environmental threats and injury. When ingested by humans, as little as 5% of these molecules are absorbed in the small intestine with the majority metabolized by the gut microbiota into absorbable simple phenolic compounds. Flavan-3-ols, a type of flavonoid, contained in grapes, berries, pome fruits, tea, and cocoa have been associated with many beneficial effects on several risk factors for cardiovascular disease, cognitive function and brain regions involved in memory formation. Both preclinical and clinical studies suggest that these brain and heart benefits can be attributed to endothelial vascular effects and anti-inflammatory properties among others. More recently the gut microbiota has emerged as a potential modulator of the aging brain and intriguingly polyphenols have been shown to alter microbiota composition and be metabolized by different microbial species. However, there is a need for well controlled studies in large populations to identify predictors of response, particularly given the vast inter-individual variation of human gut microbiota.
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Affiliation(s)
- F C Ross
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
| | - D E Mayer
- Institute of Human Nutrition, Columbia University, New York, USA
| | - J Horn
- Oppenheimer Centre for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - J F Cryan
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
- Department Anatomy & Neuroscience, University College Cork, Co. Cork, Ireland
| | - D Del Rio
- Department of Food and Drugs, University of Parma, Parma, Italy
| | - E Randolph
- Oppenheimer Centre for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - C I R Gill
- Nutrition Innovation Centre for Food and Health, Northern Ireland, UK
| | - A Gupta
- Division of Digestive Diseases, UCLA, Los Angeles, USA
- Goodman Luskin Microbiome Center at UCLA, Los Angeles, CA, USA
| | - R P Ross
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
| | - C Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - E A Mayer
- Oppenheimer Centre for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, USA
- Goodman Luskin Microbiome Center at UCLA, Los Angeles, CA, USA
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22
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Zheng Y, Gao N, Li Y, Fan M, Tian W, Jiang Y, Wang Y, Cui M, Suo C, Zhang T, Jin L, Xu K, Chen X. Unraveling the role of serum metabolites in the relationship between plant-based diets and bone health in community-dwelling older adults. Curr Res Food Sci 2024; 8:100687. [PMID: 38318314 PMCID: PMC10839558 DOI: 10.1016/j.crfs.2024.100687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
The potential adverse effects of the plant-based dietary pattern on bone health have received widespread attention. However, the biological mechanisms underlying the adverse effects of plant-based diets on bone health remain incompletely understood. The objective of this study was to identify potential biomarkers between plant-based diets and bone loss utilizing metabolomic techniques in the Taizhou Imaging Study (TIS) (N = 788). Plant-based diet indexes (overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI)) were calculated using the food frequency questionnaire, and bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. A multinomial logistic regression was used to explore the associations of plant-based diet indexes with bone loss. Furthermore, mediation analysis and exploratory factor analysis (EFA) were performed to explore the mediated effects of metabolites on the association of plant-based diets with BMD T-score. Our results showed that higher hPDI and uPDI were positively associated with bone loss. Moreover, nineteen metabolites were significantly associated with BMD T-score, among them, seven metabolites were associated with uPDI. Except for cholesterol esters in VLDL-1, the remaining six metabolites significantly mediated the negative association between uPDI and BMD T-score. Interestingly, we observed that the same six metabolites mediated the positive association between fresh fruit and BMD T-score. Collectively, our results support the deleterious effects of plant-based diets on bone health and discover the potential mediation effect of metabolites on the association of plant-based diets with bone loss. The findings offer valuable insights that could optimize dietary recommendations and interventions, contributing to alleviate the potential adverse effects associated with plant-based diets.
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Affiliation(s)
- Yi Zheng
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Ningxin Gao
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yucan Li
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Min Fan
- Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China
| | - Weizhong Tian
- Taizhou People's Hospital Affiliated to Nantong University, Taizhou, Jiangsu, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Yingzhe Wang
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Mei Cui
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chen Suo
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Tiejun Zhang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Kelin Xu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China
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23
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Welsh A, Hammad M, Piña IL, Kulinski J. Obesity and Cardiovascular Health. Eur J Prev Cardiol 2024:zwae025. [PMID: 38243826 DOI: 10.1093/eurjpc/zwae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/06/2024] [Accepted: 01/17/2024] [Indexed: 01/22/2024]
Abstract
Obesity has risen to epidemic levels worldwide over the past few decades and has become a huge global health burden owing to its direct contribution to the development of some of the most prevalent chronic diseases including diabetes, hypertension, hyperlipidemia, and other cardiovascular diseases. Obesity is a disease of positive energy balance resulting from complex interactions between abnormal neurohumoral responses and an individual's socioeconomic, environmental, behavioral, and genetic factors leading to a state of chronic inflammation. Understanding the complex nature of the disease is crucial in determining the best approach to combat its rising numbers. Despite recent advancements in pharmacological therapy for treatment of obesity, reversing weight gain and maintaining weight loss is challenging due to the relapsing nature of the disease. Prevention, therefore, remains the key which needs to start in-utero and continued throughout life. This review summarizes the role obesity plays in pathophysiology of various cardiovascular diseases both by directly affecting endothelial and myocyte function and indirectly by enhancing major cardiovascular risk factors like diabetes, hypertension, and hyperlipidemia. We highlight the importance of a holistic approach needed to prevent and treat this debilitating disease. Particularly, we analyze the effects of plant-based diet, regular exercise, and non-exercise activity thermogenesis (NEAT) on obesity and overall cardiorespiratory fitness (CRF). Moreover, we discuss the significance of individualizing obesity management with a multimodal approach including lifestyle modifications, pharmacotherapy, and bariatric surgery to tackle this chronic disease.
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Affiliation(s)
- Aimee Welsh
- Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI
| | - Muhammad Hammad
- Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI
| | - Ileana L Piña
- Division of Cardiology, Thomas Jefferson University, Philadelphia, PA
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24
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Joshi S, Shi R, Patel J. Risks of the ketogenic diet in CKD - the con part. Clin Kidney J 2024; 17:sfad274. [PMID: 38186877 PMCID: PMC10768778 DOI: 10.1093/ckj/sfad274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Indexed: 01/09/2024] Open
Abstract
The ketogenic diet is a very low carbohydrate diet that has received a lot of attention for its role in the treatment of type 2 diabetes and obesity. For patients with chronic kidney disease, there is limited evidence on the risks and/or benefits of this diet. However, from the limited evidence that does exist, there are several inferences that can be drawn regarding this diet for patients with kidney disease. The ketogenic diet may not be better than comparator higher carbohydrate diets over the long term. The diet also has low adherence levels in studies lasting ≥12 months. The diet's emphasis on fat, which often comes from animal fat, increases the consumption of saturated fat, which may increase the risk of heart disease. It has the potential to worsen metabolic acidosis by increasing dietary acid load and endogenous acid production through the oxidation of fatty acids. In addition, the diet has been associated with an increased risk of kidney stones in patients using it for the treatment of refractory epilepsy. For these reasons, and for the lack of safety data on it, it is reasonable for patients with kidney disease to avoid utilizing the ketogenic diet as a first-line option given alternative dietary patterns (like the plant-dominant diet) with less theoretical risk for harm. For those adopting the ketogenic diet in kidney disease, a plant-based version of the ketogenic diet may mitigate some of the concerns with animal-based versions of the ketogenic diet.
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Affiliation(s)
- Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA (Adjunct Faculty)
| | - Rachel Shi
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Jason Patel
- University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USA
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Aljahdali AA, Campos H, Granados K, Jones AD, Baylin A. Diet-Attributable Greenhouse Gas Emissions and Acute Myocardial Infarction in Costa Rica Heart Study. Nutrients 2023; 16:138. [PMID: 38201967 PMCID: PMC10780829 DOI: 10.3390/nu16010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/24/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Adopting sustainable dietary patterns is essential for planetary and human health. As data to address this issue are lacking in Latino populations, this study examined the association between diet-attributable greenhouse gas emissions (GHGEs) and myocardial infarction (MI) in a Costa Rica Heart Study. This analysis included 1817 cases of a first non-fatal acute MI during hospitalization and their matched population-based controls, by age, sex, and area of residence. A validated food frequency questionnaire was used to quantify habitual dietary intake and diet-attributable GHGEs (kg CO2 equivalent (eq.)/year). Due to the matching design, conditional logistic regression was used. Red meat consumption contributed approximately 50% to the total diet-attributable GHGEs among both cases and controls. Higher diet-attributable GHGEs were associated with increased odds of acute MI. The odds of MI were 63% higher (OR = 1.63; 95% CI 1.20-2.21) among participants in the highest quintile (median diet-attributable GHGEs = 6247 kg CO2 eq./year) compared to the lowest quintile (median diet-attributable GHGEs = 2065 kg CO2 eq./year). An increasing linear trend in the odds of acute MI and diet-attributable GHGEs was detected (p-trend 0.0012). These findings highlight the importance of reducing red meat consumption to sustainably mitigate the incidence of MI and improve planetary health.
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Affiliation(s)
- Abeer A. Aljahdali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Hannia Campos
- Center for Research and Innovation in Translational Nutrition, Universidad Hispanoamericana, San Jose 10101, Costa Rica; (H.C.); (K.G.)
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Keylin Granados
- Center for Research and Innovation in Translational Nutrition, Universidad Hispanoamericana, San Jose 10101, Costa Rica; (H.C.); (K.G.)
| | - Andrew D. Jones
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA;
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA;
- Department of Global Public Health, University of Michigan, Ann Arbor, MI 48109, USA
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Stanford J, McMahon S, Lambert K, Charlton KE, Stefoska-Needham A. Expansion of an Australian food composition database to estimate plant and animal intakes. Br J Nutr 2023; 130:1950-1960. [PMID: 37157848 PMCID: PMC10630146 DOI: 10.1017/s0007114523001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 02/25/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023]
Abstract
Despite evidence for favourable health outcomes associated with plant-based diets, a database containing the plant and animal content of all foods eaten is required to undertake a reliable assessment of plant-based diets within a population. This study aimed to expand an existing Australian food database to include the plant and animal content of all whole foods, beverages, multi-ingredient products and mixed dishes. Twenty-three plant- and animal-based food group classifications were first defined. The food servings per 100 g of each product were then systematically calculated using either a recipe-based approach, a food label-based approach, estimates based on similar products or online recipes. Overall, 4687 (83·5 %) foods and beverages were identified as plant or plant-containing products, and 3701 (65·9 %) were animal or animal-containing products. Results highlighted the versatility of plant and animal ingredients as they were found in various foods across many food categories, including savoury and sweet foods, as well as discretionary and core foods. For example, over 97 % of animal fat-containing foods were found in major food groups outside the AUSNUT 2011-2013 'fats and oils' group. Surprisingly, fruits, nuts and seeds were present in a greater percentage of discretionary products than in core foods and beverages. This article describes a systematic approach that is suitable for the development of other novel food databases. This database allows more accurate quantitative estimates of plant and animal intakes, which is significant for future epidemiological and clinical research aiming to investigate plant-based diets and their related health outcomes.
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Affiliation(s)
- Jordan Stanford
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW2522, Australia
| | - Sarah McMahon
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW2522, Australia
| | - Karen E. Charlton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW2522, Australia
| | - Anita Stefoska-Needham
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Ave, Wollongong, New South Wales, 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW2522, Australia
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Aceves-Martins M, Bates RL, Craig LCA, Chalmers N, Horgan G, Boskamp B, de Roos B. Consumption of foods with the highest nutritional quality, and the lowest greenhouse gas emissions and price, differs between socio-economic groups in the UK population. Public Health Nutr 2023; 26:3370-3378. [PMID: 37905562 PMCID: PMC10755419 DOI: 10.1017/s1368980023002355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/29/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE To establish a baseline understanding of whether consuming food with the highest nutritional quality, lowest greenhouse gas emissions (GHGE) and cost differs between different UK demographic and socio-economic population groups. DESIGN Multiple linear regression models were fitted to evaluate the relationship between predictor socio-demographic variables in this study (i.e. sex, ethnic group, age, BMI and level of deprivation) and the response variables (i.e. consumption of items considered most nutritious, with a low GHGE and price, as a proportion of total items consumed). SETTING The UK. PARTICIPANTS 1374 adult (18-65 years) participants from the National Diet and Nutrition Survey latest waves 9-11 (2016-2017 and 2018-2019). RESULTS Based on the total energy consumption in a day, the average diet-based GHGE was significantly higher for participants with a higher BMI. Non-white and most deprived participants spent significantly (P < 0·001) less money per total energy consumption. Participants with a BMI between 18·6 and 39·9 kg/m2 and those living in the least deprived areas consumed a significantly (P < 0·001) higher amount of those items considered the most nutritious, with the lowest GHGE and cost per 100 kcal. CONCLUSIONS Consumption of food with the highest nutritional quality, lowest GHGE and cost in the UK varies among those with different socio-demographic characteristics, especially the deprivation level of participants. Our analysis endorses the consideration of environmental sustainability and affordability, in addition to the consideration of nutritional quality from a health perspective, to make current dietary guidelines more encompassing and equitable.
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Affiliation(s)
| | - Ruth L Bates
- The Rowett Institute, University of Aberdeen, Foresterhill, AberdeenAB25 2ZD, UK
| | - Leone CA Craig
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Neil Chalmers
- The Rowett Institute, University of Aberdeen, Foresterhill, AberdeenAB25 2ZD, UK
| | - Graham Horgan
- Biomathematics & Statistics Scotland, Rowett Institute, Aberdeen, UK
| | - Bram Boskamp
- Biomathematics & Statistics Scotland, The King’s Buildings, Edinburgh, UK
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Foresterhill, AberdeenAB25 2ZD, UK
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Kahleova H, Holtz DN, Strom N, La Reau A, Kolipaka S, Schmidt N, Hata E, Znayenko-Miller T, Holubkov R, Barnard ND. A dietary intervention for postmenopausal hot flashes: A potential role of gut microbiome. An exploratory analysis. Complement Ther Med 2023; 79:103002. [PMID: 37949415 DOI: 10.1016/j.ctim.2023.103002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/11/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE This study examined the role of gut microbiome changes in mediating the effects of a dietary intervention on the frequency and severity of postmenopausal vasomotor symptoms METHODS: Postmenopausal women (n = 84) reporting ≥2 moderate-to-severe hot flashes daily were randomly assigned, in 2 successive cohorts, to an intervention including a low-fat, vegan diet and cooked soybeans (½ cup [86 g] daily) or to stay on their usual diet. Over a 12-week period, frequency and severity of hot flashes were recorded with a mobile application. In a subset of 11 women, gut microbiome was analyzed at baseline and after 12 weeks of the dietary intervention (low-fat vegan diet with soybeans), using deep shotgun metagenomic sequencing. Differences in the microbiome between baseline and 12 weeks were assessed by comparing alpha diversity with Wilcoxon signed rank tests, beta diversity with permanovaFL, and taxon abundance with Wilcoxon signed rank tests. Pearson correlations were used to assess the association between changes in hot flashes and gut bacteria. RESULTS In the subset for which microbiome testing was done, total hot flashes decreased by 95 % during the dietary intervention (p = 0.007); severe hot flashes disappeared (from 0.6 to 0.0/day; p = 0.06); and moderate-to-severe hot flashes decreased by 96 % (p = 0.01). Daytime and nighttime hot flashes were reduced by 96 % (p = 0.01) and 94 % (p = 0.004), respectively. Alpha and beta diversity did not significantly differ in the intervention group between baseline and 12 weeks. Two families (Enterobacteriaceae and Veillonellaceae), 5 genera (Erysipelatoclostridium, Fusicatenibacter, Holdemanella, Intestinimonas, and Porphyromonas), and 6 species (Clostridium asparagiforme, Clostridium innocuum, Bacteroides thetaiotaomicron, Fusicatenibacter saccharivorans, Intestinimonas butyriciproducens, Prevotella corporis, and Streptococcus sp.) were differentially abundant, but after correction for multiple comparisons, these differences were no longer significant. Changes in the relative abundance of Porphyromonas and Prevotella corporis were associated with the reduction in severe day hot flashes both unadjusted (r = 0.61; p = 0.047; and r = 0.69; p = 0.02), respectively), and after adjustment for changes in body mass index (r = 0.63; p = 0.049; and r = 0.73; p = 0.02), respectively). Changes in relative abundance of Clostridium asparagiforme were associated with the reduction in total severe hot flashes (r = 0.69; p = 0.019) and severe night hot flashes (r = 0.82; p = 0.002) and the latter association remained significant after adjustment for changes in body mass index (r = 0.75; p = 0.01). CONCLUSIONS This exploratory analysis revealed potential associations between changes in vasomotor symptoms in response to a diet change and changes in the gut microbiome. Larger randomized clinical trials are needed to investigate these findings.
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Affiliation(s)
- Hana Kahleova
- Physicians Committee for Responsible Medicine, Washington, DC, USA.
| | - Danielle N Holtz
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | | | | | - Sinjana Kolipaka
- Physicians Committee for Responsible Medicine, Washington, DC, USA; Florida Atlantic University, Charles E. Schmidt College of Medicine, FL, USA
| | - Natalie Schmidt
- Physicians Committee for Responsible Medicine, Washington, DC, USA; Florida Atlantic University, Charles E. Schmidt College of Medicine, FL, USA
| | - Ellen Hata
- Physicians Committee for Responsible Medicine, Washington, DC, USA; George Washington University, Milken Institute School of Public Health, DC, USA
| | | | | | - Neal D Barnard
- Physicians Committee for Responsible Medicine, Washington, DC, USA; Adjunct faculty, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
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Eckart A, Bhochhibhoya A, Stavitz J, Sharma Ghimire P, Mathieson K. Associations of animal source foods, cardiovascular disease history, and health behaviors from the national health and nutrition examination survey: 2013-2016. Glob Epidemiol 2023; 5:100112. [PMID: 37638374 PMCID: PMC10446117 DOI: 10.1016/j.gloepi.2023.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 08/29/2023] Open
Abstract
Background Some individuals adopt vegetarian or plant-based diets to improve their health. Observational evidence suggests diets composed of higher amounts of animal-source foods (ASFs) are associated with increased risk for disease and early mortality. In many of these studies, those who ate fewer animal-source foods reported fewer disease risk factors and unhealthy behaviors, which could indicate bias. Purpose This study aims to examine the relationships between ASF consumption, health behaviors, and cardiovascular disease (CVD) prevalence in a population-representative sample of U.S. civilians controlling for confounders. Methods Respondent data were collected from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 collection years. Collected data included demographics, ASF intake, healthy lifestyle variables, body mass index, and blood lipids. Results There was a higher proportion of those with CVD history who consumed red meat (61.3%; C.I. 41.7%-77.8%), but the proportion was lower for white (23.3%; C.I. 12.6%-39.0%) and processed meat (15.4%; C.I. 6.5%-32.3%). When adjusted for sex, the odds of CVD history increased for red meat compared to processed meat consumption (OR 2.95; C.I. 1.14-7.66). Unhealthy lifestyle increased the odds of CVD history by nearly 8-fold (OR 7.8; C.I. 3.44-17.7). Individual factors including age, smoking history, body mass index, and blood lipids, and demographic factors, including education level, race, and income, were also associated with increased odds for CVD history. ROC analysis revealed 77.2% AUC for CVD history classified by individual factors (BMI ≥30 kg/m**2, ≤ 30 min moderate physical activity, smoker, fiber intake ≤25 g, dental visit more than two years ago, and age above 60 years). Three or more factors moderately predicted CVD history when optimized for sensitivity (73.4%) and specificity (71%). Adjusted for sex, the relationship between CVD and moderate physical activity became stronger possibly reflecting lifestyle changes. Despite evidence of lifestyle changes, modifiable risk factors persisted in the CVD group. CVD diagnosis in males was substantially delayed compared to females concerning the sex-specific age cutoff associated with higher risk. The healthy lifestyle group was characterized by earlier CVD diagnosis and fewer overall risk factors compared to the unhealthy lifestyle group. Conclusion CVD history was strongly associated with demographic, lifestyle, and dietary factors. Future research should focus on multidimensional models for disease risk stratification and prevention, including individual, behavioral, and sociodemographic factors.
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Affiliation(s)
- Adam Eckart
- Kean University, College of Health Professions and Human Services, 1000 Morris Avenue, Union, NJ 07083, USA
| | - Amir Bhochhibhoya
- Kean University, College of Health Professions and Human Services, 1000 Morris Avenue, Union, NJ 07083, USA
| | - James Stavitz
- Kean University, College of Health Professions and Human Services, 1000 Morris Avenue, Union, NJ 07083, USA
| | - Pragya Sharma Ghimire
- Kean University, College of Health Professions and Human Services, 1000 Morris Avenue, Union, NJ 07083, USA
| | - Kathleen Mathieson
- A.T. Still University, College of Graduate Health Studies, 5850 E. Still Circle, Mesa, AZ 85206, USA
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Milovac T. Are Physicians Obligated to Recommend a Plant-Based Diet? A Response to Maximilian Storz. New Bioeth 2023; 29:363-381. [PMID: 37788230 DOI: 10.1080/20502877.2023.2261729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Maximilian Storz argues that physicians have an ethical obligation to recommend a plant-based diet to patients because such a diet: relieves certain chronic conditions, outperforms the Western diet (e.g. a diet containing animal products, among other things), and is ecologically sustainable. Contrary to these claims, I argue that a plant-based diet alone may not relieve chronic conditions, but potentially does so in combination with other lifestyle factors. With respect to the environment, I illuminate the landscape by discussing agricultural factors consistent across animal and plant farming such as energy and water. I conclude that physicians ought to recommend a diet that follows the science; such a diet as I have claimed is exclusionary: it excludes processed foods, especially added sugars. Lifestylfe factors also deserve to be discussed in the medical encounter as their incorporation may lead to even better health outcomes.
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Affiliation(s)
- Thomas Milovac
- Department of Philosophy, University of Waterloo, Waterloo, Canada
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Gou W, Miao Z, Deng K, Zheng JS. Nutri-microbiome epidemiology, an emerging field to disentangle the interplay between nutrition and microbiome for human health. Protein Cell 2023; 14:787-806. [PMID: 37099800 PMCID: PMC10636640 DOI: 10.1093/procel/pwad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/28/2023] Open
Abstract
Diet and nutrition have a substantial impact on the human microbiome, and interact with the microbiome, especially gut microbiome, to modulate various diseases and health status. Microbiome research has also guided the nutrition field to a more integrative direction, becoming an essential component of the rising area of precision nutrition. In this review, we provide a broad insight into the interplay among diet, nutrition, microbiome, and microbial metabolites for their roles in the human health. Among the microbiome epidemiological studies regarding the associations of diet and nutrition with microbiome and its derived metabolites, we summarize those most reliable findings and highlight evidence for the relationships between diet and disease-associated microbiome and its functional readout. Then, the latest advances of the microbiome-based precision nutrition research and multidisciplinary integration are described. Finally, we discuss several outstanding challenges and opportunities in the field of nutri-microbiome epidemiology.
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Affiliation(s)
- Wanglong Gou
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
- Research Center for Industries of the Future, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310030, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, China
| | - Zelei Miao
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
- Research Center for Industries of the Future, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310030, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, China
| | - Kui Deng
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
- Research Center for Industries of the Future, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310030, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, China
| | - Ju-Sheng Zheng
- Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
- Research Center for Industries of the Future, Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310030, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou 310024, China
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Curlin D, Hare ME, Tolley EA, Gatwood J. Plant-based dietary patterns and fasting insulin: a cross-sectional study from NHANES 2017-2018. BMC Nutr 2023; 9:122. [PMID: 37924091 PMCID: PMC10623701 DOI: 10.1186/s40795-023-00780-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/12/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Previous studies have created plant-based diet indices to assess the health effects of specific dietary patterns. OBJECTIVE To examine the association between the plant-based content of diet and fasting insulin in adults from the NHANES 2017-2018 database. METHODS Demographic, dietary, lab and clinical data and fasting insulin were obtained from the NHANES 2017-2018 database. From two 24-h dietary recalls, we created a plant-based diet index (PDI) and a healthy plant-based diet index (hPDI). A high PDI score indicated more plants were consumed versus animal foods. A high hPDI score indicated healthier, plant materials (whole grains, whole fruits, vegetables, legumes, vegetable oils, seeds and nuts) were consumed. The relationships between the natural log of fasting insulin, PDI, and hPDI were analyzed using multiple linear regression adjusting for body mass index (BMI) and alanine aminotransferase (ALT). RESULTS Analyses were based on 1,714 participants, 897 women and 817 men with a median age of 52 years. In this sample, 610 (35.6%) were white, 407 (23.8%) were black, 231 (13.5%) were Mexican, 207 (12.1%) were Asian, 157 (9.2%) were other Hispanic, and 102 (6%) were other or mixed race. Median fasting insulin was 9.74 μU/mL (IQR: 6.2, 15.56). For every 1 unit increase in PDI, the natural log of fasting insulin decreased 0.0068 ± 0.003 μU/mL (CI: -0.00097, -0.013) (p = 0.02). After adjusting for BMI and ALT, the PDI did not significantly predict fasting insulin as the association was not robust due to multicollinearity. The hPDI was inversely and significantly associated with the natural log of fasting insulin (-0.0027 ± 0.00134, CI: -0.000087, -0.0053) (p = 0.043) in a multivariable model including BMI and ALT. CONCLUSION A healthy plant-based diet is associated with a decrease in fasting insulin levels. Healthfulness of the diet is an important factor when considering the benefit of a plant-based diet.
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Affiliation(s)
- Dana Curlin
- University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Marion E Hare
- University of Tennessee Health Science Center, Memphis, TN, USA
- College of Medicine - Department of Preventive Medicine, Division of Preventive Medicine, Memphis, TN, USA
| | - Elizabeth A Tolley
- University of Tennessee Health Science Center, Memphis, TN, USA
- College of Medicine - Department of Preventive Medicine, Division of Preventive Medicine, Memphis, TN, USA
| | - Justin Gatwood
- University of Tennessee Health Science Center, Memphis, TN, USA
- College of Pharmacy - Department of Clinical Pharmacy & Translational Science, Nashville, TN, USA
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Chen KC, Hsu CN, Wu CH, Lin KL, Chen SM, Lee Y, Hsu CY, Hsu CW, Huang CY, Huang SH, Liao CT, Soong C, Chen PW, Yeh SM, Wu CC, Lin CI, Guo NW, Li YH, Lin TH, Chen CH, Huang CY, Chen SY, Wang YC, Huang WC, Chou W, Chen WJ. 2023 TAMIS/TSOC/TACVPR Consensus Statement for Patients with Acute Myocardial Infarction Rehabilitation. Acta Cardiol Sin 2023; 39:783-806. [PMID: 38022422 PMCID: PMC10646588 DOI: 10.6515/acs.202311_39(6).20230921a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023]
Abstract
Cardiac rehabilitation is a comprehensive intervention recommended in international and Taiwanese guidelines for patients with acute myocardial infarction. Evidence supports that cardiac rehabilitation improves the health-related quality of life, enhances exercise capacity, reduces readmission rates, and promotes survival in patients with cardiovascular disease. The cardiac rehabilitation team is comprehensive and multidisciplinary. The inpatient, outpatient, and maintenance phases are included in cardiac rehabilitation. All patients admitted with acute myocardial infarction should be referred to the rehabilitation department as soon as clinically feasible. Pre-exercise evaluation, including exercise testing, helps physicians identify the risks of cardiac rehabilitation and organize appropriate exercise prescriptions. Therefore, the Taiwan Myocardial Infarction Society (TAMIS), Taiwan Society of Cardiology (TSOC), and Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation (TACVPR) address this consensus statement to assist healthcare practitioners in performing cardiac rehabilitation in patients with acute myocardial infarction.
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Affiliation(s)
- Kuan-Cheng Chen
- Kangze Rehabilitation Clinic, Taoyuan
- Department of Rehabilitation, Far Eastern Memorial Hospital
- Division of Physical Medicine and Rehabilitation, Fu Jen Catholic University Hospital, New Taipei City
| | - Chih-Neng Hsu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin
| | - Cheng-Hsueh Wu
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei
| | - Ko-Lung Lin
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital
| | - Shyh-Ming Chen
- Department of Cardiology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung
| | - Yuchun Lee
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung
| | - Chien-Yi Hsu
- Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | | | - Chi-Yao Huang
- Department of Cardiology, Taichung Veterans General Hospital, Taichung
| | | | - Chia-Te Liao
- Division of Cardiovascular Medicine, Chi Mei Medical Center, Tainan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung
| | - Christina Soong
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
| | - Po-Wei Chen
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Shu-Ming Yeh
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan
| | - Chang-Cheng Wu
- Department of Physical Medicine and Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan
| | - Cho-I Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, Yunlin
| | - Nai-Wen Guo
- Institue of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan
| | - Yi-Heng Li
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
- Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University
| | - Chia-Hsin Chen
- Department of Physical Medicine and Rehabilitation, Kaoshiung Medical University Hospital
- School of Medicine, College of Medicine, Kaoshiung Medical University, Kaoshiung
| | - Chun-Yao Huang
- Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital
| | - Ssu-Yuan Chen
- Division of Physical Medicine and Rehabilitation, Fu Jen Catholic University Hospital, New Taipei City
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
- Fu Jen Catholic University College of Medicine, New Taipei City
| | - Yu-Chen Wang
- Department of Cardiology, Asia University Hospital, Taichung
| | - Wei-Chun Huang
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Department of Physical Therapy, Fooyin University, Kaohsiung
| | - Willy Chou
- Department of Rehabilitation, Chi Mei Medical Center, Tainan
| | - Wen-Jone Chen
- Department of Cardiology, Min-Sheng General Hospital, Taoyuan, Taiwan
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Young L, Mackay S, Bradbury KE. Nutrient content and cost of canned and dried legumes and plant-based meat analogues available in New Zealand supermarkets. Nutr Diet 2023; 80:472-483. [PMID: 37545013 DOI: 10.1111/1747-0080.12834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023]
Abstract
AIMS Plant-based eating patterns are recommended for human and planetary health. Plant-based protein sources in supermarkets include traditional options and plant-based meat analogues. This cross-sectional survey examined the nutritional content, healthiness, cost and labelling of these products. METHODS Nutrient content and claims on canned legumes (plain [N = 64] and flavoured [N = 25]), canned baked beans (N = 23), dried legumes (N = 21), tofu (plain [N = 8] and flavoured [N = 5]), falafels (N = 14), meat analogues (meat-free burgers [N = 11], meat-free sausages [N = 10] and 'other' meat-free products [N = 20]) were obtained from a database of packaged foods in New Zealand. Mean (SD) energy, protein, total fat, saturated fat, sodium and dietary fibre content (per 100 g) was calculated for each category. Healthiness was assessed using an estimated Health Star Rating (Rating ≥3.5 considered 'healthy'). Product data were linked with household purchasing data from the 2019 Nielsen IQ® consumer panel to calculate mean purchase price/100 g/category. The number and type of nutrition claims were compared across categories. RESULTS The highest mean protein content was 'other' meat-free products (14.8 ± 6.9 g/100 g). Meat-free sausages had the highest sodium and saturated fat content (643 ± 148 mg/100 g, 3.7 ± 4.5 g/100 g). Overall, few meat analogues (N = 5, 12%) scored an estimated Health Star Rating ≥3.5. Dried legumes were the cheapest plant protein (mean ± SD) purchase price = NZ $0.30 ± 0.16/100 g), compared with 'other' meat-free products (purchase price = NZ $2.57 ± 0.88/100 g). The most common nutrition claims on meat analogues were about protein content. Dietary fibre claims were the most common on canned and dried legumes. CONCLUSION Meat analogues offer convenience, however, may be less healthy and more expensive than traditional plant-based proteins. This study assists dietitians in providing accurate consumer messaging about healthy plant-based proteins.
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Affiliation(s)
- Leanne Young
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Kathryn E Bradbury
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
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Clarke ED, Ferguson JJ, Stanford J, Collins CE. Dietary Assessment and Metabolomic Methodologies in Human Feeding Studies: A Scoping Review. Adv Nutr 2023; 14:1453-1465. [PMID: 37604308 PMCID: PMC10721540 DOI: 10.1016/j.advnut.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/01/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
Dietary metabolomics is a relatively objective approach to identifying new biomarkers of dietary intake and for use alongside traditional methods. However, methods used across dietary feeding studies vary, thus making it challenging to compare results. The objective of this study was to synthesize methodological components of controlled human feeding studies designed to quantify the diet-related metabolome in biospecimens, including plasma, serum, and urine after dietary interventions. Six electronic databases were searched. Included studies were as follows: 1) conducted in healthy adults; 2) intervention studies; 3) feeding studies focusing on dietary patterns; and 4) measured the dietary metabolome. From 12,425 texts, 50 met all inclusion criteria. Interventions were primarily crossover (n = 25) and parallel randomized controlled trials (n = 22), with between 8 and 395 participants. Seventeen different dietary patterns were tested, with the most common being the "High versus Low-Glycemic Index/Load" pattern (n = 11) and "Typical Country Intake" (n = 11); with 32 providing all or the majority (90%) of food, 16 providing some food, and 2 providing no food. Metabolites were identified in urine (n = 31) and plasma/serum (n = 30). Metabolites were quantified using liquid chromatography, mass spectroscopy (n = 31) and used untargeted metabolomics (n = 37). There was extensive variability in the methods used in controlled human feeding studies examining the metabolome, including dietary patterns tested, biospecimen sample collection, and metabolomic analysis techniques. To improve the comparability and reproducibility of controlled human feeding studies examining the metabolome, it is important to provide detailed information about the dietary interventions being tested, including information about included or restricted foods, food groups, and meal plans provided. Strategies to control for individual variability, such as a crossover study design, statistical adjustment methods, dietary-controlled run-in periods, or providing standardized meals or test foods throughout the study should also be considered. The protocol for this review has been registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/DAHGS).
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Affiliation(s)
- Erin D Clarke
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jessica Ja Ferguson
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jordan Stanford
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
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Kendrick KN, Kim H, Rebholz CM, Selvin E, Steffen LM, Juraschek SP. Plant-Based Diets and Risk of Hospitalization with Respiratory Infection: Results from the Atherosclerosis Risk in Communities (ARIC) Study. Nutrients 2023; 15:4265. [PMID: 37836549 PMCID: PMC10574784 DOI: 10.3390/nu15194265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The benefits of plant-based diets may depend on the type of plant. To determine the associations of healthy and unhealthy plant-based diet types on risk of hospitalization with respiratory infections or any infection, we used dietary intake data reported in a food frequency questionnaire from the Atherosclerosis Risk in Communities Study to calculate a plant-based diet index (PDI), a healthy PDI (HPDI), and an unhealthy PDI (UPDI). Cox regression was used to calculate hazard ratios for the associations of the three plant-based diet indices with the risk of hospitalization with respiratory infections and any infection-related hospitalization. Comparing the highest to lowest quintiles, HPDI was associated with a lower risk of hospitalization with respiratory infections (HR 0.86, 95% CI: 0.75, 0.99), and a lower risk of hospitalization with any infections (HR 0.87, 95% CI: 0.78, 0.97). The PDI was associated with a lower risk of hospitalization with any infections (HR 0.86, 95% CI: 0.76, 0.96). Significant associations were not observed with the UPDI. Adults with a high PDI and HPDI had a lower risk of hospitalization with any infections, whereas adults with a high HPDI had lower risk of hospitalizations with respiratory infections.
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Affiliation(s)
- Karla N. Kendrick
- General Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
- Harvard Medical School, Boston, MA 02215, USA
- Beth Israel Lahey Health, Winchester Hospital Weight Management Center, Woburn, MA 01801, USA
| | - Hyunju Kim
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA; (H.K.); (C.M.R.); (E.S.)
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
- University of Washington School of Public Health, Seattle, WA 98105, USA
| | - Casey M. Rebholz
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA; (H.K.); (C.M.R.); (E.S.)
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
- Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Elizabeth Selvin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA; (H.K.); (C.M.R.); (E.S.)
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
| | - Lyn M. Steffen
- School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
| | - Stephen P. Juraschek
- General Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
- Harvard Medical School, Boston, MA 02215, USA
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Wang YB, Page AJ, Gill TK, Melaku YA. The association between diet quality, plant-based diets, systemic inflammation, and mortality risk: findings from NHANES. Eur J Nutr 2023; 62:2723-2737. [PMID: 37347305 PMCID: PMC10468921 DOI: 10.1007/s00394-023-03191-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE To our knowledge, no studies have examined the association of diet quality and plant-based diets (PBD) with inflammatory-related mortality in obesity. Therefore, this study aimed to determine the joint associations of Healthy Eating Index-2015 (HEI-2015), plant-based dietary index (PDI), healthy PDI (hPDI), unhealthy PDI (uPDI), pro-vegetarian dietary index (PVD), and systemic inflammation with all-cause, cardiovascular disease (CVD), and cancer mortality risks by obesity status. METHODS Participants from NHANES were included in cross-sectional (N = 27,915, cycle 1999-2010, 2015-2018) and longitudinal analysis (N = 11,939, cycle 1999-2008). HEI-2015, PDI, hPDI, uPDI, and PVD were constructed based on the 24-h recall dietary interview. The grade of inflammation (low, moderate, and high) was determined based on C-reactive protein (CRP) values and multivariable ordinal logistic regression was used to determine the association. Cox proportional hazard models were used to determine the joint associations of diet and inflammation with mortality. RESULTS In the fully adjusted model, HEI-2015 (ORT3vsT1 = 0.76, 95% CI 0.69-0.84; p-trend = < 0.001), PDI (ORT3vsT1 = 0.83, 95% CI 0.75-0.91; p trend = < 0.001), hPDI (ORT3vsT1 = 0.79, 95% CI 0.71-0.88; p trend = < 0.001), and PVD (ORT3vsT1 = 0.85, 95% CI 0.75-0.97; p trend = 0.02) were associated with lower systemic inflammation. In contrast, uPDI was associated with higher systemic inflammation (ORT3vsT1 = 1.18, 95% CI 1.06-1.31; p-trend = 0.03). Severe inflammation was associated with a 25% increase in all-cause mortality (ORT3vsT1 = 1.25, 95% CI 1.03-1.53, p trend = 0.02). No association was found between PDI, hPDI, uPDI, and PVD with mortality. The joint association, between HEI-2015, levels of systemic inflammation, and all-cause, CVD and cancer mortality, was not significant. However, a greater reduction in mortality risk with an increase in HEI-2015 scores was observed in individuals with low and moderate inflammation, especially those with obesity. CONCLUSION Higher scores of HEI-2015 and increased intake of a healthy plant-based diet were associated with lower inflammation, while an unhealthy plant-based diet was associated with higher inflammation. A greater adherence to the 2015 dietary guidelines may reduce the risk of mortality associated with inflammation and may also benefit individuals with obesity who had low and moderate inflammation.
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Affiliation(s)
- Yoko Brigitte Wang
- Vagal Afferent Research Group, School of Biomedicine, University of Adelaide, Adelaide, SA, Australia.
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
- Department of Cellular and Integrative Physiology, Long School of Medicine, UT Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
| | - Amanda J Page
- Vagal Afferent Research Group, School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Yohannes Adama Melaku
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- FHMRI Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
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Kocabas S, Sanlier N. The power of berries against cardiovascular diseases. Nutr Rev 2023:nuad111. [PMID: 37695292 DOI: 10.1093/nutrit/nuad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Cardiovascular diseases (CVDs) pose a serious threat to human health and incidence is increasing gradually. Nutrition has an important impact on the prophylaxis and progression of CVD. In this article, general attention is drawn to the possible positive effects of berries on CVD. Polyphenols have beneficial effects on the vascular system by inhibiting low-density lipoprotein oxidation and platelet aggregation, lowering blood pressure, improving endothelial dysfunction, and attenuating antioxidant defense and inflammatory responses. This review provides an overview of the effects of berries for the prevention and treatment of CVDs. Berries contain several cardioprotective antioxidants, vitamins, and numerous phytochemicals, such as phenolic compounds, that have antioxidant properties and antiplatelet activity. Phytochemical compounds in their structures can modulate dissimilar signaling pathways related to cell survival, differentiation, and growth. Important health benefits of berries include their antioxidant roles and anti-inflammatory impacts on vascular function. The effectiveness and potential of polyphenols primarily depend on the amount of bioavailability and intake. Although circulating berry metabolites can improve vascular function, their biological activities, mechanisms of action, and in vivo interactions are still unknown. Analyzing human studies or experimental studies to evaluate the bioactivity of metabolites individually and together is essential to understanding the mechanisms by which these metabolites affect vascular function.
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Affiliation(s)
- Sule Kocabas
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Altındağ, Ankara, Turkey
| | - Nevin Sanlier
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Altındağ, Ankara, Turkey
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Guarneiri LL, Maki KC. An Update on Nutrition Guidance for Cardiovascular Health. Curr Atheroscler Rep 2023; 25:597-603. [PMID: 37428389 DOI: 10.1007/s11883-023-01128-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW The goal of this article is to summarize recent guidance on diet and cardiovascular health. RECENT FINDINGS Cardiovascular diseases are the leading cause of death in the USA, and diet significantly impacts cardiovascular disease risk. The focus of contemporary dietary recommendations has shifted from single nutrient replacements to dietary patterns such as the Mediterranean, healthy USA, Dietary Approaches to Stop Hypertension, and healthy plant-based patterns. Recommended dietary patterns emphasize whole grains, fruits, vegetables, nuts, seeds, legumes/pulses, seafood, lean meats, and fish/seafood. They also limit intakes of ultra-processed foods, processed meats, and alcohol, as well as foods high in salt and added sugars, particularly sugar-sweetened beverages.
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Affiliation(s)
- Liana L Guarneiri
- Midwest Biomedical Research, 211 East Lake Street, Suite 3, Addison, IL, 60101, USA
| | - Kevin C Maki
- Midwest Biomedical Research, 211 East Lake Street, Suite 3, Addison, IL, 60101, USA.
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, 47408, USA.
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Rosenfeld RM, Juszczak HM, Wong MA. Scoping review of the association of plant-based diet quality with health outcomes. Front Nutr 2023; 10:1211535. [PMID: 37637943 PMCID: PMC10447911 DOI: 10.3389/fnut.2023.1211535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes. Methods Scoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI. Results We included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case-control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI. Discussion Dietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.
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Affiliation(s)
- Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Del Carmen Fernández-Fígares Jiménez M. Plant foods, healthy plant-based diets, and type 2 diabetes: a review of the evidence. Nutr Rev 2023:nuad099. [PMID: 37550262 DOI: 10.1093/nutrit/nuad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Type 2 diabetes (T2D) is a metabolic chronic disease in which insulin resistance and insufficient insulin production lead to elevated blood glucose levels. The prevalence of T2D is growing worldwide, mainly due to obesity and the adoption of Western diets. Replacing animal foods with healthy plant foods is associated with a lower risk of T2D in prospective studies. In randomized controlled trials, the consumption of healthy plant foods in place of animal foods led to cardiometabolic improvements in patients with T2D or who were at high risk of the disease. Dietary patterns that limit or exclude animal foods and focus on healthy plant foods (eg, fruits, vegetables, whole grains, nuts, legumes), known as healthy, plant-based diets, are consistently associated with a lower risk of T2D in cohort studies. The aim of this review is to examine the differential effects of plant foods and animal foods on T2D risk and to describe the existing literature about the role of healthy, plant-based diets, particularly healthy vegan diets, in T2D prevention and management. The evidence from cohort studies and randomized controlled trials will be reported, in addition to the potential biological mechanisms that seem to be involved.
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Nosworthy MG, Medina G, Lu ZH, House JD. Plant Proteins: Methods of Quality Assessment and the Human Health Benefits of Pulses. Foods 2023; 12:2816. [PMID: 37569085 PMCID: PMC10417564 DOI: 10.3390/foods12152816] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023] Open
Abstract
As countries increase their standard of living and individual income levels rise, there is a concomitant increase in the demand for animal-based protein. However, there are alternative sources. One of the alternatives available is that of increased direct human consumption of plant proteins. The quality of a dietary protein is an important consideration when discussing the merits of one protein source over another. The three most commonly used methods to express protein quality are the protein efficiency ratio (PER), a weight gain measurement; protein digestibility-corrected amino acid score (PDCAAS); and the digestible indispensable amino acid score (DIAAS). The possibility that alterations in the quality and quantity of protein in the diet could generate specific health outcomes is one being actively researched. Plant-based proteins may have additional beneficial properties for human health when compared to animal protein sources, including reductions in risk factors for cardiovascular disease and contributions to increased satiety. In this paper, the methods for the determination of protein quality and the potential beneficial qualities of plant proteins to human health will be described.
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Affiliation(s)
- Matthew G. Nosworthy
- Guelph Research and Development Center, Agriculture and Agri-Food Canada, Guelph, ON N1G 5C9, Canada;
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Gerardo Medina
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 5B2, Canada;
| | - Zhan-Hui Lu
- Guelph Research and Development Center, Agriculture and Agri-Food Canada, Guelph, ON N1G 5C9, Canada;
| | - James D. House
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada;
- Richardson Centre for Food Technology and Research, 196 Innovation Drive, Winnipeg, MB R3T 2N2, Canada
- Department of Animal Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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Wirnitzer KC, Motevalli M, Cocca A, Tanous DR, Wirnitzer G, Wagner KH, Schätzer M, Drenowatz C, Ruedl G, Kirschner W. Health behavior of Austrian tertiary students focusing on diet type linked to sports and exercise-first glimpse of results from the "sustainably healthy-from science 2 high school and university" study. Front Public Health 2023; 11:1129004. [PMID: 37533531 PMCID: PMC10392833 DOI: 10.3389/fpubh.2023.1129004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Background There is a strong association between lifestyle behavior and health status. While young adulthood is a critical period for adopting and stabilizing lifelong healthy behavior, university life is independently associated with psychological stressors that may further affect health and well-being. Objective The present multidisciplinary study aimed to examine the health behavior of Austrian college and university students, differentiated based on diet types (vegan, vegetarian, and omnivorous) and physical activity (PA) habits. Methods Following a cross-sectional study design, a total number of 6,148 students (65.3% females; 66.1% bachelor students, 67.0% from urban areas; mean age: 24.8 years) from 52 Austrian college/universities participated in an online survey and provided data on sociodemographic characteristics, dietary patterns, PA habits, and other lifestyle behavior characteristics, including alcohol intake and smoking. Results Across the total sample, 74.0% had a normal weight (BMI = 18.5-25.0 kg/m2), while the prevalence of overweight/obesity (BMI ≥ 30.0 kg/m2) was lower in females than males and more in rural than urban students (p < 0.01). The general prevalence of vegetarian and vegan diets was 22.8 and 6.0%, respectively, with a predominance of females, graduates, and urban students compared to their peers (p < 0.01). The majority of students (79.3%) had a regular engagement in sport/exercise, with a predominance of vegetarian or vegan students compared to omnivores (p < 0.01). Vegans and vegetarians had a lower alcohol intake (p < 0.01) but no differences in smoking habits (p > 0.05) compared to omnivores. Students engaging in sport/exercise had a lower smoking rate and higher intake of fruits, vegetables, and fluids compared to inactive students (p < 0.01). Conclusion The present findings suggest that diet type and PA habits of college/university students have an impact on other health behaviors, highlighting the interconnected nature of lifestyle habits and health behavior.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition (SIPCAN), Elsbethen, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Mehta P, Tawfeeq S, Padte S, Sunasra R, Desai H, Surani S, Kashyap R. Plant-based diet and its effect on coronary artery disease: A narrative review. World J Clin Cases 2023; 11:4752-4762. [PMID: 37583985 PMCID: PMC10424050 DOI: 10.12998/wjcc.v11.i20.4752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023] Open
Abstract
Coronary artery disease (CAD), a primary component of cardiovascular diseases, is one of the top contributors to mortality rates worldwide. In 2021, dietary risk was estimated to be attributed to 6.58 million cardiovascular deaths. Plant-based diets (PBDs), which encourage higher consumption of plant foods and lower intake of animal-based foods, have been shown to reduce the risk of CAD by up to 29% when compared to non-vegetarian diets in a meta-analysis. This article aims to summarize the array of PBDs and compare them with conventional Western diets that include meat. We review the various proposed mechanisms for how the bioactive nutrients of PBDs aid in preventing atherosclerosis and CAD events, as well as other cardiac diseases. We conducted a detailed search of PubMed using our exclusive search strategy using the keywords plant-based diet, vegan diet, phytosterols, CAD, myocardial ischemia, and atherosclerosis. A total of 162 pertinent articles published within the past decade were identified for qualitative synthesis. To ensure the accuracy and reliability of our review, we included a total of 55 full-text, peer-reviewed articles that demonstrated the effects of plant-based diets on CAD and were written in English. We excluded animal studies, in vitro or molecular studies, and non-original data like editorials, letters, protocols, and conference abstracts. In this article, we emphasize the importance of dietary interventions, such as PBDs, to prevent CAD and their benefits on environmental sustainability. Integrating plant foods and whole grains into one's daily eating habits leads to an increase in the intake of nutrient-rich foods while reducing the consumption of processed food could not only prevent millions of premature deaths but also provide prevention against many chronic gastrointestinal and metabolic diseases.
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Affiliation(s)
- Priyal Mehta
- Department of General Medicine, MWD Hospital, Mumbai 400097, India
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Sawsan Tawfeeq
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Smitesh Padte
- Department of General Medicine, MWD Hospital, Mumbai 400097, India
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
| | - Rayyan Sunasra
- Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R. N Cooper Hospital, Mumbai 400056, India
| | - Heet Desai
- Department of Internal Medicine, CIBNP, Fairfield, CA 94534, United States
| | - Salim Surani
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
- Department of Pulmonary & Critical Care & Pharmacology, Texas A&M University, College Station, TX 77843, United States
| | - Rahul Kashyap
- Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States
- Department of Research, WellSpan Health, York, PA 17403, United States
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Wirnitzer KC, Motevalli M, Tanous DR, Wirnitzer G, Wagner KH, Schätzer M, Drenowatz C, Cocca A, Ruedl G, Kirschner W. A glimpse of academic staff health behavior on diet type and physical activity at Austrian universities: first findings from the "Sustainably Healthy - From Science 2 Highschool & University" study. Front Public Health 2023; 11:1194602. [PMID: 37483946 PMCID: PMC10359429 DOI: 10.3389/fpubh.2023.1194602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/24/2023] [Indexed: 07/25/2023] Open
Abstract
Background The association between lifestyle and health status highlights the importance of assessing health-related behavior in different populations. This multidisciplinary study aimed to examine the health behavior of academic staff of Austrian colleges and universities, with a specific focus on diet types (vegan, vegetarian, omnivorous) and physical activity (PA) reports. Methods Following a cross-sectional study design incorporating an online survey, a sample of 1,041 academics from 52 institutes (mean age: 46.4 years) provided data on sociodemographic characteristics, dietary patterns, PA behavior, and other lifestyle behaviors (smoking, alcohol intake, etc.). Results The prevalence of vegetarian and vegan diets was 13.2 and 2.0%, respectively, and 33.2% of participants had excess body weight (BMI ≥ 25). The majority of participants (88.5%) reported regularly engaging in leisure-time PA, but 18.6% were active members of sports clubs. No difference between females and males was observed in diet type and the type of sport participation (p > 0.05). Participants with a mixed diet had a higher BMI than vegetarians and vegans (p < 0.05). Leisure-time PA participation was associated with more frequent fruit and vegetable intake (p < 0.05). The prevalence of smoking and alcohol intake was 13.1 and 73.5%, respectively, without any difference between dietary or sports participation subgroups (p > 0.05). Conclusion The present study provides an overview of the social trends in vegan and vegetarian diets linked to health behaviors in tertiary educational settings. Findings can be used by health scientists, decision-makers, and multipliers in health and education to improve public health.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition – SIPCAN, Elsbethen, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Massar RE, McMacken M, Kwok L, Joshi S, Shah S, Boas R, Ortiz R, Correa L, Polito-Moller K, Albert SL. Patient-Reported Outcomes from a Pilot Plant-Based Lifestyle Medicine Program in a Safety-Net Setting. Nutrients 2023; 15:2857. [PMID: 37447186 DOI: 10.3390/nu15132857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
Lifestyle medicine interventions that emphasize healthy behavior changes are growing in popularity in U.S. health systems. Safety-net healthcare settings that serve low-income and uninsured populations most at risk for lifestyle-related disease are ideal venues for lifestyle medicine interventions. Patient-reported outcomes are important indicators of the efficacy of lifestyle medicine interventions. Past research on patient-reported outcomes of lifestyle medicine interventions has occurred outside of traditional healthcare care settings. In this study, we aimed to assess patient-reported outcomes on nutrition knowledge, barriers to adopting a plant-based diet, food and beverage consumption, lifestyle behaviors, self-rated health, and quality-of-life of participants in a pilot plant-based lifestyle medicine program in an urban safety-net healthcare system. We surveyed participants at three time points (baseline, 3 months, 6 months) to measure change over time. After 6 months of participation in the program, nutrition knowledge increased by 7.2 percentage points, participants reported an average of 2.4 fewer barriers to adopting a plant-based diet, the score on a modified healthful plant-based diet index increased by 5.3 points, physical activity increased by 0.7 days per week while hours of media consumption declined by 0.7 h per day, and the percentage of participants who reported that their quality of sleep was "good" or "very good" increased by 12.2 percentage points. Our findings demonstrate that a lifestyle medicine intervention in a safety-net healthcare setting can achieve significant improvements in patient-reported outcomes. Key lessons for other lifestyle medicine interventions include using a multidisciplinary team; addressing all pillars of lifestyle medicine; and the ability for patients to improve knowledge, barriers, skills, and behaviors with adequate support.
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Affiliation(s)
- Rachel E Massar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Michelle McMacken
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Lorraine Kwok
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Shivam Joshi
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Division of Nephrology, Department of Medicine, Veterans Affairs, Orlando, FL 32827, USA
| | - Sapana Shah
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
| | - Rebecca Boas
- Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Robin Ortiz
- Departments of Pediatrics and Population Health, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY 10016, USA
| | - Lilian Correa
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Krisann Polito-Moller
- Department of Medicine, NYC Health + Hospitals/Bellevue, New York, NY 10016, USA
- Office of Ambulatory Care and Population Health, NYC Health + Hospitals, New York, NY 10004, USA
| | - Stephanie L Albert
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
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Ferguson JJA, Austin G, Oldmeadow C, Garg ML. Plant-Based Dietary Patterns and Cardiovascular Disease Risk in Australians: Protocol for a Cross-Sectional Study. Nutrients 2023; 15:2850. [PMID: 37447176 DOI: 10.3390/nu15132850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Plant-based diets (PBDs) emphasise higher intakes of plant foods and lower intakes of animal foods, and they have been associated with reduced cardiovascular morbidity/mortality and lower cardiovascular disease (CVD) risk factors. Evidence is limited regarding the dietary profile, diet quality, and nutritional adequacy of PBDs, including their impact on CVD risk compared with traditional meat-eating diets in Australians. The PBD Study (PBDS) is a cross-sectional study that will recruit 240 adults from the Hunter region (NSW) without known CVD who are habitually consuming vegan (no animal flesh/animal products), lacto-ovo vegetarian (dairy and/or eggs only), pesco-vegetarian (fish/seafood only), or semi-vegetarian (minimal animal flesh) diets or are a regular meat-eater. To investigate dietary profile, diet quality, nutritional adequacy, and CVD risk, questionnaires (medical history, demographics, and physical activity), blood samples (biomarkers), physical measures (anthropometry, blood pressure, body composition, and bone density), and dietary intake (food frequency questionnaire and diet history) will be collected. One-way ANOVA and Kruskal-Wallis tests will compare the CVD risk and other quantitative measures, and Chi-square or Fisher's Exact tests will be used for qualitative data. Directed acyclic graphs will determine the confounding variables, and linear regression and mediation analyses will account for the confounders and estimate the effect of dietary patterns on CVD risk. p-values will be adjusted using the Benjamini-Hochberg method to control the False Discovery Rate to 5%.
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Affiliation(s)
- Jessica J A Ferguson
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
| | - Grace Austin
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW 2308, Australia
| | - Manohar L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
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Qi R, Sheng B, Zhou L, Chen Y, Sun L, Zhang X. Association of Plant-Based Diet Indices and Abdominal Obesity with Mental Disorders among Older Chinese Adults. Nutrients 2023; 15:2721. [PMID: 37375625 DOI: 10.3390/nu15122721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/30/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
We aimed to explore the correlation between plant-based diet indices and abdominal obesity with depression and anxiety among older Chinese adults. This study used a cross-sectional design using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a simplified food frequency questionnaire to evaluate the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) separately, based on the potential health effects of the foods. Waist circumference (WC) was used to define abdominal obesity. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were applied to estimate depression symptoms and anxiety symptoms, respectively. Multi-adjusted binary logistic regression models were conducted to explore the effects of the three plant-based diet indices, abdominal obesity status, and their interaction on depression and anxiety. We enrolled a total of 11,623 participants aged 83.21 ± 10.98 years, of which 3140 (27.0%) participants had depression and 1361 (11.7%) had anxiety. The trend in the prevalence of depression/anxiety across increasing quartiles of the plant-based diet indices was statistically significant after controlling for potential confounders (p-trend < 0.05). Abdominal obesity was related to a lower prevalence of depression (OR = 0.86, 95% CI: 0.77-0.95) and anxiety (OR = 0.79, 95% CI: 0.69-0.90) compared with non-abdominal obesity. The protective effects of the PDI and hPDI against depression (OR = 0.52, 95% CI: 0.41-0.64; OR = 0.59, 95% CI: 0.48-0.73, respectively) and anxiety (OR = 0.75, 95% CI: 0.57-1.00; OR = 0.52, 95% CI: 0.39-0.70, respectively) were more pronounced in non-abdominally obese participants. The harmful effects of the uPDI against depression (OR = 1.78, 95% CI: 1.42-2.23) and anxiety (OR = 1.56, 95% CI: 1.16-2.10) were more pronounced in non-abdominally obese participants. In addition, a significant interaction between the plant-based diet indices and abdominal obesity was observed in terms of causing the prevalence of depression and anxiety. Consuming more of a healthful plant-based diet and less of an animal-based diet is related to a lower prevalence of depression and anxiety. A healthful plant-based diet plays a vital role in non-abdominally obese individuals.
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Affiliation(s)
- Ran Qi
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Baihe Sheng
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yanchun Chen
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Li Sun
- School of Nursing, Tianjin Medical University, Tianjin 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
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Koeder C, Alzughayyar D, Anand C, Kranz R, Husain S, Schoch N, Hahn A, Englert H. The healthful plant-based diet index as a tool for obesity prevention-The healthy lifestyle community program cohort 3 study. Obes Sci Pract 2023; 9:296-304. [PMID: 37287519 PMCID: PMC10242251 DOI: 10.1002/osp4.649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/13/2022] [Accepted: 12/11/2022] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND World-wide the prevalence of obesity is high, and promoting a shift toward more healthful and more plant-based dietary patterns appears to be one promising strategy to address this issue. A dietary score to assess adherence to a healthy plant-based diet is the healthful plant-based diet index. While there is evidence from cohort studies that an increased healthful plant-based diet index is associated with improved risk markers, evidence from intervention studies is still lacking. METHODS A lifestyle intervention was conducted with mostly middle-aged and elderly participants from the general population (n = 115). The intervention consisted of a 16-month lifestyle program focusing on a healthy plant-based diet, physical activity, stress management, and community support. RESULTS After 10 weeks, significant improvements were seen in dietary quality, body weight, body mass index, waist circumference, total cholesterol, measured and calculated low-density lipoprotein (LDL) cholesterol, oxidized LDL particles, non-high-density lipoprotein cholesterol, remnant cholesterol, glucose, insulin, blood pressure, and pulse pressure. After 16 months, significant decreases were seen in body weight (-1.8 kg), body mass index (-0.6 kg/m2), and measured LDL cholesterol (-12 mg/dl). Increases in the healthful plant-based diet index were associated with risk marker improvements. CONCLUSIONS The recommendation of moving toward a plant-based diet appears acceptable and actionable and may improve body weight. The healthful plant-based diet index can be a useful parameter for intervention studies.
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Affiliation(s)
- Christian Koeder
- Institute of Food Science and Human NutritionLeibniz University HannoverHannoverGermany
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Dima Alzughayyar
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Corinna Anand
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Ragna‐Marie Kranz
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Sarah Husain
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Nora Schoch
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
| | - Andreas Hahn
- Institute of Food Science and Human NutritionLeibniz University HannoverHannoverGermany
| | - Heike Englert
- Department of NutritionUniversity of Applied Sciences MünsterMünsterGermany
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50
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Feiertag N, Tawfik MM, Loloi J, Patel RD, Green B, Zhu M, Klyde D, Small AC, Watts KL. Should Men Eat More Plants? A Systematic Review of the Literature on the Effect of Plant-Forward Diets on Men's Health. Urology 2023; 176:7-15. [PMID: 36963667 DOI: 10.1016/j.urology.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE To perform a systematic review of the literature on plant-based and plant-forward diets and the prevention/treatment of the following common men's health conditions: prostate cancer (PCa), erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses system criteria were utilized to search PubMed and Medline databases for the following search terms: "Diet (Mesh)" OR "Diet Therapy (Mesh)" AND "Prostatic Hyperplasia (Mesh)" OR "Prostatic Neoplasm (Mesh)" OR "Erectile Dysfunction (Mesh)." Articles in English published from 1989 to 2022 using human participants were analyzed, data summarized, and assessed for bias. RESULTS Studies reporting on plant-based or vegetable-forward diets (Mediterranean) as an intervention were included. Cohort and cross-sectional studies using food frequency questionnaires or diet classification indices to quantify plant-based food intake patterns were included in the study. Ultimately, 12 PCa articles, 4 BPH articles, 6 ED articles, and 2 articles related to both BPH and ED were reviewed. Overall, the literature suggests plant-forward diets confer a protective effect on the men's health conditions reviewed. CONCLUSIONS Evaluation of the literature on the impact of plant-forward diets on urologic conditions includes a heterogenous range of dietary patterns and study designs. The greatest amount of research has evaluated the application of plant-forward diets for PCa. While there is currently a lack of high-quality evidence for the use of plant-forward diets as prevention and/or treatment for PCa, ED, or BPH, reported outcomes suggest a consistent small beneficial impact alongside well-established benefits for common chronic conditions.
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Affiliation(s)
| | | | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, NY
| | - Rutul D Patel
- Department of Urology, Montefiore Medical Center, Bronx, NY
| | | | - Michael Zhu
- Albert Einstein College of Medicine, Bronx, NY
| | | | - Alexander C Small
- Department of Urology, Montefiore Medical Center, Bronx, NY; Albert Einstein College of Medicine, Bronx, NY
| | - Kara L Watts
- Department of Urology, Montefiore Medical Center, Bronx, NY; Albert Einstein College of Medicine, Bronx, NY.
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