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Goldman DM, Warbeck CB, Waterfall TJ, Sud A, Quarshie M, Craddock JC. Plant-based and Early Time-restricted Eating for Prevention and Treatment of Type 2 Diabetes in Adults: A Narrative Review. Can J Diabetes 2024:S1499-2671(24)00058-3. [PMID: 38513822 DOI: 10.1016/j.jcjd.2024.03.002] [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: 12/11/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
Type 2 diabetes (T2D) is a significant public health challenge for which effective lifestyle interventions are needed. A growing body of evidence supports the use of both plant-based eating patterns and early time-restricted eating (eTRE) for the prevention and treatment of T2D, but research has not yet explored the potential of these dietary strategies in combination. In this narrative review we assessed the evidence by which plant-based diets, in conjunction with eTRE, could support T2D care. The electronic databases MEDLINE and the Web of Science were searched for relevant articles published throughout the last decade. Observational research has shown that healthy plant-based eating patterns and eTRE are associated with reductions in T2D risk. Interventional trials demonstrated that plant-based diets promote improvements in glycated hemoglobin, insulin resistance, glycemic control, and cardiometabolic risk factors. These changes may be mediated, in part, by reductions in oxidative stress, dietary acid load, and hepatocellular and intramyocellular lipids. The eTRE strategies were also shown to improve insulin resistance and glycemic control, and mechanisms of action included enhanced regulation of circadian rhythm and increased metabolic flexibility. Integrating these dietary strategies may produce additive benefits, mediated by reduced visceral adiposity and beneficial shifts in gut microbiota composition. However, potential barriers to concurrent implementation of these interventions may exist, including social challenges, scheduling constraints, and tolerance. Prospective trials are needed to examine their acceptability and clinical effects.
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Affiliation(s)
| | - Cassandra B Warbeck
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Adam Sud
- Plant-Based for Positive Change, Austin, Texas, United States
| | | | - Joel C Craddock
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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2
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Bai T, Peng J, Zhu X, Wu C. Vegetarian diets and the risk of gastrointestinal cancers: a meta-analysis of observational studies. Eur J Gastroenterol Hepatol 2023; 35:1244-1252. [PMID: 37724454 PMCID: PMC10538608 DOI: 10.1097/meg.0000000000002643] [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: 01/12/2023] [Accepted: 08/01/2023] [Indexed: 09/20/2023]
Abstract
The systematic review aimed to assess the association between vegetarian diet and the risk of gastrointestinal tumorigenesis. PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to August 2022 for observational studies on vegetarian diets and the risk of gastrointestinal tumorigenesis. The primary outcome was morbidity due to gastrointestinal cancer. The Newcastle-Ottawa Scale was used to assess the quality of included studies. Pooled effects were analyzed using a random-effects model. The study protocol was registered in PROSPERO (no. CRD42022310187). Eight original studies (seven cohorts and one case-control), involving 686 691 participants, were included. Meta-analysis showed a negative correlation between vegetarian diets and gastrointestinal tumorigenesis risk [relative risk (RR) equals 0.77, 95% confidence interval (CI) is (0.65-0.90)], compared with non-vegetarian diets. Subgroup analysis indicated that vegetarian diets were negatively correlated with the risks of gastric cancer [RR = 0.41, 95% CI (0.28-0.61)] and colorectal cancer [RR = 0.85, 95% CI (0.76-0.95)], but not with that of upper gastrointestinal cancer (excluding stomach) [RR = 0.93, 95% CI (0.61-1.42)]. Vegetarian diets were negatively correlated with the risk of gastrointestinal tumorigenesis in men [RR = 0.57, 95% CI (0.36-0.91)], but were uncorrelated in women [RR = 0.89, 95% CI (0.71-1.11)]. Vegetarian diets were negatively correlated with the risk of gastrointestinal tumorigenesis in North American [RR = 0.76, 95% CI (0.61-0.95)] and Asian populations [RR = 0.43, 95% CI (0.26-0.72)] and were uncorrelated in the European population [RR = 0.83, 95% CI (0.68-1.01)]. Adhering to vegetarian diets reduces the risk of gastrointestinal tumorigenesis. More data from well-conducted cohort and other studies are needed.
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Affiliation(s)
- Tongtong Bai
- School of Chinese Medicine & School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine
| | - Juanjuan Peng
- School of Acupuncture-Moxibustion and Tuina & School of Regimen and Rehabilitation, Nanjing University of Chinese Medicine
| | - Xinqi Zhu
- School of Foreign Studies, Nanjing University, Nanjing, China
| | - Chengyu Wu
- School of Chinese Medicine & School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine
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3
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Ocagli H, Berti G, Rango D, Norbiato F, Chiaruttini MV, Lorenzoni G, Gregori D. Association of Vegetarian and Vegan Diets with Cardiovascular Health: An Umbrella Review of Meta-Analysis of Observational Studies and Randomized Trials. Nutrients 2023; 15:4103. [PMID: 37836394 PMCID: PMC10574056 DOI: 10.3390/nu15194103] [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: 07/31/2023] [Revised: 08/22/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are leading global causes of mortality. Unhealthy diets have been linked to an increased risk of CVD, while plant-based diets have shown potential protective effects. This umbrella review summarizes the evidence on the association between vegetarian diets and cardiovascular and cerebrovascular diseases. METHODS PubMed, Scopus, Embase, CINAHL, Cochrane, and Web of Science were consulted. Meta-analyses grouped by author and outcome were performed. The heterogeneity was evaluated using I2 statistics. RESULTS There was a 41.2% risk reduction for cerebrovascular disease. CVD incidence had a 29% reduced risk. CVD mortality had a 13.8% risk reduction, while IHD incidence had a 24.1% reduction, but with high heterogeneity. IHD mortality showed a significant 32.1% risk reduction. Ischemic stroke had a significant 32.9% risk reduction across six studies. Stroke incidence showed a significant 39.1% risk reduction in a single study. There was a non-significant 11.6% risk reduction for stroke mortality with moderate heterogeneity. CONCLUSION Healthier diets are associated with reduced risks of cerebrovascular disease, CVD incidence, IHD mortality, and ischemic stroke. However, evidence quality and consistency vary, emphasizing the need for more research. Policymakers and healthcare professionals should prioritize promoting healthy diets for CVD prevention.
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Affiliation(s)
| | | | | | | | | | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35121 Padova, Italy; (H.O.); (G.B.); (D.R.); (F.N.); (M.V.C.); (G.L.)
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4
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Ferrari L, Panaite SA, Bertazzo A, Visioli F. Animal- and Plant-Based Protein Sources: A Scoping Review of Human Health Outcomes and Environmental Impact. Nutrients 2022; 14:nu14235115. [PMID: 36501146 PMCID: PMC9741334 DOI: 10.3390/nu14235115] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Dietary proteins are indispensable to human nutrition. In addition to their tissue-building function, they affect body composition and regulate various metabolic pathways, as well as satiety and immune system activity. Protein use can be examined from a quantitative or qualitative viewpoint. In this scoping review, we compare animal- and plant-based protein sources in terms of their effects on human health and the environment. We conclude that the consumption of vegetable protein sources is associated with better health outcomes overall (namely, on the cardiovascular system) than animal-based product use. The healthier outcomes of vegetable protein sources dovetail with their lower environmental impact, which must be considered when designing an optimal diet. Indeed, the health of the planet cannot be disjointed from the health of the human being. Future research will clarify the mechanisms of action underlying the health effects of plant-based protein sources when compared with animal sources, fostering better agronomic practices and influencing public health in a direction that will benefit both the planet and its inhabitants.
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Affiliation(s)
- Luca Ferrari
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy
| | - Stefan-Alexandru Panaite
- Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, School of Hygiene and Preventive Medicine, University of Padova, 35122 Padova, Italy
| | - Antonella Bertazzo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy
| | - Francesco Visioli
- Department of Molecular Medicine, University of Padova, 35122 Padova, Italy
- IMDEA-Food, CEI UAM+CSIC, 28001 Madrid, Spain
- Correspondence:
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Liu YY, Yeh YC. Complementary and Alternative Medicines Used by Middle-Aged to Older Taiwanese Adults to Cope with Stress during the COVID-19 Pandemic: A Cross-Sectional Survey. Healthcare (Basel) 2022; 10. [PMID: 36360594 DOI: 10.3390/healthcare10112250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background: This study aimed to investigate the factors influencing the use of complementary and alternative medicines (CAMs) to manage stress during the COVID-19 pandemic in Taiwan. Methods: A cross-sectional survey was administered to community-dwelling adults between the ages of 46 and 75 years, and a total of 351 participants completed the questionnaire. Log-binominal regression analyses were fitted to explore the factors associated with the use of CAMs. Results: The mean age of the participants was 57.0 years, and 67.0% reported that they had used CAMs within the past three months. Middle-aged adults were more likely to use CAMs than late middle-aged adults and older adults (p < 0.001). Overall, the major CAMs utilized to relieve psychological stress were music therapies (37.6%), massage (31.1%), spinal manipulation (25.1%), relaxing therapies (24.2%), and reading scriptures or The Bible (23.9%). Religion and vegetarian diets were the most important factors influencing participants to use CAMs, especially music therapies, massage, and reading scriptures/The Bible. Conclusions: CAM use was very prevalent among middle-aged adults in Taiwan; in particular, music therapies were the most favored activities for reducing stress. Population-specific mental health interventions using music can be developed to improve stress management outcomes during public health emergencies.
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Falchetti A, Cavati G, Valenti R, Mingiano C, Cosso R, Gennari L, Chiodini I, Merlotti D. The effects of vegetarian diets on bone health: A literature review. Front Endocrinol (Lausanne) 2022; 13:899375. [PMID: 35992115 PMCID: PMC9388819 DOI: 10.3389/fendo.2022.899375] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
In these recent years many people are adopting a vegetarian type diet due to the numerous positive health effects of this regimen such as the reduction of the incidence of many chronic disorders like diabetes, hypertension, obesity and cancer. However this diet is quite restrictive and so it could be possible to have a deficiency in some specific nutrients, increasing the risk of osteoporosis and fractures. Although there are conflicting results on the effects of the vegetarian diet on bone health and fracture incidence, it is always recommendable in vegetarian people to have an adequate intake of calcium and vitamin D, through an increased intake of supplements, natural and fortified foods, an adequate intake of protein, fruit, vegetables, as well as vitamin B12. The aim of this literature review is to revise the actual knowledge of the effect of some nutrients and vegetarian diets on bone health.
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Affiliation(s)
- Alberto Falchetti
- Experimental Research Laboratory on Bone Metabolism, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
| | - Guido Cavati
- Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Roberto Valenti
- Deparment of Surgery, Perioperative Medicine Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Christian Mingiano
- Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Roberta Cosso
- Unit of Functional and Osteoarticular Rehabilitation, San Giuseppe Hospital, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Piancavallo, Italy
| | - Luigi Gennari
- Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Iacopo Chiodini
- Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Daniela Merlotti
- Department of Medical Sciences, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- *Correspondence: Daniela Merlotti, ;
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Mocanu CA, Simionescu TP, Mocanu AE, Garneata L. Plant-Based versus Animal-Based Low Protein Diets in the Management of Chronic Kidney Disease. Nutrients 2021; 13:nu13113721. [PMID: 34835976 PMCID: PMC8621419 DOI: 10.3390/nu13113721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Recent data reiterate low-protein diets (LPDs) as cornerstones in the conservative management of chronic kidney disease (CKD). The reduction in proteinuria, better blood pressure control and the reduction in the rate of decline in kidney function with LPDs were reported, both in non-diabetics and diabetics patients. Supplemented, vegetarian, very-low-protein diets (sVLPD, 0.3 g/kg-day) could postpone kidney replacement therapy (KRT) initiation, mainly through the better control of metabolic disorders of advanced CKD in non-diabetic patients. Plant-based diets could ameliorate gut microbiota and appear to be superior to mixed hypoproteic diets in treating advanced CKD: better control of nitrogen balance, acid-base metabolism and bone mineral disorders. Vegetarian diets generate fewer uremic toxins and reduce salt intake and acid overload. At the same time, they can improve lipid metabolism, providing a high ratio of unsaturated to saturated fatty acids, as well as insulin resistance.
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Affiliation(s)
- Carmen-Antonia Mocanu
- Department of Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
- Correspondence:
| | - Tudor Petrisor Simionescu
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
| | - Andreea Elena Mocanu
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
| | - Liliana Garneata
- Department of Internal Medicine and Nephrology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Nephrology, “Dr. Carol Davila” Teaching Hospital of Nephrology, 4 Calea Grivitei, Sector 1, 010731 Bucharest, Romania; (T.P.S.); (A.E.M.)
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Bivi D, Di Chio T, Geri F, Morganti R, Goggi S, Baroni L, Mumolo MG, de Bortoli N, Peroni DG, Marchi S, Bellini M. Raising Children on a Vegan Diet: Parents' Opinion on Problems in Everyday Life. Nutrients 2021; 13:nu13061796. [PMID: 34070399 PMCID: PMC8226937 DOI: 10.3390/nu13061796] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 01/29/2023] Open
Abstract
A growing number of Italian families are adopting a vegan diet (VD) for their offspring from infancy for various reasons, with health benefits and ethics being the most common reasons. Barriers to effective communication with primary care pediatricians (PCPs) are perceived by many parents and, depending on the actors involved and the environment, a VD may affect social interactions in everyday life. A national cross-sectional survey was conducted between July and September 2020. Parents of children following a VD completed an online questionnaire. Data from 176 Italian parents were collected. About 72% (71.8%) of the children included in this study had been on a VD since weaning. Parents did not inform their primary care pediatricians (PCP) about the VD in 36.2% of the cases. In 70.8% of the cases, PCPs were perceived as skeptical or against a VD. About 70% (71.2%) of the parents relied on medical dietitians, and 28.2% on nutritionists/dietitians for dietary counseling. Parents administered an individual B12 supplement in 87.2% of the cases. To the best of our knowledge, this survey is the first which explores the relationship between vegan parents and their PCPs, the parental management of their children's diet and problems regarding the implementation of a VD in everyday life.
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Affiliation(s)
- Daisy Bivi
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Teresa Di Chio
- Pediatric Institute of Southern Switzerland, Ospedale Regionale di Bellinzona e Valli, Via Ospedale 12, 6500 Bellinzona, Switzerland
- Correspondence: ; Tel.: +41-77-953-70-77
| | - Francesca Geri
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Riccardo Morganti
- Section of Statistics, University Hospital of Pisa, 56100 Pisa, Italy;
| | - Silvia Goggi
- Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre (VE), Italy; (S.G.); (L.B.)
| | - Luciana Baroni
- Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre (VE), Italy; (S.G.); (L.B.)
| | - Maria Gloria Mumolo
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Nicola de Bortoli
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Diego Giampietro Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy;
| | - Santino Marchi
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
| | - Massimo Bellini
- Gastrointestinal Unit, Department of Translational Sciences and New Technology in Medicine and Surgery, University of Pisa, 56124 Pisa, Italy; (D.B.); (F.G.); (M.G.M.); (N.d.B.); (S.M.); (M.B.)
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Sergentanis TN, Chelmi ME, Liampas A, Yfanti CM, Panagouli E, Vlachopapadopoulou E, Michalacos S, Bacopoulou F, Psaltopoulou T, Tsitsika A. Vegetarian Diets and Eating Disorders in Adolescents and Young Adults: A Systematic Review. Children (Basel) 2020; 8:children8010012. [PMID: 33379220 PMCID: PMC7823335 DOI: 10.3390/children8010012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Eating disorders are more common among adolescents and young adults. An increase in the rates of these disorders has been reported during the last years. Meanwhile, vegetarianism is becoming more popular in these age groups. The purpose of the present paper is to evaluate the association between eating disorders and vegetarian diets in adolescents and young adults. METHODS Systematic review of related articles published in PubMed, PsycInfo and Google Scholar up to 30 May 2019. RESULTS A total of 20 studies (14,391 subjects) were deemed eligible for this systematic review. The majority of the studies reported significant correlations between vegetarianism and eating disorders. However, due to the cross-sectional design, a causal link between eating disorders and vegetarian status cannot be established. CONCLUSIONS Vegetarianism seems to be associated with eating disorders. Longitudinal studies are needed to establish temporal patterns between vegetarianism and the emergence of disordered eating.
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Affiliation(s)
- Theodoros N. Sergentanis
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Maria-Eleni Chelmi
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Clinical Psychopathology, University of Macedonia, 546 36 Thessaloniki, Greece
| | - Andreas Liampas
- Medical School, Department of Neurology, University of Cyprus, 1678 Nicosia, Cyprus;
| | - Chrysanthi-Maria Yfanti
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
| | - Eleni Panagouli
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
| | - Elpis Vlachopapadopoulou
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Stefanos Michalacos
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, “Agia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Theodora Psaltopoulou
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Artemis Tsitsika
- MSc Program “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (T.N.S.); (M.-E.C.); (C.-M.Y.); (E.P.); (T.P.)
- Correspondence: ; Tel./Fax: +30-2107710824
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Kowalska K, Brodowski J, Pokorska-Niewiada K, Szczuko M. The Change in the Content of Nutrients in Diets Eliminating Products of Animal Origin in Comparison to a Regular Diet from the Area of Middle-Eastern Europe. Nutrients 2020; 12:E2986. [PMID: 33003529 PMCID: PMC7599827 DOI: 10.3390/nu12102986] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The diet of Poles became similar to the western style of nutrition. It is rich in saturated fats, it contains significant quantities of salt, and has very low fruit and vegetable content. On the other hand, introducing an incorrectly planned diet that eliminates animal products may be associated with the risk of deficiencies of certain vitamins and minerals. Taking into account the regular diet of Poles, a properly balanced vegetarian menu may be a better and safer choice for the proper functioning of the organism. AIM The analysis of the content of individual types of vegetarian diets and a comparison with the menus of the regular diet of the Polish population. MATERIALS AND METHODS 70 menus were subjected to a quantitative analysis, 10 menus for each 7 type of diet eliminating products of animal origin and regular diets without elimination. The caloricity of the designed diets was ±2000 kcal. The quantitative evaluation of the menus was performed using the Dieta 6d dietary program. Statistical significance was established at p ≤ 0.05. RESULTS It was observed that the regular diet of Poles (RD) featured the highest content of total fats, as well as saturated acids and cholesterol. The VEGAN diet was characterized by the lowest total protein content and the lack of wholesome protein and cholesterol. RD was characterized by the lowest average content of dietary fiber. The highest content of saccharose was observed in RD. Sodium content in RD significantly exceeded the recommended daily norm. RD featured insufficient content of the following minerals and vitamins: potassium, calcium, magnesium, iodine, Vitamin E, Vitamin C, folates, and Vitamin D. The norm for calcium has not been fulfilled also in milk-free and vegan diets. All of the analyzed diets lacked proper amounts of iodine and Vitamin D. The highest content of polyunsaturated fatty acids was observed in the VEGAN diet. The periodic elimination of meat and fatty dairy products should be included in the treatment of the metabolic syndrome, hypertensions, hyperlipidemia, obesity, and type 2 diabetes. CONCLUSIONS The regular diet of Poles turned out to be more dangerous for health in terms of deficiencies than properly balanced diets eliminating products of animal origin.
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Affiliation(s)
- Kamila Kowalska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland;
| | - Jacek Brodowski
- Primary Care Department, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland;
| | - Kamila Pokorska-Niewiada
- Department of Toxicology, Dairy Technology and Food Storage, West Pomeranian University of Technology in Szczecin, Papieża Pawła VI 3, 71-459 Szczecin, Poland;
| | - Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland;
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11
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Mayra S, Ugarte N, Johnston CS. Health Biomarkers in Adults Are More Closely Linked to Diet Quality Attributes Than to Plant-Based Diet Categorization. Nutrients 2019; 11:nu11061427. [PMID: 31242604 PMCID: PMC6628127 DOI: 10.3390/nu11061427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/19/2019] [Accepted: 06/23/2019] [Indexed: 12/18/2022] Open
Abstract
Although plant-based diets are promoted for healthy outcomes, these diets are not synonymous with high-quality diets. Plant-based diets can include highly processed, less healthful foods, including savory snacks, pastries, and sugary fruit drinks. This cross-sectional study examined the diet quality of vegetarian and omnivorous adults, matched for gender, age, and adiposity, and related diet quality to standard health biomarkers. Diet quality was assessed using the Rapid Eating and Activity Assessment for Participants Short Version questionnaire. Participants (17 vegetarians and 16 omnivores; 28.2 ± 8.9 years; 22.5 ± 2.7 kg/m2) were non-smokers and healthy by self-report. The median duration of adherence to the vegetarian diet was 27 months. Physical activity level and diet quality did not differ significantly between diet groups. Moreover, health biomarkers did not differ by diet groups. When participants were regrouped by low versus high diet quality, health biomarkers differed significantly between groups for fasting insulin, HOMA-IR, triglyceride (TG)/HDL ratio, and blood folate, with more favorable levels in the group with high diet quality. These data suggest that health biomarkers more closely align with diet quality attributes than with plant-based diet categorization. Thus, messaging focused on healthy diet attributes may lead to better health outcomes than the simple promotion of plant-based diets.
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Affiliation(s)
- Selicia Mayra
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA.
| | - Noel Ugarte
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA.
| | - Carol S Johnston
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA.
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12
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Glenn AJ, Viguiliouk E, Seider M, Boucher BA, Khan TA, Blanco Mejia S, Jenkins DJA, Kahleová H, Rahelić D, Salas-Salvadó J, Kendall CWC, Sievenpiper JL. Relation of Vegetarian Dietary Patterns With Major Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Front Nutr 2019; 6:80. [PMID: 31263700 PMCID: PMC6585466 DOI: 10.3389/fnut.2019.00080] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 11/13/2018] [Accepted: 05/16/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Vegetarian dietary patterns are recommended for cardiovascular disease (CVD) prevention and management due to their favorable effects on cardiometabolic risk factors, however, the role of vegetarian dietary patterns in CVD incidence and mortality remains unclear. Objective: To update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we undertook a systematic review and meta-analysis of the association of vegetarian dietary patterns with major cardiovascular outcomes in prospective cohort studies that included individuals with and without diabetes using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Methods: MEDLINE, EMBASE, and Cochrane databases were searched through September 6th, 2018. We included prospective cohort studies ≥1 year of follow-up including individuals with or without diabetes reporting the relation of vegetarian and non-vegetarian dietary patterns with at least one cardiovascular outcome. Two independent reviewers extracted data and assessed study quality (Newcastle-Ottawa Scale). The pre-specified outcomes included CVD incidence and mortality (total CVD, coronary heart disease (CHD) and stroke). Risk ratios for associations were pooled using inverse variance random effects model and expressed as risk ratios (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed (Cochran Q-statistic) and quantified (I2-statistic). The overall certainty of the evidence was assessed using GRADE. Results: Seven prospective cohort studies (197,737 participants, 8,430 events) were included. A vegetarian dietary pattern was associated with reduced CHD mortality [RR, 0.78 (CI, 0.69, 0.88)] and incidence [0.72 (0.61, 0.85)] but were not associated with CVD mortality [0.92 (0.84, 1.02)] and stroke mortality [0.92 (0.77, 1.10)]. The overall certainty of the evidence was graded as “very low” for all outcomes, owing to downgrades for indirectness and imprecision. Conclusions: Very low-quality evidence indicates that vegetarian dietary patterns are associated with reductions in CHD mortality and incidence but not with CVD and stroke mortality in individuals with and without diabetes. More research, particularly in different populations, is needed to improve the certainty in our estimates. Clinical Trial Registration:Clinicaltrials.gov, identifier: NCT03610828.
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Affiliation(s)
- Andrea J Glenn
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Effie Viguiliouk
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Maxine Seider
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Tauseef A Khan
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hana Kahleová
- Physicians Committee for Responsible Medicine, Washington, DC, United States.,Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Dario Rahelić
- Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain.,Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Cyril W C Kendall
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
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13
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Sebastiani G, Herranz Barbero A, Borrás-Novell C, Alsina Casanova M, Aldecoa-Bilbao V, Andreu-Fernández V, Pascual Tutusaus M, Ferrero Martínez S, Gómez Roig MD, García-Algar O. The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring. Nutrients 2019; 11:E557. [PMID: 30845641 DOI: 10.3390/nu11030557] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/19/2019] [Accepted: 03/01/2019] [Indexed: 11/17/2022] Open
Abstract
Vegetarian and vegan diets have increased worldwide in the last decades, according to the knowledge that they might prevent coronary heart disease, cancer, and type 2 diabetes. Althought plant-based diets are at risk of nutritional deficiencies such as proteins, iron, vitamin D, calcium, iodine, omega-3, and vitamin B12, the available evidence shows that well planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients. A review of the scientific literature in this field was performed, focusing specifically on observational studies in humans, in order to investigate protective effects elicited by maternal diets enriched in plant-derived foods and possible unfavorable outcomes related to micronutrients deficiencies and their impact on fetal development. A design of pregestational nutrition intervention is required in order to avoid maternal undernutrition and consequent impaired fetal growth.
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14
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Attini R, Montersino B, Leone F, Minelli F, Fassio F, Rossetti MM, Colla L, Masturzo B, Barreca A, Menato G, Piccoli GB. Dialysis or a Plant-Based Diet in Advanced CKD in Pregnancy? A Case Report and Critical Appraisal of the Literature. J Clin Med 2019; 8:jcm8010123. [PMID: 30669543 PMCID: PMC6352283 DOI: 10.3390/jcm8010123] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/08/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 02/07/2023] Open
Abstract
Pregnancy is increasingly reported in chronic kidney disease (CKD), reflecting higher awareness, improvements in materno-foetal care, and a more flexible attitude towards “allowing” pregnancy in the advanced stages of CKD. Success is not devoid of problems and an important grey area regards the indications for starting dialysis (by urea level, clinical picture, and residual glomerular filtration rate) and for dietary management. The present case may highlight the role of plant-based diets in dietary management in pregnant CKD women, aimed at retarding dialysis needs. The case. A 28-year-old woman, affected by glomerulocystic disease and unilateral renal agenesis, in stage-4 CKD, was referred at the 6th week of amenorrhea: she weighed 40 kg (BMI 16.3), was normotensive, had no sign of oedema, her serum creatinine was 2.73 mg/dL, blood urea nitrogen (BUN) 35 mg/dL, and proteinuria 200 mg/24 h. She had been on a moderately protein-restricted diet (about 0.8 g/kg/real body weight, 0.6 per ideal body weight) since childhood. Low-dose acetylsalicylate was added, and a first attempt to switch to a protein-restricted supplemented plant-based diet was made and soon stopped, as she did not tolerate ketoacid and aminoacid supplementation. At 22 weeks of pregnancy, creatinine was increased (3.17 mg/dL, BUN 42 mg/dL), dietary management was re-discussed and a plant-based non-supplemented diet was started. The diet was associated with a rapid decrease in serum urea and creatinine; this favourable effect was maintained up to the 33rd gestational week when a new rise in urea and creatinine was observed, together with signs of cholestasis. After induction, at 33 weeks + 6 days, she delivered a healthy female baby, adequate for gestational age (39th centile). Urea levels decreased after delivery, but increased again when the mother resumed her usual mixed-protein diet. At the child’s most recent follow-up visit (age 4 months), development was normal, with normal weight and height (50th–75th centile). In summary, the present case confirms that a moderate protein-restricted diet can be prescribed in pregnancies in advanced CKD without negatively influencing foetal growth, supporting the importance of choosing a plant-based protein source, and suggests focusing on the diet’s effects on microcirculation to explain these favourable results.
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Affiliation(s)
- Rossella Attini
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Benedetta Montersino
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Filomena Leone
- Department of Surgery, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Fosca Minelli
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Federica Fassio
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Maura Maria Rossetti
- SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy.
| | - Loredana Colla
- SCDU Nephrology, Città della Salute e della Scienza, University of Torino, 10100 Torino, Italy.
| | - Bianca Masturzo
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Antonella Barreca
- Department of Medical Sciences, University of Torino, 10100 Torino, Italy.
| | - Guido Menato
- Department of Obstetrics and Gynecology SC2U, Città della Salute e della Scienza-O.I.R.M., Sant'Anna Hospital, 10100 Turin, Italy.
| | - Giorgina Barbara Piccoli
- Department of Biological and Clinical Sciences, University of Torino, 10100 Torino, Italy.
- Nephrology, Centre Hospitalier Le Mans, 72000 Le Mans, France.
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15
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Gili RV, Leeson S, Montes-Chañi EM, Xutuc D, Contreras-Guillén IA, Guerrero-Flores GN, Martins MCT, Pacheco FJ, Pacheco SOS. Healthy Vegan Lifestyle Habits among Argentinian Vegetarians and Non-Vegetarians. Nutrients 2019; 11:E154. [PMID: 30642046 DOI: 10.3390/nu11010154] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/23/2018] [Accepted: 01/08/2019] [Indexed: 12/16/2022] Open
Abstract
Although current research has contributed to the promotion of whole-food plant-based diets, few studies have examined healthy vegan dietary and lifestyle factors, especially in South America. Therefore, we aimed at investigating the adherence to healthy vegan lifestyle habits among Argentinian vegetarians and omnivorous, using a recently developed vegetarian lifestyle index adapted to the vegan dietary pattern. Also, accessibility of vegetarian foods, and the proportion of household income spent on food were assessed in a cross-sectional approach with 1454 participants. The population was comprised of females (84.9%), singles (55.0%), young-adults (mean age 32.1, standard deviation (SD) = 13.6), employed (50.8%), with high educational levels (50.4%), and low prevalence of both tobacco smoking (7.0%) and frequent alcohol consumption (7.6%). The mean score of adherence to healthy vegan lifestyle habits was 6.64 (SD = 1.72), with higher scores indicating better adherence. Non-vegetarians (5.75; 95% confidence interval (CI), 5.61–5.89) had a significantly lower adjusted mean score compared to semi-(6.32; 95% CI, 6.17–6.47), pesco-(6.99; 95% CI, 6.59–7.39), lacto-ovo-vegetarians (7.10; 95% CI, 6.96–7.24), as well as vegans (8.59; 95% CI, 8.35–8.83). The mean proportion of household income spent on food was significantly lower among vegans compared with other dietary patterns. The whole population that was studied showed a low consumption of whole grains, legumes, vegetables, nuts, and seeds. Although vegans showed a better diet and lifestyle pattern there is a need to improve eating and lifestyle habits to address risk factors for non-communicable diseases in Argentina.
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16
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Lütjohann D, Meyer S, von Bergmann K, Stellaard F. Cholesterol Absorption and Synthesis in Vegetarians and Omnivores. Mol Nutr Food Res 2018; 62:e1700689. [PMID: 29427539 DOI: 10.1002/mnfr.201700689] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 08/14/2017] [Revised: 01/12/2018] [Indexed: 12/22/2022]
Abstract
SCOPE Vegetarian diets are considered health-promoting; however, a plasma cholesterol lowering effect is not always observed. We investigate the link between vegetarian-diet-induced alterations in cholesterol metabolism. METHODS AND RESULTS We study male and female omnivores, lacto-ovo vegetarians, lacto vegetarians, and vegans. Cholesterol intake, absorption, and fecal sterol excretion are measured as well as plasma concentrations of cholesterol and noncholesterol sterols. These serve as markers for cholesterol absorption, synthesis, and catabolism. The biliary cholesterol secretion rate is estimated. Flux data are related to body weight. Individual vegetarian diet groups are statistically compared to the omnivore group. Lacto vegetarians absorb 44% less dietary cholesterol, synthesized 22% more cholesterol, and show no differences in plasma total and LDL cholesterol. Vegan subjects absorb 90% less dietary cholesterol, synthesized 35% more cholesterol, and have a similar plasma total cholesterol, but a 13% lower plasma LDL cholesterol. No diet-related differences in biliary cholesterol secretion and absorption are observed. Total cholesterol absorption is lower only in vegans. Total cholesterol input is similar under all vegetarian diets. CONCLUSIONS Unaltered biliary cholesterol secretion and higher cholesterol synthesis blunt the lowered dietary cholesterol intake in vegetarians. LDL cholesterol is significantly lower only in vegans.
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Affiliation(s)
- Dieter Lütjohann
- Institute for Clinical Chemistry and Clinical Pharmacology, University Clinics of Bonn, Bonn, Germany
| | - Sven Meyer
- Department of Cardiology, Heart Center Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Klaus von Bergmann
- Institute for Clinical Chemistry and Clinical Pharmacology, University Clinics of Bonn, Bonn, Germany
| | - Frans Stellaard
- Institute for Clinical Chemistry and Clinical Pharmacology, University Clinics of Bonn, Bonn, Germany
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17
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Abstract
Soy is a basic food ingredient of traditional Asian cuisine used for thousands of years. In Western countries, soybeans have been introduced about a hundred years ago and recently they are mainly used for surrogate foods production. Soy and soy foods are common nutritional solutions for vegetarians, due to their high protein content and versatility in the production of meat analogues and milk substitutes. However, there are some doubts about the potential effects on health, such as the effectiveness on cardiovascular risk reduction or, conversely, on the possible disruption of thyroid function and sexual hormones. The soy components that have stimulated the most research interest are isoflavones, which are polyphenols with estrogenic properties highly contained in soybeans. In this review, we discuss the characteristics of soy and soy foods, focusing on their nutrient content, including phytoestrogens and other bioactive substances that are noteworthy for vegetarians, the largest soy consumers in the Western countries. The safety of use will also be discussed, given the growing trend in adoption of vegetarian styles and the new soy-based foods availability.
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Affiliation(s)
| | - Luciana Baroni
- Primary Care Unit, Northern District, Local Health Unit 2, 31100 Treviso, Italy.
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18
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Porrata-Maury C, Hernández-Triana M, Ruiz-Álvarez V, Díaz-Sánchez ME, Fallucca F, Bin W, Baba-Abubakari B, Pianesi M. Ma-Pi 2 macrobiotic diet and type 2 diabetes mellitus: pooled analysis of short-term intervention studies. Diabetes Metab Res Rev 2014; 30 Suppl 1:55-66. [PMID: 24532293 DOI: 10.1002/dmrr.2519] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 10/23/2013] [Accepted: 12/19/2013] [Indexed: 02/06/2023]
Abstract
The macrobiotic, Ma-Pi 2 diet (12% protein, 18% fat and 70% carbohydrate), has shown benefit in adults with type 2 diabetes mellitus (T2DM). This pooled analysis aims to confirm results from four, 21-day intervention studies with the Ma-Pi 2 diet, carried out in Cuba, China, Ghana and Italy. Baseline and end of study biochemical, body composition and blood pressure data, were compared using multivariate statistical methods and assessment of the Cohen effect size (d). Results showed that all measured indicators demonstrated significant changes (p < 0.001); most of them with a very high (d ≥ 1.30), or high (d = 0.80-1.29) effect size. The global effect size of the diet was Italy (1.96), China (1.79), Cuba (1.38) and Ghana (0.98). The magnitude of the individual effect on each variable by country, and the global effect by country, was independent of the sample size (p > 0.05). Similarly, glycemia and glycemic profiles in all four studies were independent of the sample size (p = 0.237). The Ma-Pi diet 2 significantly reduced glycemia, serum lipids, uremia and cardiovascular risk in adults with T2DM. These results suggest that the Ma-Pi 2 diet could be a valid alternative treatment for patients with T2DM and point to the need for further clinical studies. Mechanisms related to its benefits as a functional diet are discussed.
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19
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Pribis P, Pencak RC, Grajales T. Beliefs and attitudes toward vegetarian lifestyle across generations. Nutrients 2010; 2:523-31. [PMID: 22254039 DOI: 10.3390/nu2050523] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 05/12/2010] [Accepted: 05/14/2010] [Indexed: 11/29/2022] Open
Abstract
The objective of the study was to examine whether reasons to adopt vegetarian lifestyle differ significantly among generations. Using a Food Frequency Questionnaire (FFQ), we identified that 4% of the participants were vegans, 25% lacto-ovo-vegetarians, 4% pesco-vegetarians and 67% non-vegetarian. Younger people significantly agreed more with the moral reason and with the environmental reason. People ages 41–60 significantly agreed more with the health reason. There are significant differences across generations as to why people choose to live a vegetarian lifestyle.
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20
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Rosado JL, López P, López G, Madrigal H, Huerta Z. Consumption of dietary fiber in rural Mexico. Ecol Food Nutr 1995; 34:129-136. [PMID: 29016204 DOI: 10.1080/03670244.1995.9991454] [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: 10/19/2022]
Abstract
The average per capita intake of dietary fibre and the relative contribution of different foods to its intake in the Mexican rural population was studied. Food consumption data were obtained from the National Nutrition Surveys of 1979 (21,248 families in 219 rural Mexican communities), and from a similar survey of the same communities in 1989 (20,759 families). Average per capita intake of total dietary fibre (TDF) ranged from 19.8 to 34.0 g/d (average 27.2 ± 3.3) in 1979 and from 17.5 to 27.1 g/d (average 22.5 ± 2.2) in 1989. About 13% of TDF in both surveys was contributed by soluble dietary fibre. Of the 19 regions of the country, 18 exhibited a significant reduction in TDF intake from 1979 to 1989 (p < 0.001). With the exception of two regions on the northern border, maize was the major single source of TDF (from 31 to 74% of TDF). The implication of these observations on disease patterns needs to be studied.
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Affiliation(s)
- Jorge L Rosado
- a Department of Nutritional Physiology , National Institute of Nutrition , Vasco de Quiroga No 15, Tlalpan , México , D.F. , 14000 , Mexico
| | - Patricia López
- b Department of Nutritional Physiology , National Institute of Nutrition , Mexico , D.F. , Mexico
| | - Gladys López
- b Department of Nutritional Physiology , National Institute of Nutrition , Mexico , D.F. , Mexico
| | - Herlinda Madrigal
- b Department of Nutritional Physiology , National Institute of Nutrition , Mexico , D.F. , Mexico
| | - Zenaida Huerta
- b Department of Nutritional Physiology , National Institute of Nutrition , Mexico , D.F. , Mexico
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