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European Journal of Nutrition Apr 2023Vitamin B is an essential nutrient that is not made by plants; consequently, unfortified plant-based foods are not a reliable supply. Recent estimates suggest high rates...
Vitamin B is an essential nutrient that is not made by plants; consequently, unfortified plant-based foods are not a reliable supply. Recent estimates suggest high rates of vitamin B deficiency among the vegetarian and vegan populations, particularly in pregnant women or women of child-bearing age who, for ethical and health reasons, are shifting towards higher consumption of plant-based foods in ever-increasing numbers. Vitamin B plays crucial metabolic roles across the life-course and in particular during pregnancy and in early development (first 1000 days of life). Evidence now implicates vitamin B deficiency with increased risk to a range of neuro, vascular, immune, and inflammatory disorders. However, the current UK recommended nutrient intake for vitamin B does not adequately consider the vitamin B deficit for those choosing a plant-based diet, including vegetarianism and in particular veganism, representing a hidden hunger. We provide a cautionary note on the importance of preventing vitamin B deficits for those individuals choosing a plant-based diet and the health professionals advising them.
Topics: Humans; Female; Pregnancy; Vitamin B 12; Diet; Diet, Vegetarian; Diet, Vegan; Vitamins
PubMed: 36469110
DOI: 10.1007/s00394-022-03025-4 -
Translational Psychiatry Sep 2019Western societies notice an increasing interest in plant-based eating patterns such as vegetarian and vegan, yet potential effects on the body and brain are a matter of...
Western societies notice an increasing interest in plant-based eating patterns such as vegetarian and vegan, yet potential effects on the body and brain are a matter of debate. Therefore, we systematically reviewed existing human interventional studies on putative effects of a plant-based diet on the metabolism and cognition, and what is known about the underlying mechanisms. Using the search terms "plant-based OR vegan OR vegetarian AND diet AND intervention" in PubMed filtered for clinical trials in humans retrieved 205 studies out of which 27, plus an additional search extending the selection to another five studies, were eligible for inclusion based on three independent ratings. We found robust evidence for short- to moderate-term beneficial effects of plant-based diets versus conventional diets (duration ≤ 24 months) on weight status, energy metabolism and systemic inflammation in healthy participants, obese and type-2 diabetes patients. Initial experimental studies proposed novel microbiome-related pathways, by which plant-based diets modulate the gut microbiome towards a favorable diversity of bacteria species, yet a functional "bottom up" signaling of plant-based diet-induced microbial changes remains highly speculative. In addition, little is known, based on interventional studies about cognitive effects linked to plant-based diets. Thus, a causal impact of plant-based diets on cognitive functions, mental and neurological health and respective underlying mechanisms has yet to be demonstrated. In sum, the increasing interest for plant-based diets raises the opportunity for developing novel preventive and therapeutic strategies against obesity, eating disorders and related comorbidities. Still, putative effects of plant-based diets on brain health and cognitive functions as well as the underlying mechanisms remain largely unexplored and new studies need to address these questions.
Topics: Brain; Cognition; Diet, Vegan; Diet, Vegetarian; Humans
PubMed: 31515473
DOI: 10.1038/s41398-019-0552-0 -
Journal of the Academy of Nutrition and... Oct 2022Consuming different food groups and nutrients can have differential effects on body weight, body composition, and insulin sensitivity. (Randomized Controlled Trial)
Randomized Controlled Trial
Changes in Food and Nutrient Intake and Diet Quality on a Low-Fat Vegan Diet Are Associated with Changes in Body Weight, Body Composition, and Insulin Sensitivity in Overweight Adults: A Randomized Clinical Trial.
BACKGROUND
Consuming different food groups and nutrients can have differential effects on body weight, body composition, and insulin sensitivity.
OBJECTIVE
The aim was to identify how food group, nutrient intake, and diet quality change relative to usual-diet controls after 16 weeks on a low-fat vegan diet and what associations those changes have with changes in body weight, body composition, and measures of metabolic health.
DESIGN
Secondary analysis of a randomized clinical trial conducted between October 2016 and December 2018 in four replications.
PARTICIPANTS/SETTING
Participants included in this analysis were 219 healthy, community-based adults in the Washington, DC, area, with a body mass index (BMI) between 28 and 40, who were randomly assigned to either follow a low-fat vegan diet or make no diet changes.
INTERVENTION
A low-fat, vegan diet deriving approximately 10% of energy from fat, with weekly classes including dietary instruction, group discussion, and education on the health effects of plant-based nutrition. Control group participants continued their usual diets.
MAIN OUTCOME MEASURES
Changes in food group intake, macronutrient and micronutrient intake, and dietary quality as measured by Alternate Healthy Eating Index-2010 (AHEI-2010), analyzed from 3-day diet records, and associations with changes in body weight, body composition, and insulin sensitivity were assessed.
STATISTICAL ANALYSES PERFORMED
A repeated-measure analysis of variance model that included the factors group, subject, and time was used to test the between-group differences throughout the 16-week study. Interaction between group and time was calculated for each variable. Within each diet group, paired comparison t tests were calculated to identify significant changes from baseline to 16 weeks. Spearman correlations were calculated for the relationship between changes in food group intake, nutrient intake, AHEI-2010 score, and changes in body weight, body composition, and insulin sensitivity. The relative contribution of food groups and nutrients to weight loss was evaluated using linear regression.
RESULTS
Fruit, vegetable, legume, meat alternative, and whole grain intake significantly increased in the vegan group. Intake of meat, fish, and poultry; dairy products; eggs; nuts and seeds; and added fats decreased. Decreased weight was most associated with increased intake of legumes (r = -0.38; P < 0.0001) and decreased intake of total meat, fish, and poultry (r = +0.43; P < 0.0001). Those consuming a low-fat vegan diet also increased their intake of carbohydrates, fiber, and several micronutrients and decreased fat intake. Reduced fat intake was associated with reduced body weight (r = +0.15; P = 0.02) and, after adjustment for changes in BMI and energy intake, with reduced fat mass (r = +0.14; P = 0.04). The intervention group's AHEI-2010 increased by 6.0 points on average, in contrast to no significant change in the control group (treatment effect, +7.2 [95% CI +3.7 to +10.7]; P < 0.001). Increase in AHEI-2010 correlated with reduction in body weight (r = 0.14; P = 0.04), fat mass (r = -0.14; P = 0.03), and insulin resistance as measured by the Homeostasis Model Assessment (HOMA-IR; r = -0.17; P = 0.02), after adjustment for changes in energy intake.
CONCLUSIONS
When compared with participants' usual diets, intake of plant foods increased, and consumption of animal foods, nuts and seeds, and added fats decreased on a low-fat vegan diet. Increased legume intake was the best single food group predictor of weight loss. Diet quality as measured by AHEI-2010 improved on the low-fat vegan diet, which was associated with improvements in weight and metabolic outcomes. These data suggest that increasing low-fat plant foods and minimizing high-fat and animal foods is associated with decreased body weight and fat loss, and that a low-fat vegan diet can improve measures of diet quality and metabolic health.
Topics: Body Composition; Diet, Vegan; Dietary Fiber; Eating; Energy Intake; Humans; Insulin Resistance; Micronutrients; Overweight; Vegans; Weight Loss
PubMed: 35452873
DOI: 10.1016/j.jand.2022.04.008 -
Nutrients May 2021There is a lack of data on associations between modern vegetarian and vegan diets and health among children and adolescents. The aim of the Vechi Youth Study was to...
There is a lack of data on associations between modern vegetarian and vegan diets and health among children and adolescents. The aim of the Vechi Youth Study was to cross-sectionally examine anthropometry, dietary intakes and nutritional status in a sample of 149 vegetarian, 115 vegan and 137 omnivore children and adolescents (6-18 years old, mean age: 12.7 ± 3.9 years). Group differences of dietary intake (calculated from three-day dietary records), nutrient biomarker and blood lipid concentrations were assessed using an analysis of covariance, adjusted for sex, age and other covariates. The total energy intake did not differ significantly between groups, but intake of carbohydrates was higher among vegetarians and vegans than among omnivores ( = 0.0002, respectively). The median protein intake exceeded 0.9 g/kg body weight/day in all diet groups and was lowest among vegetarians ( < 0.02). There was no significant difference of haemoglobin, vitamin B2, 25-OH vitamin D3, HDL-C and triglycerides blood concentrations between diet groups. Vegan participants had higher folate concentrations than vegetarian participants ( = 0.0053). Ferritin concentration was significantly higher in omnivores than in vegetarians ( = 0.0134) and vegans ( = 0.0404). Vegetarians had lower concentrations of holotranscobalamin ( = 0.0042) and higher concentrations of methylmalonic acid ( = 0.0253) than omnivores. Vegans had the lowest non-HDL-C and LDL-C concentrations in comparison to vegetarians ( = 0.0053 and = 0.0041) and omnivores ( = 0.0010 and = 0.0010). A high prevalence (>30%) of 25-OH vitamin D3 and vitamin B2 concentrations below reference values were found irrespective of the diet group. In conclusion, the Vechi Youth Study did not indicate specific nutritional risks among vegetarian and vegan children and adolescents compared to omnivores.
Topics: Adolescent; Biomarkers; Child; Diet; Diet Records; Diet, Vegan; Diet, Vegetarian; Eating; Feeding Behavior; Female; Germany; Humans; Lipids; Male; Nutrients; Nutritional Requirements; Nutritional Status
PubMed: 34069944
DOI: 10.3390/nu13051707 -
European Journal of Nutrition Apr 2022There is an ongoing debate whether vegetarian (VG) and especially vegan (VN) diets are nutritionally adequate in early childhood. Hence, the Vegetarian and Vegan...
PURPOSE
There is an ongoing debate whether vegetarian (VG) and especially vegan (VN) diets are nutritionally adequate in early childhood. Hence, the Vegetarian and Vegan Children Study (VeChi Diet Study) aimed to assess the food and nutrient intake of VG and VN infants.
METHODS
The study examined the diets of 1-3-year-old VG, VN, and omnivorous (OM) children (n = 430). Dietary intake was assessed via a 3-day weighed dietary record and compared between groups using ANCOVA. Lifestyle data were collected using a questionnaire. Here, the results of micronutrient and fatty acid intakes are presented.
RESULTS
Most nutrient intakes (with and without supplements) differed significantly between VN children and the two other groups, with a more favourable overall micronutrient intake in VN, followed by VG children, [e.g., the highest intake of vitamin E (8.3 mg/d vs. VG 7.4 mg/d and OM 5.1 mg/d), vitamin B (569 µg/d vs. VG 513 µg/d and OM 481 µg/d), folate (143 µg/d vs. VG 116 µg/d and OM 108 µg/d), magnesium (241 mg/d vs. VG 188 mg/d and OM 164 mg/d), and iron (8.9 mg/d vs. VG 7.3 mg/d and OM 6.0 mg/d)] as well as fat quality [highest intake of polyunsaturated fatty acids (8.7 E% vs. VG 6.9 E% and OM 4.5 E%) and lowest intake of saturated fatty acids (9.1 E% vs. VG 11.9 E% and OM 14.0 E%)]. In contrast, OM children had the highest intake of vitamin B (639 µg/d vs. VG 461 µg/d and VN 429 µg/d), calcium (445 mg/d vs. VG 399 mg/d and VN 320 mg/d), iodine (47 µg/d vs. VG 33 µg/d and VN 31 µg/d), and DHA (35.4 mg/d vs. VG 16.6 mg/d and VN 18.4 mg/d). Without supplementation, OM children had the highest average vitamin B intake (1.5 µg/d vs. VG 0.6 µg/d and VN 0.2 µg/d), whereas VN children had the highest average vitamin B intake with supplementation (73.8 µg/d vs. VG 1.3 µg/d and OM 1.7 µg/d). Without supplementation, none of the groups' median intakes met the harmonised Average Requirement (h-AR) for vitamin D and iodine. Moreover, VG and VN children did not achieve h-ARs for vitamin B, vitamin B, and iron-if a low absorption of iron is anticipated; VN children also did not do so for calcium.
CONCLUSION
In early childhood, VN and VG diets can provide most micronutrients in desirable amounts and a preferable fat quality compared to an OM diet. Special focus should be paid to (potentially) critical nutrients, particularly vitamin D, iodine, and DHA for all children regardless of diet, as well as vitamin B, vitamin B, calcium, and iron for VG and VN children.
TRAIL REGISTRATION
This study was registered with the German Clinical Trials Register (DRKS00010982) on (September 2, 2016).
Topics: Child; Child, Preschool; Diet; Diet, Vegan; Diet, Vegetarian; Fatty Acids; Germany; Humans; Infant; Micronutrients; Vegans; Vegetarians
PubMed: 34855006
DOI: 10.1007/s00394-021-02753-3 -
The Journal of Nutrition Jun 2020For >50 y, dietary guidelines in the United States have focused on reducing intakes of saturated and total fat. However, rates of obesity and diabetes rose markedly...
For >50 y, dietary guidelines in the United States have focused on reducing intakes of saturated and total fat. However, rates of obesity and diabetes rose markedly throughout this period, with potentially catastrophic implications for public health and the economy. Recently, ketogenic diets have received substantial attention from the general public and nutrition research community. These very-low-carbohydrate diets, with fat comprising >70% of calories, have been dismissed as fads. However, they have a long history in clinical medicine and human evolution. Ketogenic diets appear to be more effective than low-fat diets for treatment of obesity and diabetes. In addition to the reductions in blood glucose and insulin achievable through carbohydrate restriction, chronic ketosis might confer unique metabolic benefits of relevance to cancer, neurodegenerative conditions, and other diseases associated with insulin resistance. Based on available evidence, a well-formulated ketogenic diet does not appear to have major safety concerns for the general public and can be considered a first-line approach for obesity and diabetes. High-quality clinical trials of ketogenic diets will be needed to assess important questions about their long-term effects and full potential in clinical medicine.
Topics: Blood Glucose; Diet, Ketogenic; Dietary Carbohydrates; Humans; Insulin; Insulin Resistance; Nutrition Policy; Obesity; Research; Weight Loss
PubMed: 31825066
DOI: 10.1093/jn/nxz308 -
The Proceedings of the Nutrition Society Mar 2022Plant-based (PB) diets are associated with good health and are also recommended for environmental sustainability. The present review aimed to summarise the definitions... (Review)
Review
Plant-based (PB) diets are associated with good health and are also recommended for environmental sustainability. The present review aimed to summarise the definitions of PB diets globally and to investigate the nutritional role of PB diets in adults. This review found that there is a wide range of PB definitions ranging from the traditional vegetarian diets (including vegan) to semi-vegetarian/flexitarian diets. Furthermore, other diets which were originally developed due to their associations with positive health outcomes, such as the portfolio, Mediterranean-style, DASH, healthy US-style, planetary health and Nordic-style diets, have been encompassed in PB definitions due to their emphasis on certain PB components. This review has highlighted that those consuming a PB diet are more likely to meet recommended intakes for carbohydrate, dietary fibre and vitamin E and are less likely to meet recommendations for protein, vitamin B12 and iodine compared to omnivores. Regardless of consumer type, neither PB consumers nor omnivores met recommendations for intakes of vitamin D, calcium and sodium. While intakes of protein, -3, iron and zinc were generally sufficient from the PB diet, it is important to acknowledge the lower bioavailability of these nutrients from PB foods compared to animal-derived products. As dietary patterns shift towards a more PB diet, there is a need for further studies to investigate the role of PB diets for nutritional adequacy and status in populations currently accustomed to consuming a primarily omnivorous diet.
Topics: Animals; Diet; Diet, Vegan; Diet, Vegetarian; Health Status; Humans; Vitamins
PubMed: 35760588
DOI: 10.1017/S0029665121003839 -
Nutrients Apr 2023Vegetarian diets have gained in popularity worldwide and therefore an increasing number of children may be exposed to the resulting nutritional consequences. Among them,... (Review)
Review
Vegetarian diets have gained in popularity worldwide and therefore an increasing number of children may be exposed to the resulting nutritional consequences. Among them, the risk of micronutrient shortfall is particularly of concern. This narrative review aims to assess and discuss the relevance of micronutrient deficiency risk based on the available data. It mainly draws attention to iron, zinc, iodine, and vitamins B12 and D intake. Diets that are more restrictive in animal source foods, such as vegan diets, have a greater likelihood of nutritional deficiencies. However, the actual risk of micronutrient deficiency in vegetarian children is relatively difficult to assert based on the limitations of evidence due to the lack of well-designed studies. The risk of vitamin B12 deficiency must be considered in newborns from vegan or macrobiotic mothers and children with the most restrictive diet, as well as the risk of iron, zinc, and iodine deficiency, possibly by performing the appropriate tests. A lacto-ovo-vegetarian diet exposes a low risk if it uses a very varied diet with a sufficient intake of dairy products. Vegan and macrobiotic diets should be avoided during pregnancy and childhood. There is a need for education and nutrition guidance and the need for supplementation should be assessed individually.
Topics: Animals; Female; Pregnancy; Humans; Vegans; Diet, Vegan; Vegetarians; Malnutrition; Risk Assessment; Iodine; Iron; Micronutrients
PubMed: 37432244
DOI: 10.3390/nu15092129 -
Nutrients Oct 2023Health authorities increasingly recommend sustainable and healthy diets rich in plant foods and with moderate amounts of animal foods. However, there are concerns about... (Review)
Review
Health authorities increasingly recommend sustainable and healthy diets rich in plant foods and with moderate amounts of animal foods. However, there are concerns about whether such diets can meet all nutrient requirements, especially in children and adolescents, who have relatively high nutrient needs for growth and development. Therefore, we aimed to evaluate the nutrient intake and status of children and adolescents (2-18 y) consuming plant-based (i.e., vegetarian and vegan) diets compared to those of meat-eating children following a systematic literature review of studies published between 2000 and 2022. Mean intake and status data of nutrients were calculated across studies and benchmarked to dietary reference values and cut-off values for nutrient deficiencies. A total of 30 studies were included (15 in children 2-5 y, 24 in children 6-12 y, and 11 in adolescents 13-18 y). In all diets, there were risks of inadequate intakes of vitamin D and calcium. Children consuming meat had a risk of inadequate folate and vitamin E intake; and mean fiber, SAFA, and PUFA intakes were not in line with the recommendations. Children consuming plant-based diets risked inadequate vitamin B12, iron, and zinc intakes. In contrast to vegans, vegetarian children may not meet the recommended intakes of fiber, SAFA, and possibly PUFA, but their mean intakes were more favorable than in meat-eating children. Although the data are limited and need further validation, our findings indicate that there are risks of nutritional inadequacies in all diet groups. Therefore, increasing consumption of a variety of plant-based foods, in combination with food fortification and supplementation where needed, is recommended for children and adolescents to have sustainable and nutritionally adequate diets.
Topics: Animals; Humans; Child; Adolescent; Diet; Energy Intake; Meat; Eating; Diet, Vegan; Diet, Vegetarian
PubMed: 37892416
DOI: 10.3390/nu15204341 -
Sports (Basel, Switzerland) Jan 2021Vegan diets are increasingly of interest to athletes, but require a well-planned approach in order to mitigate the risk of potential adverse effects on nutrient intakes,...
Vegan diets are increasingly of interest to athletes, but require a well-planned approach in order to mitigate the risk of potential adverse effects on nutrient intakes, and consequently performance. This case study reports the process of an elite male Gaelic football player (age 25 years; height, 1.88 m; body mass, 87.8 kg; lean body mass, 73.26 kg; body fat, 11.3%) transitioning from an omnivorous diet to a vegan diet at the beginning of a competitive season. The report encompasses key considerations in the planning and provision of nutrition support in this context, in addition to iterations needed based on challenges presented by the athlete. Analysis of nutrient intake (Nutritics Dietary Analysis Software), body composition (dual X-ray absorptiometry; Lunar iDXA, GE Healthcare), and running performance during match-play (global positioning system-based tracking; STATSports Apex) each indicated that with adequate knowledge and education, and appropriate planning, commitment and iterative feedback, the athlete was able to meet nutrition targets on a vegan diet without compromising key performance indicators compared to the omnivorous diet of the previous season. We anticipate that this case study will assist practitioners to recognize the key considerations to address when working with athletes transitioning to a vegan diet.
PubMed: 33466231
DOI: 10.3390/sports9010006