Article

Position of the Academy of Nutrition and Dietetics: Vegetarian Diets

Authors:
  • Physicians Committee for Responsible Medicine
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Abstract

It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage. Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity. Low intake of saturated fat and high intakes of vegetables, fruits, whole grains, legumes, soy products, nuts, and seeds (all rich in fiber and phytochemicals) are characteristics of vegetarian and vegan diets that produce lower total and low-density lipoprotein cholesterol levels and better serum glucose control. These factors contribute to reduction of chronic disease. Vegans need reliable sources of vitamin B-12, such as fortified foods or supplements.

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... Vitamin B12 is without question the most important nutrient to address in the case of vegan diets (Melina, Craig, and Levin 2016;Wokes, Badenoch, and Sinclair 1955;Haddad et al. 2020;Pawlak 2021). The danger of severe vitamin B12 deficiency due to an unsupplemented vegan diet has been known since the 1950s (Wokes, Badenoch, and Sinclair 1955), and since at least the 1960s efforts to educate vegans in this regard have been made (Ellis and Mumford 1967;Ellis, Powell, and Kuktha 1968;Wokes 1967 West andEllis 1966;Ellis and Montegriffo 1970;Ellis and Sanders 1977;Sanders and Ellis 1981). ...
... Apart from vitamin B12, a suboptimal intake of several other nutrients may occur depending on the foods and supplements consumed (Thorpe et al. 2021;Tong et al. 2020). Specifically, it can be postulated that there are ten key nutrients which require at least some attention when "planning" nutritionally adequate vegan diets: these nutrients are (with particular emphasis) vitamin B12, calcium, vitamin D, iodine, and omega-3 fatty acids as well as (with potentially lower emphasis) iron, zinc, selenium, vitamin A, and protein (Melina, Craig, and Levin 2016;Craig et al. 2021;Fallon and Dillon 2020;Craddock et al. 2021). ...
... With regard to the scientific literature, a number of nutrition societies around the world have published position papers or similar official statements about vegan diets, with only a small number of these having been published in PubMed-indexed journals (Melina, Craig, and Levin 2016;Agnoli et al. 2017;Redecilla Ferreiro et al. 2020). The key nutrients mentioned in all of these statements are a selection of the ten key nutrients addressed in the present article (Melina, Craig, and Levin 2016;Agnoli et al. 2017;Redecilla Ferreiro et al. 2020). ...
Article
Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.
... Well-planned vegetarian and vegan (supplemented with vitamin B12) diets are healthy, nutritionally adequate, and appropriate for all age groups, including pregnancy and breastfeeding, infants, children and adolescents, adults and seniors, and athletes. Moreover, the Academy of Nutrition and Dietetics (161) explicitly emphasizes the health benefits of plant-based diets, especially in the prevention and treatment of certain chronic disease (161,162). Health benefits of plant-based diets are well-documented, from lower body weight, BMI, blood pressure, low risk of obesity, type 2 diabetes, and certain cancers to increased antioxidant status (reduced oxidative stress) and reduced micro-inflammatory processes (76,161). Vegetarian children have also been shown to be leaner than non-vegetarian children, with these differences in BMI increasing during adolescence into adulthood, and reduced risk of developing overweight and obesity, high cholesterol, hypertension, heart disease and type 2 diabetes. ...
... Moreover, the Academy of Nutrition and Dietetics (161) explicitly emphasizes the health benefits of plant-based diets, especially in the prevention and treatment of certain chronic disease (161,162). Health benefits of plant-based diets are well-documented, from lower body weight, BMI, blood pressure, low risk of obesity, type 2 diabetes, and certain cancers to increased antioxidant status (reduced oxidative stress) and reduced micro-inflammatory processes (76,161). Vegetarian children have also been shown to be leaner than non-vegetarian children, with these differences in BMI increasing during adolescence into adulthood, and reduced risk of developing overweight and obesity, high cholesterol, hypertension, heart disease and type 2 diabetes. ...
... Vegetarian children have also been shown to be leaner than non-vegetarian children, with these differences in BMI increasing during adolescence into adulthood, and reduced risk of developing overweight and obesity, high cholesterol, hypertension, heart disease and type 2 diabetes. Children on a full vegan therapy diet effectively reduced blood pressure, cholesterol levels, body weight (obesity), and risk for/status of chronic disease(s) (98,(161)(162)(163). Furthermore, the long-term positive influence of plant protein sources, as well as fruit and vegetable consumption, on health and high life expectancy is evident, especially in long-term vegetarianism (≥ 17 years: +3.6 years), as well as a significant reduction in all-cause mortality of up to−34% with a plant-based compared to a mixed diet (18,57,76,98). ...
Article
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The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10–19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the “From Science 2 School” study.
... Vitamin B12 is without question the most important nutrient to address in the case of vegan diets (Melina, Craig, and Levin 2016;Wokes, Badenoch, and Sinclair 1955;Haddad et al. 2020;Pawlak 2021). The danger of severe vitamin B12 deficiency due to an unsupplemented vegan diet has been known since the 1950s (Wokes, Badenoch, and Sinclair 1955), and since at least the 1960s efforts to educate vegans in this regard have been made (Ellis and Mumford 1967;Ellis, Powell, and Kuktha 1968;Wokes 1967 West andEllis 1966;Ellis and Montegriffo 1970;Ellis and Sanders 1977;Sanders and Ellis 1981). ...
... Apart from vitamin B12, a suboptimal intake of several other nutrients may occur depending on the foods and supplements consumed (Thorpe et al. 2021;Tong et al. 2020). Specifically, it can be postulated that there are ten key nutrients which require at least some attention when "planning" nutritionally adequate vegan diets: these nutrients are (with particular emphasis) vitamin B12, calcium, vitamin D, iodine, and omega-3 fatty acids as well as (with potentially lower emphasis) iron, zinc, selenium, vitamin A, and protein (Melina, Craig, and Levin 2016;Craig et al. 2021;Fallon and Dillon 2020;Craddock et al. 2021). ...
... With regard to the scientific literature, a number of nutrition societies around the world have published position papers or similar official statements about vegan diets, with only a small number of these having been published in PubMed-indexed journals (Melina, Craig, and Levin 2016;Agnoli et al. 2017;Redecilla Ferreiro et al. 2020). The key nutrients mentioned in all of these statements are a selection of the ten key nutrients addressed in the present article (Melina, Craig, and Levin 2016;Agnoli et al. 2017;Redecilla Ferreiro et al. 2020). ...
... A vegetarian eating pattern can be nutritionally adequate [12,13], as well as healthful [12], and well-planned vegetarian diets have been deemed appropriate for all stages of life [12]. However, in planning vegetarian meals for children, added attention is required in order to assure the adequate intake of nutrients such as iron, zinc, and vitamin B-12 [12]. ...
... A vegetarian eating pattern can be nutritionally adequate [12,13], as well as healthful [12], and well-planned vegetarian diets have been deemed appropriate for all stages of life [12]. However, in planning vegetarian meals for children, added attention is required in order to assure the adequate intake of nutrients such as iron, zinc, and vitamin B-12 [12]. ...
... A vegetarian eating pattern can be nutritionally adequate [12,13], as well as healthful [12], and well-planned vegetarian diets have been deemed appropriate for all stages of life [12]. However, in planning vegetarian meals for children, added attention is required in order to assure the adequate intake of nutrients such as iron, zinc, and vitamin B-12 [12]. ...
Article
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While plant-based eating has become increasingly popular, little is known of how this trend has impacted childcare center meals. The purpose of this study was to measure the nutrient content and diet quality of vegetarian alternative lunches and compare these measures to those of standard childcare lunches and nutrient benchmarks representing one-third of the Dietary Reference Intake for 3-year-olds and 4–5-year-olds. Menu data were obtained from seven urban Kansas childcare centers participating in the Child and Adult Care Food Program and regularly providing a vegetarian alternative lunch. The centers provided detailed menu information for 27 days’ worth of meals. The most common vegetarian substitution was cheese, which was used to fulfill all or part of the meat/meat alternative requirement in over three-quarters of the vegetarian alternative meals (n = 22). Compared to the standard meals, the vegetarian alternative meals were higher in calories, fat, saturated fat, calcium, and sodium and lower in protein, choline, and diet quality (p = 0.05). Both lunch options met the benchmarks for vitamin A, vitamin D, vitamin B12, calcium, and protein. Iron content for both (95% CI: standard 1.61–2.17 mg; vegetarian 1.37–2.7 mg) was below the benchmark. Although additional research is needed to better understand how vegetarianism has impacted childcare meals in the U.S., important differences in the nutrient contents were observed between the standard and vegetarian alternative meals. In addition, the results suggest vegetarian alternative meals that rely heavily on cheese may be of lower diet quality.
... Vegetarian diets can be classified as pescetarian, lacto-ovo vegetarian (LOV), lactovegetarian, ovo-vegetarian and vegan. These forms can have specific subtypes, such as: raw food diet, fruitarian diet, macrobiotic diet, etc. [4,[7][8][9][10][11][12][13][16][17][18][19][20][21][22][23] (Table 1). Fish, mollusks, crustaceans, seafood. ...
... Several nutrition societies support the use of vegetarian diets at all life stages, requiring, however, nutrient supplementation when needed. According to the Academy of Nutrition and Dietetics (USA) [18], the Australian National Health and Medical Research Council [19] and the Portuguese National Program for the Promotion of a Healthy Diet [20], well-planned vegetarian diets are appropriate for individuals during all life stages, including pregnancy, lactation, infancy, childhood and adolescence. The Canadian Paediatric Society [21] also states that well-planned vegetarian and vegan diets, with the use of food supplements, can meet the nutritional needs of children and adolescents. ...
... With regard to meat intake, the SR by English et al. [41] reports that "twelve articles, seven RCTs (references in the SR nr. 2,3,5,11,14,15,18) and five articles from four observational studies (references in the SR n. 32,33,39,44,49) examined the relationship between meat intake and growth, size, body composition, and/or risk of overweight or obesity outcomes. Studies varied in terms of whether they assessed meat compared to cereal, meat and cereal compared to controls, or the amount of meat consumed". ...
Article
Full-text available
During the complementary feeding period, any nutritional deficiencies may negatively impact infant growth and neurodevelopment. A healthy diet containing all essential nutrients is strongly recommended by the WHO during infancy. Because vegetarian diets are becoming increasingly popular in many industrialized countries, some parents ask the pediatrician for a vegetarian diet, partially or entirely free of animal-source foods, for their children from an early age. This systematic review aims to evaluate the evidence on how vegetarian complementary feeding impacts infant growth, neurodevelopment, risk of wasted and/or stunted growth, overweight and obesity. The SR was registered with PROSPERO 2021 (CRD 42021273592). A comprehensive search strategy was adopted to search and find all relevant studies. For ethical reasons, there are no interventional studies assessing the impact of non-supplemented vegetarian/vegan diets on the physical and neurocognitive development of children, but there are numerous studies that have analyzed the effects of dietary deficiencies on individual nutrients. Based on current evidence, vegetarian and vegan diets during the complementary feeding period have not been shown to be safe, and the current best evidence suggests that the risk of critical micronutrient deficiencies or insufficiencies and growth retardation is high: they may result in significantly different outcomes in neuropsychological development and growth when compared with a healthy omnivorous diet such as the Mediterranean Diet. There are also no data documenting the protective effect of vegetarian or vegan diets against communicable diseases in children aged 6 months to 2–3 years.
... The PBDs, if well planned, can support healthy nutrition at every age and life-stage in healthy subjects and contribute to preserving the environment (10) . In fact, the 2020 Dietary Guidelines Advisory Committee Scientific Report recommends the promotion of PBD for a better health, among other dietary patterns (11) . ...
... It is also worth mentioning that very restrictive PBDs might present an increased risk of nutritional deficiencies and could seriously affect health (6,13) . Additionnally, supplementation of specific nutrients such as I, Ca and vitamins B12 and D should be considered in several risk groups that follows a PBD (10,14,15) . ...
... However, a direct association was found between the adherence to overall provegetarian FP and the risk of micronutrient inadequacy of vitamin B 12 and I. It has been previously reported that the requirements of these two micronutrients cannot be met in some vegetarian diets (10,35,36) . These results are in line with other studies that evaluated the degree of micronutrient adequacy when switching from omnivorous to plant-based diets (37)(38)(39)(40)(41)(42) . ...
Article
Objective To investigate the association between different versions of a provegetarian food pattern (FP) and micronutrient inadequacy Design Cross-sectional analysis. Dietary intake was assessed at baseline through a validated 136-item food frequency questionnaire (FFQ). Participants were classified according to groups of different versions of a provegetarian FP: overall, healthful and unhealthful. The prevalence of inadequate intake of vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, Zn, I, Se, Fe, Ca, K, P, Mg and Cr was evaluated using the Estimated Average Requirement (EAR) cut-point method and the probabilistic approach. Logistic regression analyses were conducted to estimate the probability of failing to meet EAR for either ≥3 or ≥6 micronutrients. Setting Seguimiento Universidad de Navarra (SUN) cohort Participants 17,825 Spanish adults Results Overall, subjects in the highest group of the unhealthful provegetarian FP had the highest prevalence of inadequate dietary intake for every vitamin and mineral, compared to those in the lowest group. The adjusted ORs of failing to meet ≥3 EAR (highest vs . lowest group) was 0.65 (0.54-0.69) for the overall, 0.27 (0.24-0.31) for the healthful and 9.04 (7.57-10.4) for the unhealthful provegetarian FP. Conclusion A higher adherence to an overall and healthful provegetarian FP was inversely associated with the risk of failing to meet EAR values, whereas the unhealthful version was directly associated with micronutrient inadequacy. Provegetarian FPs should be well planned, prioritizing nutrient-dense plant foods and minimizing ultra-processed and unhealthy ones.
... A vegan diet imposes a risk for nutrient deficiencies, especially for pregnant females who have a higher recommended daily intake (RDI). The Academy of Nutrition and Dietetics advises to monitor the intake of iron, zinc, vitamin B12, and essential fatty acids in pregnancy [3]. Recent studies demonstrate the association of a maternal vegan diet with an increased risk of the infant being small for gestational age [4]. ...
... Cases of exclusively breastfed children with B12 deficiency and clinical symptoms born to mothers on a vegan diet have been reported [5]. Remarkably, the risk of riboflavin (vitamin B2) deficiency is not considered in the current guidelines for pregnancy [3,[6][7][8]. ...
... Both studies and guidelines discuss potential insufficient content of essential nutrients (vitamin B12, vitamin D, calcium, zinc, iron, proteins, essential fatty acids, iodine) in vegan diets [3,7]. However, there are no reports of the need for monitoring of riboflavin intake. ...
Article
Full-text available
An increasing number of women of reproductive age follow vegan diets. Because vegan diets are deficient in a number of essential nutrients, guidelines address the necessity of supplementations such as iron, zinc, and vitamin B12. However, the risk of riboflavin (vitamin B2) deficiency is not properly addressed. We report a case of a male neonate with a life-threatening hypoglycaemia and lactic acidosis due to severe riboflavin deficiency. The mother followed a strict vegan diet with intermittent use of supplements (folic acid, vitamin B12, vitamin D, omega 3). This case highlights the importance of adequate counselling of all pregnant women adhering to vegan diets to ensure sufficient intake of essential nutrients and vitamins, including riboflavin.
... A recent nutrition report from Germany stated that the number of vegetarians and vegans have doubled from pre-COVID (5%) to post-COVID (10%) (11). Vegetarians refer to those who do not eat any meat, poultry or fish and may or may not consume egg or dairy products (12), while vegan refers to those who refrain from eating any animal product including dairy, eggs and other animal-derived food (12). ...
... A recent nutrition report from Germany stated that the number of vegetarians and vegans have doubled from pre-COVID (5%) to post-COVID (10%) (11). Vegetarians refer to those who do not eat any meat, poultry or fish and may or may not consume egg or dairy products (12), while vegan refers to those who refrain from eating any animal product including dairy, eggs and other animal-derived food (12). ...
... The participants were classified as vegan, vegetarian, and non-vegetarian. Vegan refers to those who refrain from eating any animal product including dairy, eggs and other animal-derived food; vegetarians refers to those who do not eat any meat, poultry or fish; while non-vegetarians refers to those who consume meat, poultry, fish and their products (12). The third section had questions related to the eating behavior of the participants (like eating breakfast daily, having three meals a day, fruit & vegetable and dairy product intake, fast-food consumption, sugar-sweetened beverages consumption). ...
Article
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Background Globalization has steered the spread of vegetarianism around the world. Vegetarianism has achieved increased acceptance by different populations. Objective The present study aims to assess vegetarian diet, and eating behavior prevalence among Saudi adults and their association with demographics and body mass index. Method A cross-sectional study conducted on 1,143 Saudi adults [418 (36.6%) males and 725 (63.4%) females]. An online survey questionnaire containing questions on demographics, type of diet, eating behavior and physical activity was provided to participants for self-administration. Statistical analysis was performed to associate demographic and eating behavior variables with the type of diet using Pearson's Chi-square test and Spearman's partial correlation test was used to correlate BMI and eating behavior. Results Prevalence of veganism was 4.7% ( n = 54/1,143) and vegetarianism was 7.8% (89/1,143). A significantly higher prevalence of vegan diet was observed in females than males (79.6% vs. 20.4%, p < 0.0001). A significantly higher proportion of participants on vegetarian diet selected “Always” as response for eating breakfast, vegetables and fruits as well as for eating or drinking dairy foods, and for eating canned food than participants on non-vegetarian diet ( p < 0.0001). A significantly higher proportion of participants on vegan diet selected ‘Never' for eating fast-food and fried food as well as for drinking fizzy or soft drinks ( p < 0.0001). A positive moderate correlation was found between BMI and eating fast-food and fried food [r (1, 140) = 0.529, p < 0.0001], drinking fizzy or soft drinks with meals [r (1, 140) = 0.495, p = 0.001], and eating canned food [r (1, 140) = 0.510, p < 0.0001]. Conclusion Our study shows that vegan and vegetarian diet have gained access into the lifestyle of Saudi adults with a prevalence of 4.7 and 7.8%, respectively. Participants on vegetarian diet showed better lifestyle like higher physical activity level, higher consumption of fruits, vegetables, dairy products and low intake of fast-foods and fizzy beverages.
... Vegetarian diets can be appropriate for pregnant and lactating women (84). However, individuals following a vegetarian diet are at greater risk for some nutrient deficiencies and may require supplementation to meet the increased nutritional demands of pregnancy (85). ...
... The Academy of Nutrition and Dietetics recommends that a registered dietitian assesses intake of all micronutrients, particularly folate, vitamin B12, iron, and zinc in pregnant women following a vegetarian diet to ensure that dietary reference intakes are met (86). Evidence suggests that intake of a healthy vegetarian diet during pregnancy is associated with low risk of excessive gestational weight gain and gestational diabetes, while having limited impact on infant birth weight or birth duration (84). ...
Article
A healthy eating pattern is recommended for all life stages and is central to achieving optimal pregnancy outcomes and successful lactation. The preconception period is a critical window of time during which good nutritional status benefits both the mother and the offspring. The ongoing overweight and obesity epidemic, especially in conjunction with poor nutritional status, presents maternal and infant health risks. Preconception and postpartum weight loss are routinely recommended in clinical practice. In this review, we discuss the nutritional recommendations for healthy weight loss during these periods. Unhealthy weight loss during preconception and for lactating women, postpartum, can cause adverse maternal consequences that can impact the offspring.
... Dietary subgroup classification of participants was based on the following groups: omnivorous (also known as the Western diet, includes no dietary restriction), vegetarian (no consumption of meat or fish), or vegan (no consumption of products from animal origin: meat, processed meat, fish, seafood, shellfish, milk, dairy products, eggs, or honey) [20]. Participants must have followed their respective diet for the minimum duration of 6 months to be included in the omnivore, vegetarian, or vegan subgroup. ...
... In addition, any particular diet type may also play a role in a person's nutrient status. While the vegan/vegetarian population is often criticized for lacking the socalled critical nutrients of protein, vitamin B12, vitamin D, iron, calcium, or essential fatty acids [55], the American Academy for Nutrition and Dietetics has maintained their position for over 40 years regarding their approval for such diets, which they advocate for being nutritionally adequate, healthful, and may help to prevent non-communicable diseases over the lifespan (i.e., heart diseases, type II diabetes) when planned appropriately [20,56]. The omnivore diet, on the other hand, is consistently found to be associated with higher incidences of overweight/obesity [57,58] and may also pose specific nutrient concerns, including insufficient vitamins B12 and D for the general population and endurance runners alike [17,59]. ...
Article
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This study aims to investigate vegetarian and mixed diet type prevalences among distance runners at running events around the world and associations with running-related patterns and performance. Following a cross-sectional approach, linear regression analyses were carried out to identify potential associations among body mass index (BMI), diet type, and average best performance times of half-marathon and marathon events for males and females. From a sample of 3835 runners who completed an online questionnaire, 2864 all-distance runners (age: 37 years; 57% females) were included in inferential analyses and categorized into dietary subgroups according to self-reports: 994 vegans (34.7%), 598 vegetarians (20.9%), and 1272 omnivores (44.4%). Significant associations were identified between kind of diet and best average time to finish (i) half-marathons in females where vegans (p = 0.001) took longer than omnivores, (ii) half-marathons in males where vegans (p < 0.001) and vegetarians (p = 0.002) took longer than omnivores, and (iii) marathons in males where vegans (p < 0.001) and vegetarians (p = 0.043) averaged slower than omnivores. Increased units of BMI (+1.0) in males influenced best runtimes: 2.75 (3.22–2.27) min slower for HM and 5.5 (5.69–4.31) min slower for M. The present study did not take detailed confounders into account such as runner motives or training behaviors; however, the results may provide valuable insight for running event organizers, nutrition experts, coaches, and trainers advising runners who adhere to a general diet type regarding the basic question of who participates in running events around the world.
... Diet type can significantly impact the nutritional status of endurance athletes, thus influencing their health and performance [1,2]. Two major diet type categories are vegan (defined as a diet containing ingredients from 100% plants only) and vegetarian (defined as a diet devoid of meat and flesh foods), which can be adopted for several motives, including performance, health, ethical issues, and environmental aspects [3,4]. In line with the increasing expansion of veganism and vegetarianism trends [5], the prevalence of vegan and vegetarian diets increased over the past years, especially among endurance athletes [6,7]. ...
... Endurance runners were classified according to the race distance and their selfreported diet types with a minimum of six months of adherence. Three diet-based groups were defined, including omnivorous (or Western diet, with no food restriction), vegetarian (devoid of meat and all flesh foods, including seafood), and vegan diet (devoid of all types of foods from animal sources, including eggs, dairy products, and honey) [3,4]. The initial race distance subgroups were "half-marathon" and "marathon/ultra-marathon". Marathoners and ultra-marathoners were pooled in the same group since marathon distance is usually included in an ultra-marathon event. ...
Article
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Nowadays, the growing popularity of distance running has been accompanied by the increasing prevalence of vegan and vegetarian diets, especially among endurance athletes. The present study aimed to examine the association between diet type and dietary intake of distance runners competing at distances longer than 10 km. From a total of 317 participants, 211 endurance runners (57% females) were considered the final sample after applying the exclusion criteria. Runners were assigned to three groups based on the self-reported diet types: 95 omnivores, 40 vegetarians, and 76 vegans. Data collection was conducted using an online survey with questions about sociodemographic information, dietary intake, and dietary-associated motives. A comprehensive food frequency questionnaire with 53 food groups (categorized in 14 basic—plus three umbrella—food clusters) was used to assess dietary intake. Vegan runners had a higher intake of “beans and seeds”, “fruit and vegetables”, and “dairy alternatives”, as well as lower intakes of “oils” than other two groups. Vegetarian runners had a lower intake of “dairy products” and “eggs” than omnivores. A greater intake of “alcohol” and a lower intake of “meat alternatives” was observed in omnivorous runners compared to vegans and vegetarians. Despite the existence of a tendency toward the consumption of health-related food clusters by vegan runners, further investigations are needed to verify the predominance of vegans in health-oriented dietary patterns.
... These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes. (Melina et al. 2016(Melina et al. : 1970 The position is mirrored by the British Dietetic Association (2017). It should be noted that both entities include the element of planning in their statements. ...
Article
This viewpoint piece aims to draw attention to the opportunities that the development and active promotion of an attractive and nutritionally sound plant-based offer present to the hospitality industry on environmental, health and ethical bases that impact societal well-being. The case for advancing the promotion and normalization of plant-based eating at catering facilities is argued using the threefold dimensions associated with food production. First, the environmental impacts of different food types are discussed. This is followed by an evaluation of health-related debates linked to culinary consumption along with a selection of ethical issues involved in food production systems. This review highlights that the environmental sustainability challenges posed by the animal agricultural sector call for innovative and effective mitigating measures that can be linked to the development and promotion of plant-based food consumption which the hospitality industry can actively promote. From the health perspective, plant-based diets can report health benefits in the prevention and treatment of health conditions, but this requires planning by catering providers for nutritionally adequate and wholesome eating. From the ethical dimension, removing animals from the food chain would not only achieve lesser environmental pressures and social issues associated with the consumption of animal-derived produce. This would also reduce the suffering that sentient beings endure across different stages in food production which in turn can improve the hospitality sector’s corporate image and ethical stance whilst progressing positive social messages on sustainability, ethics and health.
... In developing counties where the diet of children, especially in the rural areas, is primarily plant-based and nutrient-deficient, essential minerals and vitamins such as vitamin B, riboflavin, vitamin A, vitamin E, iron, zinc, calcium, and vitamin D can be derived from foods of animal source. Although the above-mentioned nutrients are not unique to animal sources and can be derived from non-animal sources (Vesanto et al. 2016), animal proteins are more digestible (about 20-30%) than plant protein forms (96-98% vs. 65-70%) and their minerals and vitamins are in higher and in more bioavailable levels than the plant protein forms. Vitamin A, which is an important micronutrient for development of children, is present in the animal source force (Murphy and Allen 2003). ...
Chapter
Cultural or indigenous practices refer to long-standing traditions and ways of life of specific communities or locales. These practices are place-based and often location- and culture-specific. Plants are integral to livelihood especially in indigenous communities within the Global South. Ethnologists including ethnobotanists continue to enumerate the interface between nature and culture, which addresses the need to provide quality information for plant conservation and their sustainable utilization. Plant conservation is the wise use of plant resources by the present generation so that future generations can benefit. Traditional conservation ethics protect plant diversity and natural resources because local communities consider themselves as the major stakeholders. Globally, support for contemporary plant conservation approaches exists whereas none exists for traditional methods. Some traditional systems used for plant conservation through their utilization include taboos, totemism, rituals, domestication, reserves, secrecy, selective harvesting, sacred groves, etc. Totemism is the practice-based consciousness of the supernatural link that exists between people and specific objects including plant species, natural resources and or objects made from these items whereas taboo is the forbidden practice of using or consuming some plant species, natural resources and objects or their parts (totems). Sacred groves are described as patches of land considered sacred and conserved by indigenes through sociocultural, economic and religious observances and include traditional sacred groves, temple groves, burial and cremation grounds, etc. like the Asanting Ibiono sacred forest, Nigeria; Anweam sacred grove within the Esukawkaw forest reserve, Ghana; sacred Mijikenda kaya forest, Kenya; Kpaa Mende sacred grove, Sierra Leone; Thathe Vondo holy forest Limpopo, South Africa and Kwedivikilo sacred forest, Tanzania. These largely informal conservation and utilization practices have several ecological, sociocultural and economic relevance. They have contributed towards the protection of plant species like Lippia javanica, Milicia excelsa, Adansonia digitata, Spathodea campanulata, Ziziphus mucronata and Ficus thonningii. However, growing pressures from human population boom, reduced environmental quality, and neglect of sociocultural norms and traditional belief systems are undermining the relevance of these practices. Therefore, it is essential to document these practices, enlighten future generations of their importance and institute legal instruments to promote the sustainable management and application of these cultural heritage and natural resources for societal development.KeywordsCultural practicesEthnobotanyPlant conservationTaboos and totemsGlobal SouthSustainable development
... Concerning adults, they are exposed to vitamin B12 deficiency as well and must be supplemented [16]. Several countries have already published guidelines to help physicians in the follow-up of their vegetarian patients [39][40][41][42]; yet, such recommendations are still lacking in France. ...
Article
Studies suggest a decreasing trend in the consumption of meat products and a growing interest in vegetarian diets. Medical support may be relevant, especially when switching to a vegan diet. Our objective was to describe the beliefs and attitudes of primary care physicians toward vegetarian diets. A cross-sectional survey was conducted among general practitioners and pediatricians thorough a questionnaire including socio-demographic characteristics, specific care to vegetarians, and the risks and benefits of vegetarian diets according to physicians. Out of the 177 participating physicians, 104 (59%) have seen at least one vegetarian patient in consultation in the last three months. Half of the physicians declared that they would dissuade their patients from switching to a vegan diet (n = 88, 51%) and 14% (n = 24) from switching to an ovo-lacto-vegetarian (OLV) diet. Most physicians (n = 141, 88%) did not feel informed enough about these diets. Physicians thought that the most frequent deficiencies for OLV and vegan diets were iron (76% and 84%, respectively) and protein (45% and 79%, respectively). These results highlight the fact that French primary care physicians feel concerned by this subject and need more information on these diets. Specific recommendations would be useful to support their practice and relationship with vegetarians.
... Plant sources were formerly regarded as incomplete proteins. However, new studies have revealed that prudent vegetarian diets could adequately supply all essential amino acids (13). Yet, the absorption of which is still considered lower than that of animal sources (14). ...
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Background Mental disorders are conditions that affect the usual function of the brain, causing a huge burden on societies. The causes are often unclear, but previous research has pointed out, as is the case with many other diseases, that nutrition could have a major role in it. Amino acids, the building blocks of proteins, are the main precursor of neurotransmitters (the chemical messengers in the brain) malfunction of which is heavily associated with a wide range of brain disorders. Methods We assumed different sources of dietary protein could have different impacts on mental wellbeing. Hence, we decided to collect the nutritional data (with a validated and reliable semi-quantitative food-frequency questionnaire) from a sample of 489 Iranian women and investigate the association between animal and plant protein sources and the risk of depression, anxiety, and stress. Symptoms of these mental disorders were assessed using a validated Depression, Anxiety, Stress Scales (DASS) questionnaire with 21 items. Results After multivariable adjustment, it was shown that women in the highest tertile of animal protein intake were more likely to show symptoms of depression (OR: 2.63; 95% CI: 1.45, 4.71; P = 0.001), anxiety (OR: 1.83; 95% CI: 1.04, 3.22; P = 0.03), and stress (OR: 3.66; 95% CI: 2.06, 6.50; p < 0.001). while no significant association was seen between plant protein and any of the studied mental disorders. Conclusion Overall, our findings suggest that a diet high in animal protein could predispose individuals to mental illnesses.
... These patterns have in common the exclusion of animal foods such as meat and meat-derived products, and the inclusion of a plethora of plant-based foods such as wholegrains, fruits and vegetables, legumes, nuts and seeds. These foods represent a rich source of micronutrients and bioactives such as polyphenols, glucosinolates and carotenoids which are well known for their protective effects against different chronic diseases [1,2]. In fact, several observational studies have reported an inverse association between vegetarian/vegan-dietary patterns and the risk of different chronic diseases and mortality [3][4][5][6][7]. ...
Article
Optimal Vitamin B12 status is important for vascular health. Vascular endothelial cadherin (VE-cadherin) is an adherent junction protein involved in the maintenance of a functional endothelium. We hypothesized that a vitamin B12 deficiency can negatively affect markers of vascular function, such as VE-cadherin. Within a human intervention study, we explored the possible association between cobalamin status (i.e., vitamin B12, holotranscobalamin, homocysteine) and VE-cadherin (as marker of vascular health) in vegetarians/vegans (VEG) with a B12 deficiency. The associations were evaluated at baseline and after 90-day supplementation with 2000 µg/week of vitamin B12. On the whole, an inverse association between VE-cadherin and holotranscobalamin (p=0.014) and a positive association between VE-cadherin and homocysteine (p=0.041) was documented at baseline. Interestingly, VEG women showed higher levels of VE-cadherin compared to VEG men (p=0.044) suggesting an increase in endothelial permeability. The intervention with vitamin B12 restored serum vitamin levels and improved the overall cobalamin status, while it did not affect VE-cadherin levels. The inverse association between holoTC and VE-cadherin was also maintained after intervention in women, corroborating the strong correlation between these two parameters. The results obtained seem to suggest a possible association between cobalamin status and VE-cadherin even if the intervention with B12 failed to positively affect VE-cadherin levels. Thus, further studies are needed in order to corroborate these findings and clarify the contribution of a vitamin B12 intervention on VE-cadherin levels in this target population. This trial was registered at ISRCTN registry (http://www.isrctn.com/ISRCTN75099618).
... Whereas diets high in animal foods have been commonly discouraged owing to high saturated fats content and low density of essential nutrients and bioactive compounds (e.g., fiber, phytonutrients) (12), little is known about the health status of people habitually following a carnivore eating pattern. According to a common view, long-term consumption of a strictly animal-based diet would be associated with significant nutritional deficiencies (13) and confer negative health effects compared with a plant-based diet (14,15), including poor gut and gut-microbiota health (16)(17)(18)(19), an adverse cardiovascular disease risk pattern (20,21), and other chronic health complications (22). ...
Article
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ABSTRACT Background The “carnivore diet,” based on animal foods and excluding most or all plant foods, has attracted recent popular attention. However, little is known about the health effects and tolerability of this diet, and concerns for nutrient deficiencies and cardiovascular disease risk have been raised. Objectives We obtained descriptive data on the nutritional practices and health status of a large group of carnivore diet consumers. Methods A social media survey was conducted 30 March–24 June, 2020 among adults self-identifying as consuming a carnivore diet for ≥6 mo. Survey questions interrogated motivation, dietary intake patterns, symptoms suggestive of nutritional deficiencies or other adverse effects, satisfaction, prior and current health conditions, anthropometrics, and laboratory data. Results A total of 2029 respondents (median age: 44 y, 67% male) reported consuming a carnivore diet for 14 mo (IQR: 9–20 mo), motivated primarily by health reasons (93%). Red meat consumption was reported as daily or more often by 85%. Under 10% reported consuming vegetables, fruits, or grains more often than monthly, and 37% denied vitamin supplement use. Prevalence of adverse symptoms was low (<1% to 5.5%). Symptoms included gastrointestinal (3.1%–5.5%), muscular (0.3%–4.0%), and dermatologic (0.1%–1.9%). Participants reported high levels of satisfaction and improvements in overall health (95%), well-being (66%–91%), various medical conditions (48%–98%), and median [IQR] BMI (in kg/m2) (from 27.2 [23.5–31.9] to 24.3 [22.1–27.0]). Among a subset reporting current lipids, LDL-cholesterol was markedly elevated (172 mg/dL), whereas HDL-cholesterol (68 mg/dL) and triglycerides (68 mg/dL) were optimal. Participants with diabetes reported benefits including reductions in median [IQR] BMI (4.3 [1.4–7.2]), glycated hemoglobin (0.4% [0%–1.7%]), and diabetes medication use (84%–100%). Conclusions Contrary to common expectations, adults consuming a carnivore diet experienced few adverse effects and instead reported health benefits and high satisfaction. Cardiovascular disease risk factors were variably affected. The generalizability of these findings and the long-term effects of this dietary pattern require further study.
... Other consumer practices that may contribute to recent declines in dietary intake of iodine include veganism and some forms of vegetarianism [39][40][41] which have substantially increased in popularity in industrialized countries in recent years [41]. For example, in Britain the number of vegans quadrupled to 600,000 from 2014 to 2018 and they have lower iodine levels than the general population [8,23]. ...
Article
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Iodine is a mineral nutrient essential for the regulation of a variety of key physiological functions including metabolism and brain development and function in children and adults. As such, iodine intake and status within populations is an area of concern and research focus. This paper will review recently published studies that focus on the re-emerging issue of iodine deficiency as a global concern and declining intake among populations in developed countries. Historically, the implementation of salt-iodization programs worldwide has reduced the incidence of iodine deficiency, but 30% of the world’s population is still at risk. Iodine nutrition is a growing issue within industrialized countries including the U.S. as a result of declining iodine intake, in part due to changing dietary patterns and food manufacturing practices. Few countries mandate universal salt iodization policies, and differing agriculture and industry practices and regulations among countries have resulted in inconsistencies in supplementation practices. In the U.S., in spite of salt-iodization policies, mild-to-moderate iodine deficiency is common and appears to be increasing. European countries with the highest incidence of deficiency lack iodization programs. Monitoring the iodine status of at-risk populations and, when appropriate, public health initiatives, appear to be warranted.
... Р азличные продукты могут быть исключены из рациона по разным причинам: медицинским показаниям, религиозным, культурным или морально-этическим убеждениям [1,2]. Отличительная черта рациона веганов -полное отсутствие продуктов животного происхождения [1]. ...
Article
Purpose. Insufficient vitamin D intake and its low serum levels are a global problem in extratropical regions, since its content in food is negligible. Even more risks of vitamin D deficiency are increased by avoiding those foods that provide at least some amounts of it – oily fish, liver, dairy products and eggs, in particular, in vegans. Many vegans regularly consume vitamin D supplements. However, due to Russian mentality or other reasons, most vegans select the dosage and frequency of the supplementation on their own, not being guided by the opinion of a medical professional or the result of a study of vitamin D levels in the blood. One of the main manifestations of vitamin D deficiency is a violation of calcium metabolism and, as a result, a decrease in bone mineralization. The aim of this study was to evaluate the adequacy of long-term, regular, but uncontrolled vitamin D supplementation in vegans for prevention of its deficiency and maintaining normal bone mineral density. Patients and methods. In the present study, 32 vegans were examined, 9 people took vitamin D regularly for at least three years. The regularity and doses were not taken into account. 23 vegans made up the control group, these people stated that they did not regularly take vitamin D. The intake of vitamin D, its serum concentrations were assessed, as well as the mineral density of the lumbar vertebrae and the neck of the left femur using X-ray densitometry. Results. Vitamin D was almost absent in the diet of all examined patients. A third of vegans had insufficient levels of calcidiol in the blood, half were deficient. Only five people had serum calcidiol concentrations above 30 ng/mL. However, no intergroup differences were found (only one well supplied vegan took extra vitamin D). About a quarter of the subjects had osteopenia. At the same time, osteoporosis was not found among them. Again, no differences were found between the groups. Conclusion. Self-selection of a nutritional supplementation strategy, at least, is not always justified. The regimen and dosage should be based on the results of vitamin D sufficiency investigation and the recommendations of a specialist. For vegans, given the increased risks of the demineralizing diseases development, it is reasonable to check bone mineral density at regular intervals.
... Die hier gegebenen Empfehlungen orientieren sich an denen von Fachgesellschaften in Deutschland und in anderen Ländern [112,129,141,149,150,157,225,227]. EineovolaktovegetarischeErnährung wird auch für Kleinkinder als geeignet angesehen; auf die notwendige besondere Sorgfalt bei der Lebensmittelauswahl hinsichtlich der kritischen Nährstoffe wird hingewiesen. ...
Article
BackgroundA balanced, age-appropriate, sustainable diet, and plenty of physical activity contribute to a healthy development and well-being of young children. An early adaptation of appropriate behavior can positively influence later behavior and thus improve health in the short, medium and long term. The recommendations for action on nutrition and physical activity in young children have been updated and are intended to provide professionals with a reliable basis for counselling of families with young children.Methods Current systematic reviews, meta-analyses, guidelines, and other relevant articles on the topics of nutrition and physical activity in young children (aged 1–3 years), were reviewed by representatives of the professional societies and institutions of the network. They evaluated the scientific evidence and updated the existing recommendations or formulated recommendations for action on some issues for the first time. Sustainability aspects were also taken into account. The process was coordinated by the Healthy Start—Young Family Network.RecommendationsSmall children should have regular mealtimes. They should participate in family meals and eat with other family members as often as possible. Attention to the child’s hunger and satiety signals (responsive feeding) contributes to the development of healthy eating habits. Food should not be used as a reward or punishment. The recommended infant diet includes plenty of plant foods and moderate amounts of animal foods. A vegetarian diet must be carefully matched to the child’s nutritional needs. Young children should be physically active as much as possible, especially outside and in a variety of ways. Parents should support physical activity. Screen devices are not recommended for young children. Parents should provide the child with opportunities for regular rest and sleep. Professionals and families should explore together ways to implement these recommendations in everyday family life.
... 76 The plant-based diet is recognised as a safe, sustainable diet for all lifestyles by various nutrition institutes. [77][78][79] Dissemination plan The research group intends to publish the data generated from this study in peer-reviewed journals. In addition, results will be communicated at international ...
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Introduction People with mild cognitive impairment (MCI) are at increased risk of decreasing cognitive functioning. Computerised cognitive training (CCT) and nutrition have been shown to improve the cognitive capacities of people with MCI. For each variable, we developed two kinds of interventions specialised for people with MCI (CCT: ‘individualised’ CCT; nutrition: a whole-food, plant-based diet). Additionally, there are two kinds of active control measures (CCT: ‘basic’ CCT; nutrition: a healthy diet following the current guidelines of the German Nutrition Society). The aim of this study is to investigate the effects of the two interventions on cognition in people with MCI in a 2×2 randomised controlled trial with German participants. Methods and analysis Participants will be community-dwelling individuals with a psychometric diagnosis of MCI based on the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination. With N=200, effects with an effect size of f ≥0.24 (comparable to Cohen’s d ≥0.48) can be detected. Screening, baseline, t6 and t12 testing will be conducted via a videoconferencing assessment, telephone, and online survey. Participants will be randomly allocated to one of four groups and will receive a combination of CCT and online nutritional counselling. The CCT can be carried out independently at home on a computer, laptop, or tablet. Nutrition counselling includes 12 online group sessions every fortnight for 1.5 hours. The treatment phase is 6 months with follow-ups after six and 12 months after baseline. Ethics and dissemination All procedures were approved by the Friedrich-Alexander-Universität Erlangen-Nürnberg Ethics Committee (Ref. 21-318-1-B). Written informed consent will be obtained from all participants. Results will be published in peer-reviewed scientific journals, conference presentations. Trial registration number ISRCTN10560738 .
... Plant-based diets are addressed in the literature as both healthier and more sustainable (Chen et al. 2019;Clark et al. 2019;Springmann 2019), with the Academy of Nutrition and Dietetics defending that, if planned and diversified, they can satisfy all nutritional requirements (Melina et al. 2016). Furthermore, the World Health Organization (WHO) has also classified processed meat as "carcinogenic to humans" and red meat as "probably carcinogenic", recommending a reduction in these types of meat followed by an increase in plant-based foods (Bouvard et al. 2015). ...
Article
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Plant-based diets are often promoted as healthier and more sustainable and thus as a mechanism to achieve the targets proposed to mitigate climate change and noncommunicable diseases. However, plant-based diets can be perceived as more expensive than the common omnivorous diets, when considering the expensive novel meat substitutes and also the higher costs of fruits and vegetables, whose consumption is perceived to increase. Therefore, the present study assesses the question: Do plant-based consumers spend more on food compared to omnivorous consumers? Based on primary data ( n = 1040) collected through an online survey, representative of the Portuguese population, through logistic regressions, it was possible to conclude that plant-based consumers, particularly vegan, are associated with lower food expenditures compared to omnivorous consumers. In fact, plant-based consumers are shown to spend less than all other consumers assessed. Food policies aligning healthiness and sustainability with affordability can deliver a major boost for the promotion of plant-based diets and help achieve the mitigation targets proposed.
... In order to avoid an irreversible loss of these valuable data sets, those who met the inclusion criteria (1) to (3) were kept as additional race distance subgroup. Dietary subgroups were omnivorous (or Western diet, with no restriction on any food items), vegetarian (devoid of all flesh foods, including fish and shellfish, but including eggs and/or dairy products), and vegan diet (devoid of all foods from animal sources, including honey) [40,41] with a minimum of 6-month adherence to the self-reported diet types. ...
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Sex has been recognized to be an important indicator of physiological, psychological, and nutritional characteristics among endurance athletes. However, there are limited data addressing sex-based differences in dietary behaviors of distance runners. The aim of the present study is to explore the sex-specific differences in dietary intake of female and male distance runners competing at >10-km distances. From the initial number of 317 participants, 211 endurance runners (121 females and 90 males) were selected as the final sample after a multi-level data clearance. Participants were classified to race distance (10-km, half-marathon, marathon/ultra-marathon) and type of diet (omnivorous, vegetarian, vegan) subgroups. An online survey was conducted to collect data on sociodemographic information and dietary intake (using a comprehensive food frequency questionnaire with 53 food groups categorized in 14 basic and three umbrella food clusters). Compared to male runners, female runners had a significantly greater intake in four food clusters, including “beans and seeds”, “fruit and vegetables”, “dairy alternatives”, and “water”. Males reported higher intakes of seven food clusters, including “meat”, “fish”, “eggs”, “oils”, “grains”, “alcohol”, and “processed foods”. Generally, it can be suggested that female runners have a tendency to consume healthier foods than males. The predominance of females with healthy dietary behavior can be potentially linked to the well-known differences between females and males in health attitudes and lifestyle patterns.
... In its most recent position manuscript on vegetarian diets, published in December 2016, the Academy of Nutrition and Dietetics affirmed that well-planned vegetarian diets are appropriate for all phases of life, are wholesome and nutritionally complete, and might be beneficial for the mitigation and therapeutic interventions of chronic illnesses, and are linked to less environmental harm. [159] Other vegetarian food guides have been created after the 1997 release of the first pyramid-shaped Vegetarian Food Guide (VFG). [160,161] The Dietary Guidelines for People in Some Western Countries [162] also provide information and suggestions for vegetarians. ...
Article
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Sportsmen may choose to include vegetarian diet in their dietary regime for a variety of ways like its beneficial health impact, due to religious restrictions or to protect animals for environmental integrity. These diets are loaded with a wide variety of phytochemicals with superior health benefits safeguarding against chronic diseases. Besides their role in health management these foods also play a key role in enhancing different sports performances owing to contained with instant energy providing carbohydrates that are crucial for competitive sports performance. Furthermore, they are also richly enriched with antioxidants that are essential for high-end sports performance. However, few vegetarian diets are the source of anti-nutritional entities like high fiber content, chelating agents, phytates, and tannic acid. These interfere with the bio-availability of crucial dietary components like iron, zinc, proteins. Therefore, a sound nutritional approach is required while planning plant-based dietary regimes for sports performance. This review will systematically focus on the impact of vegetarian diets on sports performance in the light of currently available research findings in this field to provide a guiding hand to sports specialists and nutritional experts in planning the vegetarian dietary plans for optimizing the sports performance. In addition, this review explains the bio-availability and enhancement strategies of different vegetarian diet-based nutrients through different energy metabolism pathways.
... Therefore, 10-km, half-marathon, and marathon/ultra-marathon were defined as study groups. In addition, participants were categorized according to their self-reported diet types: omnivores (those with no restriction on any food items); vegetarians (those who avoid all flesh foods, including fish and shellfish, but consume egg and/or dairy); and vegans (those who avoid any type of food from animal sources) [29,30]. ...
Article
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While the popularity of distance running is growing worldwide, endurance runners’ dietary challenges associated with their prolonged training and racing activities have not yet been fully understood. The present investigation was conducted with the aim of examining the association between race distance and dietary intake of distance runners. A total of 317 runners initially participated, and after data clearance, 211 endurance runners (57% females) were finally considered the study sample. Runners were assigned to three race distance groups: 10-km (n = 74), half-marathon (n = 83), and marathon/ultra-marathon (n = 54). An online survey was used to collect data; dietary intake was monitored using a comprehensive food frequency questionnaire, including 53 food groups categorized in 14 basic and three umbrella clusters. There was no significant difference (p > 0.05) between race distance groups in consumption of most food clusters except for “fruits and vegetables” and “total of protein”, with a predominance of 10-km runners compared to half-marathoners and (ultra-)marathoners (p ≤ 0.05). Age was a significant predictor for the consumption of only five (out of 17) food clusters (p ≤ 0.05), including “fruit and vegetables”, “unprocessed meat”, “processed meat”, “eggs”, and “plant protein”. Future investigations with a larger sample size and more differentiated (sub)groups may help provide comparable data to develop a better understanding of the dietary behaviors among shorter versus longer distance runners.
... The present findings could be influenced by the distribution of diet types, particularly vegetarians and vegans, among the endurance runners. It has been reported that appropriately planned vegetarian and vegan diets are healthful and nutritionally adequate even for athletes and provide health benefits for the prevention and treatment of cardio-metabolic disorders and certain diseases such as ischemic heart disease, type 2 diabetes, hypertension, inflammatory problems, and some types of cancer 47,62 . More specifically, the higher prevalence of plant diets together with the null association between race distance and the incidence of allergies in the present study is in line with the available data on the protective effects of fruits and vegetables on the incidence of food allergies, including allergic asthma 18 as well as the lower prevalence of allergies in vegan endurance runners (20%) compared to omnivores (32%) and vegetarians (36%) 10 . ...
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Endurance running is well-documented to affect health beneficially. However, data are still conflicting in terms of which race distance is associated with the maximum health effects to be obtained. Therefore, the aim of this study was to compare the health status of endurance runners over different race distances. A total of 245 recreational runners (141 females, 104 males) completed an online survey. Health status was assessed by measuring eight dimensions in two clusters of health-related indicators (e.g., body weight, mental health, chronic diseases and hypersensitivity reactions, medication intake) and health-related behaviors (e.g., smoking habits, supplement intake, food choice, healthcare utilization). Each dimension consisted of analytical parameters derived to a general domain score between 0 and 1. Data analysis was performed by using non-parametric ANOVA and MANOVA. There were 89 half-marathon (HM), 65 marathon/ultra-marathon (M/UM), and 91 10-km runners. 10-km runners were leaner than both the HM and M/UM runners (p ≤ 0.05). HM runners had higher health scores for six dimensions (body weight, mental health, chronic diseases and hypersensitivity reactions, medication intake, smoking habits, and health care utilization), which contributed to an average score of 77.1% (score range 62–88%) for their overall state of health. Whereas 10-km and M/UM runners had lesser but similar average scores in the overall state of health (71.7% and 72%, respectively). Race distance had a significant association with the dimension “chronic diseases and hypersensitivity reactions” (p ≤ 0.05). Despite the null significant associations between race distance and seven (out of eight) multi-item health dimensions, a tendency towards better health status (assessed by domain scores of health) among HM runners was found compared to other distance runners. However, the optimal state of health across all race distances supported the notion that endurance running contributed to overall health and well-being. Trial registration number: ISRCTN73074080. Retrospectively registered 12th June 2015.
... Adequately planned vegetarian diets, including vegan diets, can provide many health benefits that are largely attributed to the lower intake of saturated fat and higher intake of fiber and phytochemicals [122]. However, the lower intake of protein and Ca (and other micronutrients) may be factors leading to the lower BMD and higher risk of hip fracture in vegans compared to omnivores. ...
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Purpose of Review There is strong evidence that poor dietary intake of certain micro- and macro-nutrients can negatively affect bone health. It is unclear if diet is the primary culprit for poor bone health in the vegan population. Recent Findings Plant-based diets are gaining public interest since they may improve metabolic health. Studies that examine vegetarians and vegans together show a lower bone mineral density (BMD), but not always increased fracture risk compared to omnivores. However, vegans consistently have higher risk of fracture at multiple bone sites, especially at the hip. Summary There is higher fracture risk in vegans which may be due to calcium and vitamin D intake, as well as amount of dietary protein and quality. Other nutrients (B vitamins, Se, Zn, Fe, iodine) or physiological factors (lower body mass index, microbiome, or endocrine profile) may also play a role but have not been examined and require further study.
... Proteins play a key role for health and athletic performance since they are involved in protein synthesis, body composition, and energy metabolism (12). Several studies demonstrated that it is important to balance plant-based foods and counteract this deficit by varying protein sources on the diet to satisfy and ensure proteins and amino acids needs, especially for athletes (2,11,(29)(30)(31). Starting from evidence, our nu- tritional assessment evaluated all macronutrients intake and we ensure the correct macronutrients intake thanks to the variation of plant-based protein sources, selecting food sources to compensate animal proteins lack in the plant-based diets (i.e. ...
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Background: Plant-based diets have spread widely in the general population and among athletes too, both for well-documented health benefits and for eco-sustainability and ethical concerns. Despite appropriate nutrition is essential for satisfying training, performance, and recovery needs in athletes, little is known about the effects of plant-based diets on body composition in athletes. Appropriate training and nourishment strategies are a daily priority to arrive at victory and achieving an optimal body composition helps achieve success. Our study aimed to shed light on the adequacy of a vegetarian or vegan diet on the body composition of the athlete, in comparison with an omnivorous diet. In particular, we had tried to clarify the effects of well-structured plant-based nutrition in competitive athletes, who, previously, had never followed a diet under specialist supervision. Methods: The groups were followed for 8 months and subjected to a well-planned diet under medical supervision. Anthropometric parameters and body composition evaluation through Bio-electrical Impedance Analysis (BIA) were performed in each participant. Results: All subjects, especially ve-gans, showed an improvement in cellular efficiency, muscle mass, and a redistribution of body water thanks to a better distribution of macronutrients with dietary plans. These changes demonstrate improvement in the athlete's body composition thanks to well-structured plant-based diets that meet the nutrient requirements , without a change in physical training, especially in vegan athletes. Conclusions: The administration of well-structured dietetic schemes for each group has reduced the differences between omnivores, vegetarians, and vegans, underling their more difficult autonomous management and the important role of the nutrition specialist. Given the evidence collected, we demonstrate that plant-based diets are sustainable for athletes and that the role of nutritionist is central to sports and food choices to achieve an optimal body composition.
... Recently, there has been a growing interest among consumers in the use of vegetarian products [25]. The vegetarian concept is widely applied in a population that does not eat meat, seafood or foods made up of these elements [26]. Recent evidence suggests that vegetarian foods are an important source of a wide variety of essential micronutrients, and there is strong evidence that eating vegetarian can be effective in preventing many chronic diseases, such as cardiovascular disorders, diabetes and some cancers [27]. ...
Article
Dining out is one of the biggest expenditures for travelers worldwide and is essential for tourism-dependent destinations. Market segmentation gives industries the potential to classify similar customers and categorize their preferred target markets to ensure marketing expenses' operative management. It has been a practical approach for business improvement in tourism and hospitality. Big data are fundamentally changing the management of the hospitality sector and the relationship between the customer and business by simplifying the decision-making process based on large amounts of data. The data provided in social media have played an important role in customer segmentation. In fact, the data provided by the customers in social media have been a valuable source for decision-makers to precisely discover the customers' satisfaction dimensions on their services. Therefore, there is a need for the development of data-driven approaches for social data analysis for customers segmentation. This research aims to develop a new data-driven approach to reveal customers' satisfaction in restaurants. Specifically, k-means and Artificial Neural Network (ANN) with the aid of the Particle Swarm Optimization (PSO) technique are, respectively, used in data clustering and prediction tasks. In this research, the data of customers on the service quality of restaurants are collected from the TripAdvisor platform. The results of the data analysis are provided. We evaluate the prediction model through a set of evaluation metrics, Mean Squared Error (MSE) and coefficient of determination (R 2), compared with the other prediction approaches. The results showed that k-means-PSO-ANN (MSE = 0.09847; R 2 = 0.98764) has outperformed other methods. The current study demonstrates that the use of online review data for customer segmentation can be an effective way in the restaurant industry in relation to the traditional data analysis approaches.
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Dietas vegetarianas vêm sendo cada vez mais adotadas no mundo. Com isso, há uma preocupação com a adequação nutricional e desempenho esportivo crescente entre profissionais de saúde e treinadores. O objetivo do presente estudo foi analisar a percepção corporal sobre o treinamento físico entre indivíduos onívoros e vegetarianos e, de forma secundária, comparar a percepção entre as diferentes dietas vegetarianas no desempenho esportivo. A amostra teve um total de 189 participantes (47 do sexo masculino e 142 do sexo feminino), sendo 91 onívoros (31 do sexo masculino e 60 do sexo feminino) e 98 vegetarianos (17 do sexo masculino e 81 do sexo feminino). Foi utilizado o questionário de Percepção do Corpo na Performance Esportiva (Pecopes), constituído por duas dimensões: dimensão 1 = percepção do corpo no desempenho esportivo; dimensão 2 = percepção do corpo no treinamento técnico e tático. Os resultados mostraram uma diferença significativa na dimensão 1 favorável aos vegetarianos quando comparados aos onívoros. O subgrupo ovolactovegetariano também obteve resultado significativamente superior aos onívoros na dimensão 1. Assim, foi possível concluir que os participantes vegetarianos do presente estudo apresentaram uma melhor percepção do corpo no desempenho esportivo comparado com os onívoros, porém não foram encontradas diferenças na percepção do corpo quanto ao treinamento técnico e tático.
Article
Veganism is a form of nutrition that is becoming increasingly popular. There is also a pandemic-related increase in mental illness, which often manifests itself in the form of an eating disorder among children and adolescents. Particularly challenging in nutritional therapy is anorexia nervosa in combination with veganism.There is consensus that a correctly implemented vegan diet can generally cover the daily nutritional requirements. However, this does not apply to people who are in a growth period. Therefore, this article attempts to highlight the special requirements of a vegan diet along the dietary process development.The basis is provided by a specific anamnesis as well as the elicitation of nutritional status by means of nutrition protocol and bioelectrical impedance analysis. The treatment and goal setting are influenced by the motives behind a vegan diet and further diagnoses such as orthorexia or food intolerance. Regarding the course of action, it must be clarified how an adequate vegan diet can be guaranteed and which conditions are needed to create a space where different diets can be accepted simultaneously. Withing the daily care, nutritional aspects such as the reduction of anorexia-related digestive complaints as well as the selection, quantity and preparation of vegan foods are foregrounded. This is illustrated by nutritional analyses. The objective is to achieve a high level of compliance and to ensure a sufficient nutrient supply in order to make food, as well as vegan food, enjoyable.
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Cardiovascular diseases (CVD) are the leading cause of death globally, with over 17.9 million attributed deaths in 2019. Unhealthy diet is an often-overlooked major modifiable risk factor for CVD. Global Burden of Disease (GBD) estimates suggest that unhealthy diets account for nearly 26% of all deaths, of which 84% were attributed to CVD. Plant-based diets (PBDs), which are a diverse group of dietary patterns focused on plant produce, with flexibility for varying levels of vegetarianism, have been suggested to decrease the incidence of various cardiovascular and cardiometabolic diseases. In this review, we aim to delve into the spectrum of PBDs, revisit objective definitions and classifications, and compare them with standard non-vegetarian diets. We examine plausible mechanisms underlying the cardiovascular benefits of PBDs with a particular focus on the dietary manipulation of gut microbiota-host interaction and its effect on energy metabolism, and local and systemic inflammation. In addition, we explore the evidence on the impact of PBDs on cardiovascular disease, examine the challenges and limitations associated with dietary intervention studies, and devise strategies to draw valid conclusions. Dietary interventions, such as PBDs are one of the most powerful, attainable, cost-effective tools for health and environmental protection at the population level. We conclude with a clear appreciation for PBDs in environmental sustainability, climate change, and animal welfare.
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The scientific literature and advocacy organisations highlight three harm-related arguments as paramount reasons for the reduction and cessation of the consumption of animal-derived products (ADP) – violence toward animals, damage to the environment, and human health. However, research on their comparative effects is scarce and there is no clear definition of which type of argument is the most effective in restricting ADP consumption. Based on cognitive dissonance theory, this study aimed to investigate the effects of these types of arguments on meat-eaters’ attitudes and beliefs toward the propositions of reducing and ceasing ADP consumption. The study sample comprised 545 Brazilian adults. We adopted an experimental between-subjects design based on the presentation of vignettes. Each participant responded to one of the vignettes (animal rights, environmental, or health arguments) or a control condition. Results showed that greater levels of ADP-related dissonance provoked greater positive attitudes toward the reduction and cessation of ADP consumption. Compared to baseline, the animal rights and environmental messages significantly increased dissonance and positive attitudes toward ADP restriction, but not the health argument. Participants most frequently adopted the dissonance-management strategies of denial of responsibility, denial of harm, and the articulation of beliefs favourable to change. The discussion highlights that the different effects of social influence contexts and argument types depend on their capacity to reveal ADP consumption as morally problematic behaviour. To our knowledge, this is the first study to experimentally compare the effects of animal rights, environmental and health-related arguments in generating ADP-related dissonance and attitude change.
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One of the most significant variables that can hinder the development of the brain is malnutrition. Malnutrition can lead to aberrant growth and behavioral issues. Brain growth, synapse formation, and cell differentiation are all impacted by nutritional deficiencies. A diet deficient in protein during pregnancy is associated with alterations in the neurotransmitters as well as the oxidative state of the brain. As a result, psychosocial problems emerge in childhood that last throughout adulthood. Understanding the deleterious effects of a nutrition deficiency on brain function requires an understanding of the length and commencement of dietary requirements. Many concerns remain unanswered about the long-term implications of prenatal starvation, even after decades of research. Since children’s neurological systems are still developing, they are more vulnerable to the consequences of nutritional inadequacies than adults’ brains. Some of the impacts of caloric deficiency [including in some cases protein-calorie malnutrition (PCM), and a lesser degree of essential fatty acid (EFA) deficit] on some indices of brain damage, behavioral change, and intellect (IQ tests) have been studied in the context of the war years in Europe and the emergence of famine circumstances in other nations. Research on the impact of malnutrition on the developing brain can be broken down into two categories: studies that focus on physical and clinical brain growth and maturation, and studies that focus on the development of “brain function,” which includes neurological, psychomotor, and intellectual development. This chapter explores the effects of a lack of nutrients on the neurodevelopment.KeywordsMalnutritionNeurological developmentBrain chemistryProtein malnutritionCell divisionBrain growth
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Introduction: In recent decades, there has been an increasing interest in vegetarian diets. It is therefore interesting to analyse the benefits and risks of these diets. To this end, a review has been done on the benefits and risks of vegetarian diets. Vegetarian diets have been associated with different health benefits. On the contrary, nutritional deficiencies has been observed in those people who follow this type of diet, mainly in those risk groups such as pregnant and lactating women, children, adolescents, and elderly. Vegetarian diets may have some health benefits, however further studies are required.
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Vegetarians are reported to have lower body weight, blood pressure (BP) and cardiovascular disease (CVD) risk compared to omnivores, yet the mechanisms remain unclear. A vegetarian diet may protect the vascular endothelium, reducing the risk of atherosclerosis and CVD. This cross-sectional study compared vascular function between omnivores (OMN) and vegetarians (VEG). We hypothesized that VEG would have greater vascular function compared to OMN. Fifty-eight normotensive young healthy adults participated (40W/18M; 28 OMN (15W/13M) and 30 VEG (25W/5M); 26±7 yr; BP: 112±11 / 67±8 mm Hg). Arterial stiffness, assessed by carotid-to-femoral pulse wave velocity (OMN: 5.6±0.8 m/s, VEG: 5.3±0.8 m/s; P=0.17) and wave reflection assessed by aortic augmentation index (OMN: 6.9±12.3%, VEG: 8.8±13.5%; P=0.57) were not different between groups. However, central pulse pressure (OMN: 32±5; VEG: 29±5 mmHg; P=0.048) and forward wave reflection were greater in omnivores (O: 26±3; V: 24±3 mmHg P=0.048). Endothelial-dependent dilation measured by brachial artery flow-mediated dilation was not different between groups (OMN: 6.0±2.9 %, VEG: 6.9±3.3 %; P=0.29). Percent change in femoral blood flow from baseline during passive leg movement, another assessment of nitric oxide-mediated endothelial dilation, was similar between groups (OMN: 203±88 mL/min, VEG: 253±192 mL/min; P=0.50). These data suggest that healthy young adults, normotensive vegetarians do not have significantly improved vascular function compared to omnivores however, they have a lower central pulse pressure and forward wave amplitude which may lower the risk of future CVD.
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A heart-healthy lifestyle, beginning at an early age and sustained throughout life, may reduce risk for cardiovascular disease in youth. Among youth with moderate to severe dyslipidemia and/or those with familial hypercholesterolemia, lipid-lowering medications are often needed for primary prevention of cardiovascular disease. However, lifestyle interventions are a foundation for youth with dyslipidemia, as well as those without dyslipidemia. There are limited data supporting the use of dietary supplements in youth with dyslipidemia at this time. A family-centered approach and the support of a multi-disciplinary healthcare team, which includes a registered dietitian nutritionist to provide nutrition counseling, provides the best opportunity for primary prevention and improved outcomes. While there are numerous guidelines that address the general nutritional needs of youth, few address the unique needs of those with dyslipidemia. The goal of this National Lipid Association Clinical Perspective is to provide guidance for healthcare professionals caring for youth with disorders of lipid and lipoprotein metabolism, including nutritional guidance that complements the use of lipid lowering medications.
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Vegan diets are widely promoted as protective against cardiovascular disease (CVD); however, removing all animal foods from a human's diet usually causes unfavorable health consequences. Our hominin ancestors began consuming meat, fish, seafood, and eggs >2 million years ago. Consequently, humans are genetically adapted to procure nutrients from both plant and animal sources. In contrast, veganism is without evolutionary precedent in Homo sapiens species. Strict adherence to a vegan diet causes predictable deficiencies in nutrients including vitamins B12, B2, D, niacin, iron, iodine, zinc, high-quality proteins, omega-3, and calcium. Prolonged strict veganism increases risk for bone fractures, sarcopenia, anemia, and depression. A more logical diet is a plant-forward omnivorous eating pattern that emphasizes generous consumption of natural, unprocessed foods predominantly from plants. To balance this diet, modest amounts of wholesome animal foods, such wild-caught fish/seafood, pasture-raised meat and eggs, and fermented unsweetened dairy should be consumed regularly.
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Are plant-based meat alternative products healthier than the animal meats they mimic? There is no simple answer to this question because these products have both nutritional strengths and shortcomings. On the plus side, most are a good source of dietary fiber and contain less saturated fat and cholesterol in comparison to the animal meats they mimic. In addition, most contain iron in amounts comparable to the animal products they are designed to replace. As for shortcomings, plant-based meat alternative products generally contain less protein, zinc, and vitamin B12 than animal meats. Most also contain sodium in high amounts. Products can vary greatly in their nutrient content, which means consumers should read nutrition facts labels to choose a product that best aligns with their health and nutrition goals.
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Food is required by all living things without which life processes will be on halt. Food security defined by the United Nations’ Committee on World Food Security is a condition in which people have access to adequate, safe, and nutritious food at all times that meet their dietary needs for a healthy life. The importance of biodiversity in the conservation of African foods for the sustenance of healthy and nutritious diets cannot be overemphasized. It is crucial for improving food security, conservation, livelihood, human well-being, and ecosystem services in Africa, and can be said to be a basis the Sustainable Development Goals (SDGs) 1 and 2. However, there has been a steady decline in species biodiversity for food and agriculture at the level of genetic composition, species, and ecosystem levels resulting in deteriorating diet quality and subsequently increase in the risk of malnutrition. The natural resources which may serve as for food include diverse vegetation, various species of sea life, including fishes, crabs, prawns, and shrimps, as well as animals. All of these have been depended on by mankind since time immemorial. Some African countries have been using some biodiversity friendly approaches, yet their usage needs to be amplified to increase the potentials of food security and biodiversity across Africa. These approaches can increase the plant and animal sources by increasing their ability and ensures sustained production for the long-term survival of mankind. However, the biodiversity that underpins much of modern agriculture is fast disappearing as our reliance on plants and animal species has led to increased biodiversity loss which puts food security livelihoods and health at risk. In this chapter, some biodiversity friendly approach as it enhances food security in Africa is expounded. Biodiversity conservation strategies practised in Africa, plant and animal sources of biodiversity, and the application of biodiversity friendly approaches to food production are also discussed. Likewise, the peculiarity of Africa potentials towards the biodiversity of food and animals is well captured in this chapter.KeywordsAgricultureConservation strategiesFood securitySustainable Development GoalsWest Africa
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This form of nutrition is a special way of life of people with which they want to avoid cruelties to animals for the procurement of food and clothing. Vegans also do without animal products such as eggs and milk in comparison to vegetarians. The term “vegan” was coined in England in 1944 by Donald Watson.
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The 2020 Dietary Guidelines for Americans (DGA) recommends a Healthy Vegetarian Dietary Pattern (HVDP) but does not provide guidance for dairy‐free vegetarian (ovo‐vegetarian) or vegan diets. A recent study from our lab modeled ovo‐vegetarian and vegan HVDPs for healthy adults and found minimal impacts on nutrient content. However, since these models provide only recommendations for food group amounts, the objective of this study was to determine the feasibility of implementing the 2000 kcal ovo‐vegetarian and vegan models by developing sample menus and evaluating them for nutrient adequacy and diet quality. We implemented a search strategy for ovo‐vegetarian and vegan recipes on the MyPlate.gov website, using the most frequently consumed foods from each food group as a guide. We then developed 5‐day sample menus for each model and analyzed these menus for diet quality using the Healthy Eating Index Score‐2015 (HEI‐2015) and nutrient content. The HEI‐2015 scores were 99.4 and 98.4 for the vegan and ovo‐vegetarian menus, respectively. These sample menus did not achieve a perfect score of 100 due to sodium and refined grains (both menus), added sugars (ovo‐vegetarian menu only), and fatty acid profiles (vegan menu only). Mean total energy was 1860 kcal (vegan) and 1880 kcal (ovo‐vegetarian). Amounts of all macronutrients were within the Acceptable Macronutrient Distribution Ranges, but amounts of some micronutrients were below 90% of recommended levels. Healthy adults may be able to follow ovo‐vegetarian and vegan diets with careful planning, but this study reveals challenges in meeting micronutrient needs with these eating patterns. This study assessed the quality and nutrient adequacy of sample vegan and dairy‐free vegetarian menus developed based on adaptations of the 2000 kcal vegetarian dietary pattern from the 2020 Dietary Guidelines for Americans. We found that our sample vegan and dairy‐free vegetarian menus, created with publicly available resources, contained enough servings of fruits, vegetables, grains, protein foods, dairy, and oils, but did not provide enough vitamin D, vitamin E, choline, zinc (for males), and iron (for females). Following vegan and ovo‐vegetarian diets requires careful planning to ensure sources of these micronutrients are included in adequate amounts.
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Het aantal personen dat kiest voor een op planten gebaseerde voeding neemt toe omwille van onder meer bezorgdheid over het milieu en het klimaat. Wat volgt is gebaseerd op twee recente consensusrichtlijnen over vegetarische voeding van de Vlaamse Vereniging voor Kindergeneeskunde en de Hoge Gezondheidsraad. Een vegetarisch voedingspatroon hangt samen met lagere cardiovasculaire morbiditeit en mortaliteit, en een lagere prevalentie van obesitas. De groei van vegetarisch gevoede kinderen is gelijkaardig aan die van omnivore leeftijdgenoten, op voorwaarde dat de energieaanbreng voldoende is. Bij adolescenten hangt vegetarisme soms samen met eetstoornissen, maar er is géén evidentie voor een causaal verband. Een evenwichtig gevarieerd lacto-ovo-vegetarisch voedingspatroon kan voldoen aan alle behoeften, ook van een groeiend kind. Een veganistische voeding, die alle voedingsmiddelen van dierlijke oorsprong uitsluit, moet in elk geval aangevuld worden met een vitamine B12-supplement of vitamine B12-gesupplementeerde voedingswaren. Ook belangrijk is aandacht voor de inname van calcium en van voedingsmiddelen die voldoende energie en eiwit van goede kwaliteit bevatten. Hoe restrictiever het voedingspatroon, en hoe jonger het kind, des te groter het risico op deficiënties, tenzij gebruikgemaakt wordt van supplementen of gesupplementeerde producten.
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Objective To assess the prevalent consumption trend between 2001 and 2017 and the healthy lifestyles associated with consuming a plant-based diet in the Spanish population. Methodology A representative Spanish sample was analysed (>15 years old) from the Spanish National Health Survey for years 2001 (n = 8568), 2006 (n = 25,649), 2011 (n = 19,027) and 2017 (n = 21,986). The population was classified as omnivore, vegetarian, or vegan. The lifestyle variables were physical activity, tobacco and alcohol consumption, and body mass index (BMI). The χ² test was used to evaluate diet change between 2001 and 2017. T-Student and χ² were used to compare lifestyles of omnivores and vegetarians/vegans. Logistic regression was used to analyse lifestyles associated with plant-based diets. Results 0.2% of the Spanish population followed a plant-based diet. Between plant-based diet consumers there was an increase in vegans vs. vegetarians between 2001 (9.5% vs. 90.5%) and 2017 (65.3% vs. 34.7%) (p = 0.007). Compared to 2001, following a plant-based diet was more likely in 2006 (OR = 2.08, p = 0.004), 2011 (OR = 1.89, p = 0.02) and 2017 (OR = 1.75, p = 0.04). Those who consume alcohol (OR = 0.65, p = 0.008), who were overweight (OR = 0.48, p < 0.001) or who were obese (OR = 0.40, p = 0.001) were less likely to consume a plant-based diet. Conclusions Despite an increase in the consumption of plant-based diets between 2001 and 2017, there was a low prevalence of consumption in all years studied. There was a greater probability of consuming plant-based diets among the Spanish population with healthy behaviours. These findings could help design strategies focused on healthy nutritional behaviours.
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Overproduction of oxidants (reactive oxygen species and reactive nitrogen species) in the human body is responsible for the pathogenesis of some diseases. The scavenging of these oxidants is thought to be an effective measure to depress the level of oxidative stress of organisms. It has been reported that intake of vegetables and fruits is inversely associated with the risk of many chronic diseases, and antioxidant phytochemicals in vegetables and fruits are considered to be responsible for these health benefits. Antioxidant phytochemicals can be found in many foods and medicinal plants, and play an important role in the prevention and treatment of chronic diseases caused by oxidative stress. They often possess strong antioxidant and free radical scavenging abilities, as well as anti-inflammatory action, which are also the basis of other bioactivities and health benefits, such as anticancer, anti-aging, and protective action for cardiovascular diseases, diabetes mellitus, obesity and neurodegenerative diseases. This review summarizes recent progress on the health benefits of antioxidant phytochemicals, and discusses their potential mechanisms in the prevention and treatment of chronic diseases.
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Background: According to the American Cancer Society, prostate cancer accounts for ∼27% of all incident cancer cases among men and is the second most common (noncutaneous) cancer among men. The relation between diet and prostate cancer is still unclear. Because people do not consume individual foods but rather foods in combination, the assessment of dietary patterns may offer valuable information when determining associations between diet and prostate cancer risk. Objective: This study aimed to examine the association between dietary patterns (nonvegetarian, lacto-ovo-vegetarian, pesco-vegetarian, vegan, and semi-vegetarian) and prostate cancer incidence among 26,346 male participants of the Adventist Health Study-2. Design: In this prospective cohort study, cancer cases were identified by matching to cancer registries. Cox proportional hazards regression analysis was performed to estimate HRs by using age as the time variable. Results: In total, 1079 incident prostate cancer cases were identified. Around 8% of the study population reported adherence to the vegan diet. Vegan diets showed a statistically significant protective association with prostate cancer risk (HR: 0.65; 95% CI: 0.49, 0.85). After stratifying by race, the statistically significant association with a vegan diet remained only for the whites (HR: 0.63; 95% CI: 0.46, 0.86), but the multivariate HR for black vegans showed a similar but nonsignificant point estimate (HR: 0.69; 95% CI: 0.41, 1.18). Conclusion: Vegan diets may confer a lower risk of prostate cancer. This lower estimated risk is seen in both white and black vegan subjects, although in the latter, the CI is wider and includes the null.
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Background Vegetarian diets exclude all animal flesh and are being widely adopted by an increasing number of people; however, effects on blood lipid concentrations remain unclear. This meta‐analysis aimed to quantitatively assess the overall effects of vegetarian diets on blood lipids. Methods and Results We searched PubMed, Scopus, Embase, ISI Web of Knowledge, and the Cochrane Library through March 2015. Studies were included if they described the effectiveness of vegetarian diets on blood lipids (total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, and triglyceride). Weighted mean effect sizes were calculated for net changes by using a random‐effects model. We performed subgroup and univariate meta‐regression analyses to explore sources of heterogeneity. Eleven trials were included in the meta‐analysis. Vegetarian diets significantly lowered blood concentrations of total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, and non–high‐density lipoprotein cholesterol, and the pooled estimated changes were −0.36 mmol/L (95% CI −0.55 to −0.17; P<0.001), −0.34 mmol/L (95% CI −0.57 to −0.11; P<0.001), −0.10 mmol/L (95% CI −0.14 to −0.06; P<0.001), and −0.30 mmol/L (95% CI −0.50 to −0.10; P=0.04), respectively. Vegetarian diets did not significantly affect blood triglyceride concentrations, with a pooled estimated mean difference of 0.04 mmol/L (95% CI −0.05 to 0.13; P=0.40). Conclusions This systematic review and meta‐analysis provides evidence that vegetarian diets effectively lower blood concentrations of total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, and non–high‐density lipoprotein cholesterol. Such diets could be a useful nonpharmaceutical means of managing dyslipidemia, especially hypercholesterolemia.
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Environmental and lifestyle factors are known to play an important role during gestation, determining newborns' health status and influencing their risk of being subject to certain noncommunicable diseases later in life. In particular, maternal nutritional patterns characterized by a low intake of plant-derived foods could increase the risk of gestation-related issues, such as preeclampsia and pregravid obesity, increase genotoxicant susceptibility, and contribute to the onset of pediatric diseases. In particular, the risk of pediatric wheeze, diabetes, neural tube defects, orofacial clefts, and some pediatric tumors seems to be reduced by maternal intake of adequate amounts of vegetables, fruits, and selected antioxidants. Nevertheless, plant-based diets, like any other diet, if improperly balanced, could be deficient in some specific nutrients that are particularly relevant during gestation, such as n-3 (ω-3) fatty acids, vitamin B-12, iron, zinc, and iodine, possibly affecting the offspring's health state. Here we review the scientific literature in this field, focusing specifically on observational studies in humans, and highlight protective effects elicited by maternal diets enriched in plant-derived foods and possible issues related to maternal plant-based diets.
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Although the association between red meat consumption and colorectal cancer (CRC) is well established, the association across subsites of the colon and rectum remains uncertain, as does time of consumption in relation to cancer development. As these relationships are key for understanding the pathogenesis of CRC, they were examined in two large cohorts with repeated dietary measures over time, the Nurses' Health Study (n = 87,108 women, 1980-2010) and Health Professionals Follow-up Study (n = 47,389 men, 1986-2010). Cox proportional hazards regression models generated hazard ratios (HRs) and 95% confidence intervals (CIs), which were pooled by random-effects meta-analysis. In combined cohorts, there were 2,731 CRC cases (1,151 proximal colon, 816 distal colon, and 589 rectum). In pooled analyses, processed red meat was positively associated with CRC risk (per 1 serving/day increase: HR = 1.15, 95% CI: 1.01-1.32; P for trend 0.03) and particularly with distal colon cancer (per 1 serving/day increase; HR = 1.36; 95% CI: 1.09-1.69; P for trend 0.006). Recent consumption of processed meat (within the past 4 years) was not associated with distal cancer. Unprocessed red meat was inversely associated with risk of distal colon cancer and a weak non-significant positive association between unprocessed red meat and proximal cancer was observed (per 1 serving/day increase: distal HR = 0.75; 95% CI: 0.68-0.82; P for trend
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Vegetarian diets may promote weight loss, but evidence remains inconclusive. PubMed, EMBASE and UpToDate databases were searched through September 22, 2014, and investigators extracted data regarding study characteristics and assessed study quality among selected randomized clinical trials. Population size, demographic (i.e., gender and age) and anthropometric (i.e., body mass index) characteristics, types of interventions, follow-up periods, and trial quality (Jadad score) were recorded. The net changes in body weight of subjects were analyzed and pooled after assessing heterogeneity with a random effects model. Subgroup analysis was performed based on type of vegetarian diet, type of energy restriction, study population, and follow-up period. Twelve randomized controlled trials were included, involving a total of 1151 subjects who received the intervention over a median duration of 18 weeks. Overall, individuals assigned to the vegetarian diet groups lost significantly more weight than those assigned to the non-vegetarian diet groups (weighted mean difference, -2.02 kg; 95 % confidence interval [CI]: -2.80 to -1.23). Subgroup analysis detected significant weight reduction in subjects consuming a vegan diet (-2.52 kg; 95 % CI: -3.02 to -1.98) and, to a lesser extent, in those given lacto-ovo-vegetarian diets (-1.48 kg; 95 % CI: -3.43 to 0.47). Studies on subjects consuming vegetarian diets with energy restriction (ER) revealed a significantly greater weight reduction (-2.21 kg; 95 % CI: -3.31 to -1.12) than those without ER (-1.66 kg; 95 % CI: -2.85 to -0.48). The weight loss for subjects with follow-up of <1 year was greater (-2.05 kg; 95 % CI: -2.85 to -1.25) than those with follow-up of ≥1 year (-1.13 kg; 95 % CI: -2.04 to -0.21). Vegetarian diets appeared to have significant benefits on weight reduction compared to non-vegetarian diets. Further long-term trials are needed to investigate the effects of vegetarian diets on body weight control.
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One of the major breakthroughs in the history of medicine is undoubtedly the discovery of antibiotics. Their use in animal husbandry and veterinary medicine has resulted in healthier and more productive farm animals, ensuring the welfare and health of both animals and humans. Unfortunately, from the first use of penicillin, the resistance countdown started to tick. Nowadays, the infections caused by antibiotic-resistant bacteria are increasing, and resistance to antibiotics is probably the major public health problem. Antibiotic use in farm animals has been criticized for contributing to the emergence of resistance. The use and misuse of antibiotics in farm animal settings as growth promoters or as nonspecific means of infection prevention and treatment has boosted antibiotic consumption and resistance among bacteria in the animal habitat. This reservoir of resistance can be transmitted directly or indirectly to humans through food consumption and direct or indirect contact. Resistant bacteria can cause serious health effects directly or via the transmission of the antibiotic resistance traits to pathogens, causing illnesses that are difficult to treat and that therefore have higher morbidity and mortality rates. In addition, the selection and proliferation of antibiotic-resistant strains can be disseminated to the environment via animal waste, enhancing the resistance reservoir that exists in the environmental microbiome. In this review, an effort is made to highlight the various factors that contribute to the emergence of antibiotic resistance in farm animals and to provide some insights into possible solutions to this major health issue.
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Methylcobalamin (MeCbl) and adenosylcobalamin (AdoCbl) are coenzymes for methionine synthase and methylmalonylCoA-mutase, respectively. Hydroxylcobalamin (HOCbl) and cyanocobalamin (CNCbl) are frequently used for supplementation. MeCbl and AdoCbl have recently emerged as alternative forms in supplements. In the light of metabolic transformation of Cbl into its co-factor forms, this review discusses current evidence on efficacy and utility of different Cbl forms in preventing or treating Cbl deficiency. Cbl-transporting proteins bind and mediate the uptake of all aforementioned forms of Cbl. After internalization and lysosomal release, Cbl binds to the cytosolic chaperon MMACHC that is responsible for (i) flavin-dependent decyanation of [CN-Co(3+) ]Cbl to [Co(2+) ]Cbl; (ii) glutathione-dependent dealkylation of MeCbl and AdoCbl to [Co(2+/1+) ]Cbl; and (iii) glutathione-dependent decyanation of CNCbl or reduction of HOCbl under anaerobic conditions. MMACHC shows a broad specificity for Cbl forms and supplies the Cbl(2+) intermediate for synthesis of MeCbl and AdoCbl. Cobalamin chemistry, physiology and biochemistry suggest that MeCbl and AdoCbl follow the same route of intracellular processing as CNCbl does. We conclude that supplementing MeCbl or AdoCbl is unlikely to be advantageous compared to CNCbl. On the other hand, there are obvious advantages of high parenteral doses (1-2 mg) of HOCbl in treating inborn errors of Cbl metabolism. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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For agriculture, there are three major options for mitigating greenhouse gas (GHG) emissions: 1) productivity improvements, particularly in the livestock sector; 2) dedicated technical mitigation measures; and 3) human dietary changes. The aim of the paper is to estimate long-term agricultural GHG emissions, under different mitigation scenarios, and to relate them to the emissions space compatible with the 2 °C temperature target. Our estimates include emissions up to 2070 from agricultural soils, manure management, enteric fermentation and paddy rice fields, and are based on IPCC Tier 2 methodology. We find that baseline agricultural CO2-equivalent emissions (using Global Warming Potentials with a 100 year time horizon) will be approximately 13 Gton CO2eq/year in 2070, compared to 7.1 Gton CO2eq/year 2000. However, if faster growth in livestock productivity is combined with dedicated technical mitigation measures, emissions may be kept to 7.7 Gton CO2eq/year in 2070. If structural changes in human diets are included, emissions may be reduced further, to 3–5 Gton CO2eq/year in 2070. The total annual emissions for meeting the 2 °C target with a chance above 50 % is in the order of 13 Gton CO2eq/year or less in 2070, for all sectors combined. We conclude that reduced ruminant meat and dairy consumption will be indispensable for reaching the 2 °C target with a high probability, unless unprecedented advances in technology take place.
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OBJECTIVE: To compare the use of water, energy, pesticides and fertilizer to produce commodities for two dietary patterns that vary in the content of plant and animal products. DESIGN: A unique analysis using 'real-world' data was performed, in contrast to previous analyses which applied simulated data. Consumption data from the Adventist Health Study were used to identify two dietary patterns with a markedly different consumption of several plant and animal products. State agricultural data were collected and applied to commodity production statistics. Indices were created to allow a comparison of the resource requirements for each dietary pattern. SETTING: California, USA. SUBJECTS: None. RESULTS: The diet containing more animal products required an additional 10 252 litres of water, 9910 kJ of energy, 186 g of fertilizer and 6 g of pesticides per week in comparison to the diet containing less animal products. The greatest contribution to the difference came from the consumption of animal products, particularly beef. CONCLUSIONS: Consuming a more plant-based diet could to an extent alleviate the negative environmental impacts related to food production. As a method to feed ourselves more sustainably, behavioural adjustments appear to be a very important tool.
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Objective To clarify and quantify the potential dose–response association between the intake of fruit and vegetables and risk of type 2 diabetes. Design Meta-analysis and systematic review of prospective cohort studies. Data source Studies published before February 2014 identified through electronic searches using PubMed and Embase. Eligibility criteria for selecting studies Prospective cohort studies with relative risks and 95% CIs for type 2 diabetes according to the intake of fruit, vegetables, or fruit and vegetables. Results A total of 10 articles including 13 comparisons with 24 013 cases of type 2 diabetes and 434 342 participants were included in the meta-analysis. Evidence of curve linear associations was seen between fruit and green leafy vegetables consumption and risk of type 2 diabetes (p=0.059 and p=0.036 for non-linearity, respectively). The summary relative risk of type 2 diabetes for an increase of 1 serving fruit consumed/day was 0.93 (95% CI 0.88 to 0.99) without heterogeneity among studies (p=0.477, I2=0%). For vegetables, the combined relative risk of type 2 diabetes for an increase of 1 serving consumed/day was 0.90 (95% CI 0.80 to 1.01) with moderate heterogeneity among studies (p=0.002, I2=66.5%). For green leafy vegetables, the summary relative risk of type 2 diabetes for an increase of 0.2 serving consumed/day was 0.87 (95% CI 0.81 to 0.93) without heterogeneity among studies (p=0.496, I2=0%). The combined estimates showed no significant benefits of increasing the consumption of fruit and vegetables combined. Conclusions Higher fruit or green leafy vegetables intake is associated with a significantly reduced risk of type 2 diabetes.
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While intakes of the omega-3 fatty acid 𝛼-linolenic acid (ALA) are similar in vegetarians and non-vegetarians, intakes of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are low in vegetarians and virtually absent in vegans. Plasma, blood and tissue levels of EPA and DHA are lower in vegetarians than in non-vegetarians, although the clinical significance of this is unknown. Vegetarians do not exhibit clinical signs of DHA deficiency, but further research is required to ascertain whether levels observed in vegetarians are sufficient to support optimal health. ALA is endogenously converted to EPA and DHA, but the process is slow and inefficient and is affected by genetics, sex, age and dietary composition. Vegetarians can take practical steps to optimise conversion of ALA to EPA and DHA, including reducing intake of linoleic acid. There are no official separate recommendations for intake of fatty acids by vegetarians. However, we suggest that vegetarians double the current adequate intake of ALA if no direct sources of EPA and DHA are consumed. Vegetarians with increased needs or reduced conversion ability may receive some advantage from DHA and EPA supplements derived from microalgae. A supplement of 200-300 mg/day of DHA and EPA is suggested for those with increased needs, such as pregnant and lactating women, and those with reduced conversion ability, such as older people or those who have chronic disease (eg, diabetes).
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In the past couple of decades, evidence from prospective observational studies and clinical trials has converged to support the importance of individual nutrients, foods, and dietary patterns in the prevention and management of type 2 diabetes. The quality of dietary fats and carbohydrates consumed is more crucial than is the quantity of these macronutrients. Diets rich in wholegrains, fruits, vegetables, legumes, and nuts; moderate in alcohol consumption; and lower in refined grains, red or processed meats, and sugar-sweetened beverages have been shown to reduce the risk of diabetes and improve glycaemic control and blood lipids in patients with diabetes. With an emphasis on overall diet quality, several dietary patterns such as Mediterranean, low glycaemic index, moderately low carbohydrate, and vegetarian diets can be tailored to personal and cultural food preferences and appropriate calorie needs for weight control and diabetes prevention and management. Although much progress has been made in development and implementation of evidence-based nutrition recommendations in developed countries, concerted worldwide efforts and policies are warranted to alleviate regional disparities.
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Background: Greenhouse gas emissions (GHGEs) are a major consequence of our dietary choices. Assessments of plant-based compared with meat-based diets are emerging at the intersection of public health, environment, and nutrition. Objectives: The objective was to compare the GHGEs associated with dietary patterns consumed in a large population across North America and to independently assess mortality according to dietary patterns in the same population. Design: Data from the Adventist Health Study 2 (AHS-2) were used to characterize the differential environmental and health impacts of the following 3 dietary patterns, which varied in the quantity of animal and plant foods: vegetarian, semivegetarian, and nonvegetarian. The GHGE intensities of 210 foods were calculated through life-cycle assessments and by using published data. The all-cause mortality rates and all-cause mortality HRs for the AHS-2 subjects were adjusted for a range of lifestyle and sociodemographic factors and estimated according to dietary pattern. Results: With the use of the nonvegetarian diet as a reference, the mean reductions in GHGEs for semivegetarian and vegetarian diets were 22% and 29%, respectively. The mortality rates for nonvegetarians, semivegetarians, and vegetarians were 6.66, 5.53, and 5.56 deaths per 1000 person-years, respectively. The differences were significant. Compared with nonvegetarians, mortality HRs were lower for semivegetarians (0.86) and vegetarians (0.91). Conclusions: Moderate differences in the caloric intake of meat products provided nontrivial reductions in GHGEs and improved health outcomes, as shown through the mortality analyses. However, this does not mean that diets lower in GHGEs are healthy.
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Background & Aims Several studies have demonstrated that vegetarians and vegans have much lower plasma concentrations of omega-3 fatty acids (i.e., docosahexaenoic and eicosapentaenoic acids) when compared to those who eat fish. The purposes of this study were 1) to define the age and/or sex-specific docosahexaenoic plus eicosapentaenoic acids levels in red blood cell membranes (expressed as a percent of total fatty acids; hereafter the omega-3 index) in long-term vegans, and 2) to determine the effects of a vegetarian omega-3 supplement (254 mg docosahexaenoic plus eicosapentaenoic acids /day for 4 months) on the omega-3 index. Methods A sample (n=165) of vegans was recruited, and their omega-3 index was determined using a dried blood spot. A subset of 46 subjects with a baseline omega-3 index of <4% was given a vegetarian omega-3 supplement for 4 months and then retested. Results The mean±SD omega-3 index was 3.7±1.0% which was similar to that of a cohort of omnivores (deployed US soldiers) from a recently-reported study. Among the vegan cohort, the index was significantly higher in females than males (3.9±1.0% vs. 3.5± 1.0%; p=0.026) and was directly related to age (p for trend = 0.009). The omega-3 index increased from 3.1±0.6% to 4.8±0.8% (p=0.009) in the supplementation study. Conclusions We conclude that vegans have low baseline omega-3 levels, but not lower than omnivores who also consume very little docosahexaenoic and eicosapentaenoic acids. The vegans responded robustly to a relatively low dose of a vegetarian omega-3 supplement.
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Greenhouse gas emissions from ruminant meat production are significant. Reductions in global ruminant numbers could make a substantial contribution to climate change mitigation goals and yield important social and environmental co-benefits. A lthough a main focus of climate policy has been to reduce fossil fuel consumption, large cuts in CO 2 emissions alone will not abate climate change. At present non-CO 2 greenhouse gases contribute about a third of total anthropogenic CO 2 equivalent (CO 2 e) emissions and 35–45% of climate forcing (the change in radiant energy retained by Earth owing to emissions of long-lived greenhouse gases) resulting from those emissions 1 (Fig.1a). Only with large simultaneous reductions in CO 2 and non-CO 2 emissions will direct radiative forcing be reduced during this century (Fig.1b). Methane (CH 4) is the most abundant non-CO 2 greenhouse gas and because it has a much shorter atmospheric lifetime (~9years) than CO 2 it holds the potential for more rapid reductions in radiative forcing than would be possible by controlling emissions of CO 2 alone. There are several important anthropogenic sources of CH 4 : ruminants, the fossil fuel industry, landfills, biomass burning and rice production (Fig.1c). We focus on ruminants for four reasons. First, ruminant production is the largest source of anthropogenic CH 4 emissions (Fig.1c) and globally occupies more area than any other land use. Second, the relative neglect of this greenhouse gas source suggests that awareness of its importance is inappropriately low. Third, reductions in ruminant numbers and ruminant meat production would simultaneously benefit global food security, human health and environmental conservation. Finally, with political will, decreases in worldwide ruminant populations could potentially be accomplished quickly and relatively inexpensively. Ruminant animals consist of both native and domesticated herbivores that consume plants and digest them through the process of enteric fermentation in a multichambered stomach. Methane is produced as a by-product of microbial digestive processes in the rumen. Non-ruminants or 'monogastric' animals such as pigs and poultry have a single-chambered stomach to digest food, and their methane emissions are negligible in comparison. There are no available estimates of the number of wild ruminants, but it is likely that domestic ruminants greatly outnumber the wild population, with a reported 3.6billion domestic ruminants on Earth in 2011 (1.4 billon cattle, 1.1 billion sheep, 0.9 billion goats and 0.2 billon buffalo) 2 . On average, 25million domestic ruminants have been added to the planet each year (2million per month) 2 over the past 50years (Fig.1d). Worldwide, the livestock sector is responsible for approximately 14.5% of all anthropogenic greenhouse gas emissions 3 (7.1of 49GtCO 2 eyr –1). Approximately 44% (3.1GtCO 2 eyr –1) of the livestock sector's emissions are in the form of CH 4 from enteric fermentation, manure and rice feed, with the remaining portions almost equally shared between CO 2 (27%, 2GtCO 2 eyr –1) from land-use change and fossil fuel use, and nitrous oxide (N 2 O) (29%, 2GtCO 2 eyr –1) from fertilizer applied to feed-crop fields and manure 3 . Ruminants contribute significantly more (5.7GtCO 2 eyr –1) to greenhouse gas emissions than monogastric livestock (1.4GtCO 2 eyr –1), and emissions due to cattle (4.6GtCO 2 eyr –1) are substantially higher than those from buffalo (0.6GtCO 2 eyr –1) or sheep and goats (0.5GtCO 2 eyr –1) 3 . Globally, ruminants contribute 11.6% and cattle 9.4% of all greenhouse gas emissions from anthropogenic sources. The total area dedicated to grazing encompasses 26% of the terrestrial surface of the planet 4 . Livestock production accounts for 70% of global agricultural land and the area dedicated to feed-crop production represents 33% of total arable land 4 . The feeding of crops to livestock is in direct competition with producing crops for human consumption (food security) and climate mitigation (bioenergy production or carbon sequestration) 5 . Deforestation has been responsible for a significant proportion of global greenhouse gas emissions from the livestock sector and takes place mostly in tropical areas, where expansion of pasture and arable land for animal feed crops occurs primarily at the expense of native forests 4,6 . Lower demand for ruminant meat would therefore reduce a significant driver of tropical deforestation and associated burning and black carbon emissions. The accompanying reduction in grazing intensity could also allow regrowth of forests and other natural vegetation, resulting in additional carbon sequestration in both biomass and soils with beneficial climate feedbacks 5,6 . Lower global ruminant numbers would have simultaneous benefits for other systems and processes. For example, in some grassland and savannah ecosystems, domestic ruminant grazing contributes to land degradation through desertification and reduced soil organic carbon 5 . Ruminant agriculture can also have negative impacts on water quality and availability, hydrology and riparian ecosystems 4,7 . Ruminant production can erode biodiversity through a wide range of processes such as forest loss and degradation, land-use intensification, exotic plant invasions, soil erosion, persecution of large predators and competition with wildlife for resources 4–7 . Ruminant production also has implications for food security and human
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BACKGROUND The objective of this study was to describe serum lipid concentrations, including apolipoproteins A-I and B, in different diet groups. METHODS A cross-sectional analysis of a sample of 424 meat-eaters, 425 fish-eaters, 423 vegetarians, and 422 vegans, matched on sex and age, from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford cohort. Serum concentrations of total, and HDL cholesterol, as well as apolipoproteins A-I and B were measured, and serum non-HDL cholesterol was calculated. RESULTS Vegans had the lowest BMI, and the highest and lowest intakes of polyunsaturated and saturated fat, respectively. After adjustment for age, alcohol and physical activity, compared to meat-eaters, fish-eaters and vegetarians, serum concentrations of total and non-HDL cholesterol, and apolipoprotein B were significantly lower in vegans. Serum apolipoprotein A-I concentrations did not differ between the diet groups. In males, the mean serum total cholesterol concentration was 0.87 nmol/L lower in vegans than in meat-eaters; after further adjustment for BMI this difference was 0.76 nmol/L. In females, the difference in total cholesterol between these two groups was 0.60 nmol/L, and after further adjustment for BMI was 0.55 nmol/L. CONCLUSIONS In this study, which included a large number of vegans, serum total cholesterol and apolipoprotein B concentrations were lower in vegans compared to meat-eaters, fish-eaters and vegetarians. A small proportion of the observed differences in serum lipid concentrations was explained by differences in BMI, but a large proportion is most likely due to diet.
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In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors. A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007. Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members. Respondents (n 33 208) to a baseline and a follow-up questionnaire. In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64 % (hazard ratio = 0·36, 95 % CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40 % reduced risk of hip fracture (hazard ratio = 0·60, 95 % CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49 % reduced risk of hip fracture (hazard ratio = 0·51, 95 % CI 0·27, 0·98) compared with an intake of less than once weekly. Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.
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The challenges of mitigating nitrous oxide (N2O) emissions are substantially different from those for carbon dioxide (CO2) and methane (CH4), because nitrogen (N) is essential for food production, and over 80% of anthropogenic N2O emissions are from the agricultural sector. Here I use a model of emission factors of N2O to demonstrate the magnitude of improvements in agriculture and industrial sectors and changes in dietary habits that would be necessary to match the four representative concentration pathways (RCPs) now being considered in the fifth assessment report (AR5) of the Intergovernmental Panel on Climate Change (IPCC). Stabilizing atmospheric N2O by 2050, consistent with the most aggressive of the RCP mitigation scenarios, would require about 50% reductions in emission factors in all sectors and about a 50% reduction in mean per capita meat consumption in the developed world. Technologies exist to achieve such improved efficiencies, but overcoming social, economic, and political impediments for their adoption and for changes in dietary habits will present large challenges.
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Importance Some evidence suggests vegetarian dietary patterns may be associated with reduced mortality, but the relationship is not well established.Objective To evaluate the association between vegetarian dietary patterns and mortality.Design Prospective cohort study; mortality analysis by Cox proportional hazards regression, controlling for important demographic and lifestyle confounders.Setting Adventist Health Study 2 (AHS-2), a large North American cohort.Participants A total of 96 469 Seventh-day Adventist men and women recruited between 2002 and 2007, from which an analytic sample of 73 308 participants remained after exclusions.Exposures Diet was assessed at baseline by a quantitative food frequency questionnaire and categorized into 5 dietary patterns: nonvegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo–vegetarian, and vegan.Main Outcome and Measure The relationship between vegetarian dietary patterns and all-cause and cause-specific mortality; deaths through 2009 were identified from the National Death Index.Results There were 2570 deaths among 73 308 participants during a mean follow-up time of 5.79 years. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per 1000 person-years. The adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97). The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo–vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians. Significant associations with vegetarian diets were detected for cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality, and endocrine mortality. Associations in men were larger and more often significant than were those in women.Conclusions and Relevance Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality. Results appeared to be more robust in males. These favorable associations should be considered carefully by those offering dietary guidance.
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Background: Absorption factors are required to convert physiologic requirements for iron into Dietary Reference Values, but the absorption from single meals cannot be used to estimate dietary iron absorption. Objective: The objective was to conduct a systematic review of iron absorption from whole diets. Design: A structured search was completed by using the Medline, EMBASE, and Cochrane CENTRAL databases from inception to November 2011. Formal inclusion and exclusion criteria were applied, and data extraction, validity assessment, and meta-analyses were undertaken. Results: Nineteen studies from the United States, Europe, and Mexico were included. Absorption from diets was higher with an enhancer (standard mean difference: 0.53; 95% CI: 0.21, 0.85; P = 0.001) and was also higher when compared with low-bioavailability diets (standard mean difference: 0.96; 95% CI: 0.51, 1.41; P < 0.0001); however, single inhibitors did not reduce absorption (possibly because of the limited number of studies and participants and their heterogeneity). A regression equation to calculate iron absorption was derived by pooling data for iron status (serum and plasma ferritin) and dietary enhancers and inhibitors from 58 individuals (all from US studies): log[nonheme-iron absorption, %] = −0.73 log[ferritin, μg/L] + 0.11 [modifier] + 1.82. In individuals with serum ferritin concentrations from 6 to 80 μg/L, predicted absorption ranged from 2.1% to 23.0%. Conclusions: Large variations were observed in mean nonheme-iron absorption (0.7–22.9%) between studies, which depended on iron status (diet had a greater effect at low serum and plasma ferritin concentrations) and dietary enhancers and inhibitors. Iron absorption was predicted from serum ferritin concentrations and dietary modifiers by using a regression equation. Extrapolation of these findings to developing countries and to men and women of different ages will require additional high-quality controlled trials.
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Many algorithms have been developed in the past few decades to estimate nonheme iron absorption from the diet based on single meal absorption studies. Yet single meal studies exaggerate the effect of diet and other factors on absorption. Here, we propose a new algorithm based on complete diets for estimating nonheme iron absorption. We used data from 4 complete diet studies each with 12-14 participants for a total of 53 individuals (19 men and 34 women) aged 19-38 y. In each study, each participant was observed during three 1-wk periods during which they consumed different diets. The diets were typical, high, or low in meat, tea, calcium, or vitamin C intakes. The total sample size was 159 (53 × 3) observations. We used multiple linear regression to quantify the effect of different factors on iron absorption. Serum ferritin was the most important factor in explaining differences in nonheme iron absorption, whereas the effect of dietary factors was small. When our algorithm was validated with single meal and complete diet data, the respective R(2) values were 0.57 (P < 0.001) and 0.84 (P < 0.0001). The results also suggest that between-person variations explain a large proportion of the differences in nonheme iron absorption. The algorithm based on complete diets we propose is useful for predicting nonheme iron absorption from the diets of different populations.
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Walnuts are rich in polyunsaturated fatty acids and have been shown to improve various cardiometabolic risk factors. We aimed to investigate the association between walnut intake and incident type 2 diabetes in 2 large cohort studies: the Nurses' Health Study (NHS) and NHS II. We prospectively followed 58,063 women aged 52-77 y in NHS (1998-2008) and 79,893 women aged 35-52 y in NHS II (1999-2009) without diabetes, cardiovascular disease, or cancer at baseline. Consumption of walnuts and other nuts was assessed every 4 y using validated food frequency questionnaires. Self-reported type 2 diabetes was confirmed by a validated supplemental questionnaire. We documented a total of 5930 incident type 2 diabetes cases during 10 y of follow-up. In the multivariable-adjusted Cox proportional hazards model without body mass index (BMI), walnut consumption was associated with a lower risk of type 2 diabetes, and the HRs (95% CIs) for participants consuming 1-3 servings/mo (1 serving = 28 g), 1 serving/wk, and ≥2 servings/wk of walnuts were 0.93 (0.88-0.99), 0.81 (0.70-0.94), and 0.67 (0.54-0.82) compared with women who never/rarely consumed walnuts (P-trend < 0.001). Further adjustment for updated BMI slightly attenuated the association and the HRs (95% CIs) were 0.96 (0.90-1.02), 0.87 (0.75-1.01), and 0.76 (0.62-0.94), respectively (P-trend = 0.002). The consumption of total nuts (P-trend < 0.001) and other tree nuts (P-trend = 0.03) was also inversely associated with risk of type 2 diabetes, and the associations were largely explained by BMI. Our results suggest that higher walnut consumption is associated with a significantly lower risk of type 2 diabetes in women.
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BACKGROUND: Current evidence indicates that red and processed meat intake increases the risk of colorectal cancer; however, the association with colorectal adenomas is unclear. OBJECTIVE: To conduct a systematic review and meta-analysis of epidemiological studies of red and processed meat intake and risk of colorectal adenomas as part of the Continuous Update Project of the World Cancer Research Fund. DESIGN: PubMed and several other databases were searched for relevant studies from their inception up to 31 December 2011. Summary relative risks (RRs) were estimated using a random effects model. RESULTS: Nineteen case-control studies and seven prospective studies were included in the analyses. The summary RR per 100 g/day of red meat was 1.27 (95 % CI 1.16-1.40, I (2) = 5 %, n = 16) for all studies combined, 1.20 (95 % CI 1.06-1.36, I (2) = 0 %, n = 6) for prospective studies, and 1.34 (95 % CI 1.12-1.59, I (2) = 31 %, n = 10) for case-control studies. The summary RR per 50 g/day of processed meat intake was 1.29 (95 % CI 1.10-1.53, I (2) = 27 %, n = 10) for all studies combined, 1.45 (95 % CI 1.10-1.90, I (2) = 0 %, n = 2) for prospective studies, and 1.23 (95 % CI 0.99-1.52, I (2) = 37 %, n = 8) for case-control studies. There was evidence of a nonlinear association between red meat (p (nonlinearity) < 0.001) and processed meat (p (nonlinearity) = 0.01) intake and colorectal adenoma risk. CONCLUSION: These results indicate an elevated risk of colorectal adenomas with intake of red and processed meat, but further prospective studies are warranted.