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Advances in Kidney Disease and Health Nov 2023Popular diets often influence dietary patterns, which have different implications for kidney stone risk. Despite the wide variety of popular diets, some general... (Review)
Review
Popular diets often influence dietary patterns, which have different implications for kidney stone risk. Despite the wide variety of popular diets, some general principles can be gleaned from investigating their potential impact on nephrolithiasis. Plant-based diets, including Dietary Approaches to Stop Hypertension, Mediterranean, flexitarian, and vegetarian diets, may protect against nephrolithiasis when they consist largely of unprocessed plant foods, while carbohydrate-restricted diets (including high-protein diets and the ketogenic diet) may raise kidney stone risk. Patients should be advised to consume a diet rich in whole plants, particularly fruits and vegetables, and minimize their consumption of animal proteins. Accompanying fruits and vegetables that are higher in oxalate content with more water and some dairy intake may also be useful. (We address the oxalate content of fruits and vegetables further below). Calcium consumption is an important component of decreasing the risk of kidney stones, as higher dietary calcium from dairy or nondairy sources is independently associated with lower kidney stone risk. Patients should also be advised to be conscious of fat intake, as fat in the intestinal lumen may complex with calcium and therefore increase urinary oxalate excretion. Finally, patients should avoid consumption of processed foods, which often contain added fructose and high sodium content, two factors that increase kidney stone risk.
Topics: Animals; Humans; Diet; Kidney Calculi; Diet, Vegetarian; Calcium, Dietary; Oxalates; Vegetables
PubMed: 38453270
DOI: 10.1053/j.akdh.2023.10.002 -
European Journal of Nutrition Mar 2024With dairy products and fish being major sources of iodine in Switzerland, the growing popularity of plant-based alternatives may impact iodine nutrition. This study...
PURPOSE
With dairy products and fish being major sources of iodine in Switzerland, the growing popularity of plant-based alternatives may impact iodine nutrition. This study aimed to assess the iodine content in plant-based dairy and fish alternatives available in the Swiss market and compare them with conventional products.
METHODS
In 2022, a market survey was conducted in Zurich, Switzerland, to identify the plant-based dairy and fish alternatives available and assess their iodine content. To evaluate the impact of plant-based alternatives on iodine consumption in Switzerland, we modeled dietary scenarios by substituting the intake of dairy and fish items with plant-based alternatives. In addition, we investigated fortification with calcium, vitamins B2, B12, and D.
RESULTS
Out of 477 identified products, only four milk-alternative products were iodine fortified (median iodine concentration: 22.5 μg/100 ml). The median iodine concentration in unfortified plant-based alternatives was negligible compared to conventional dairy and fish products (milk: 0.21 vs 9.5 μg/100 ml; yogurt 0.36 vs 6.1 μg/100 g; cheese: 0.10 vs 20 μg/100 g; fish 0.50 vs 44 μg/100 g). Three portions of dairy per day as recommended by the Swiss Food Pyramid provide 25% of the RDA for iodine (150 μg/day), whereas substituting those with unfortified alternatives provides only 0.7% of the RDA.
CONCLUSION
Only four out of 477 plant-based alternative products are iodine fortified in the Swiss market. Thus, the risk for consumers to miss out on the ca. 25% of the RDA for iodine by consuming plant-based alternatives is high, placing them at a risk for inadequate iodine intake.
PubMed: 38451284
DOI: 10.1007/s00394-024-03339-5 -
Breast Cancer Research and Treatment Jun 2024Breast cancer treatment is associated with weight gain, and obesity and its related cardiometabolic and hormonal risk factors have been associated with poorer outcomes.... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Breast cancer treatment is associated with weight gain, and obesity and its related cardiometabolic and hormonal risk factors have been associated with poorer outcomes. Dietary intervention may address these risk factors, but limited research has been done in the setting of metastatic breast cancer requiring systemic therapy.
METHODS
Women with metastatic breast cancer on stable treatment were randomized 2:1 to an 8-week intervention (n = 21) or control (n = 11). The intervention included weekly assessment visits and an ad libitum whole-food, plant-based (WFPB) diet with provided meals. Cardiometabolic, hormonal, and cancer markers were assessed at baseline, 4 weeks, and 8 weeks.
RESULTS
Within the intervention group, mean weight decreased by 6.6% (p < 0.01) after 8 weeks. Fasting insulin decreased from 16.8 uIU/L to 11.2 uIU/L (p < 0.01), concurrent with significantly reduced insulin resistance. Total cholesterol decreased from 193.6 mg/dL to 159 mg/dL (p < 0.01), and low-density lipoprotein (LDL) cholesterol decreased from 104.6 mg/dL to 82.2 mg/dL (p < 0.01). Total testosterone was unchanged, but free testosterone trended lower within the intervention group (p = 0.08) as sex hormone binding globulin increased from 74.3 nmol/L to 98.2 nmol/L (p < 0.01). There were no significant differences in cancer progression markers at week 8, although mean CA 15-3, CA 27.29, and CEA were lower in the intervention group (p = 0.53, p = 0.23, and p = 0.54, respectively) compared to control, when adjusted for baseline.
CONCLUSION
WFPB dietary changes during treatment for metastatic breast cancer are well tolerated and significantly improve weight, cardiometabolic and hormonal parameters. Longer studies are warranted to assess the durability of changes. Trial registration First registered at Clinicaltrials.gov (NCT03045289) on February 7, 2017.
Topics: Humans; Female; Breast Neoplasms; Middle Aged; Adult; Neoplasm Metastasis; Aged; Diet, Vegetarian; Body Weight; Treatment Outcome; Insulin Resistance; Cardiometabolic Risk Factors; Obesity; Insulin; Testosterone; Sex Hormone-Binding Globulin
PubMed: 38446316
DOI: 10.1007/s10549-024-07266-1 -
JAMA Network Open Feb 2024Previous research has found that vegetarian diets are associated with lower bone mineral density and higher risk of fractures, but these studies did not differentiate...
IMPORTANCE
Previous research has found that vegetarian diets are associated with lower bone mineral density and higher risk of fractures, but these studies did not differentiate the quality of the plant-based foods.
OBJECTIVE
To examine the association between the quality of plant-based diets (not necessarily vegan but also omnivorous) and hip fracture risk among postmenopausal women in the Nurses' Health Study.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study analyzed data from 70 285 postmenopausal women who participated in the US Nurses' Health Study from 1984 through 2014. Data were analyzed from January 1 to July 31, 2023.
MAIN OUTCOMES AND MEASURES
Hip fractures were self-reported on biennial questionnaires. Diet was assessed every 4 years using a validated semiquantitative food frequency questionnaire. Plant-based diet quality was assessed using 2 previously established indices: the healthful Plant-Based Diet Index (hPDI), for which healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea or coffee) received positive scores, whereas less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets or desserts) and animal foods received reversed scores; and the unhealthful Plant-Based Diet Index (uPDI), for which positive scores were given to less healthy plant foods and reversed scores to healthy plant and animal foods. Quintile scores of 18 food groups were summed, with a theoretical range for both indices of 18 to 90 (highest adherence). Cox proportional hazards regression with time-varying covariates was used to compute hazard ratios (HRs) and 95% CIs for hip fracture.
RESULTS
In total, 70 285 participants (mean [SD] age, 54.92 [4.48] years; 100% White women) were included, and 2038 cases of hip fracture were ascertained during the study and for up to 30 years of follow-up. Neither the hPDI (HR for highest vs lowest quintile, 0.97 [95% CI, 0.83-1.14]) nor the uPDI (HR for highest vs lowest quintile, 1.02 [95% CI, 0.87-1.20]) for long-term diet adherence was associated with hip fracture risk. However, when examining recent intake for the highest vs lowest quintiles, the hPDI was associated with 21% lower risk of hip fracture (HR, 0.79 [95% CI, 0.68-0.92]; P = .02 for trend), and the uPDI was associated with 28% higher risk (1.28 [95% CI, 1.09-1.51]; P = .008 for trend).
CONCLUSIONS AND RELEVANCE
Findings of this cohort study indicated that long-term adherence to healthful or unhealthful plant-based diets as assessed by hPDI and uPDI scores was not associated with hip fracture risk. Future research should clarify whether the associations observed with recent dietary intake are due to short-term effects of these dietary patterns, reverse causality, or both.
Topics: Animals; Female; Humans; Middle Aged; Cohort Studies; Diet, Plant-Based; Postmenopause; Hip Fractures; Diet; Vegetables
PubMed: 38421643
DOI: 10.1001/jamanetworkopen.2024.1107 -
Nutrients Feb 2024Plant-based dietary patterns are a source of different amounts and proportions of fatty acids (FAs) from those in traditional diets. Information about the full FAs...
BACKGROUND
Plant-based dietary patterns are a source of different amounts and proportions of fatty acids (FAs) from those in traditional diets. Information about the full FAs profile provided by plant-based diets is widely lacking. The aim of this study was to present the exact serum profiles of FAs among people on a plant-based diet compared with omnivorous subjects.
METHODS
FAs compositions and inflammation statuses (based on serum C-reactive protein (CRP) levels) were studied in serum samples obtained from 102 female volunteers (divided into four groups: vegans, vegetarians, pescatarians, and omnivores). The quality of the volunteers' diets was assessed based on seven-day dietary records.
RESULTS
Both vegans and vegetarians had lower total -3 PUFAs, EPA, and DHA serum levels than omnivores. Decreased levels of these FAs presumably did not cause inflammation in vegetarians and vegans, as vegetarians had similar serum levels of CRP compared to omnivores, and vegans had even lower levels.
CONCLUSION
The analysis of serum FAs and CRP levels in vegetarians and vegans suggests that factors other than diet alone influence inflammation and overall health status. Further research on long-term plant-based diet users is needed to better understand this issue, and supplementation with EPA and DHA is worth considering in vegans and vegetarians.
Topics: Humans; Female; Fatty Acids; Diet, Vegetarian; Diet; Vegetarians; Diet, Vegan; Health Status; Inflammation
PubMed: 38398839
DOI: 10.3390/nu16040516 -
Nutrients Feb 2024A cholesterol-lowering diet score was previously developed for epidemiological studies; its association with serum lipid profile was not confirmed yet.
BACKGROUND
A cholesterol-lowering diet score was previously developed for epidemiological studies; its association with serum lipid profile was not confirmed yet.
METHODS
The score was developed as an adaptation of the dietary portfolio for cholesterol reduction, assigning one point for adherence to seven dietary indicators and ranging from 0 (null adherence) to 7 (highest adherence). The score was calculated for breast cancer patients enrolled in the DEDiCa study using a 7-day food record; serum lipid profile, including total and low-density lipoprotein cholesterol (LDL-C), was evaluated in serum at baseline.
RESULTS
Patients with the highest adherence to the cholesterol-lowering diet (i.e., score ≥ 4) reported lower LDL-C level than women with score 0-1 (median: 107 mg/dL and 122 mg/dL, respectively; < 0.01). The proportion of women with LDL-C above the recommended limit of 116 mg/dL was 60.0% with score 0-1 and 42.6% with score ≥4. Although the score directly correlates with consumption of foods from vegetal sources, it was mildly associated with the healthful plant-based diet index (r-Spearman = 0.51) and the Mediterranean Diet Adherence Screener (r-Spearman = 0.30) Conclusions: These results provide experimental evidence that the cholesterol-lowering diet score is capable of detecting a specific plant-based dietary pattern that affects circulating cholesterol levels.
Topics: Humans; Female; Cholesterol, LDL; Cholesterol; Diet, Healthy; Diet, Mediterranean
PubMed: 38398819
DOI: 10.3390/nu16040495 -
Foods (Basel, Switzerland) Feb 2024Reliance on animal foods must be reduced to improve planetary and human well-being. This research studied plant-based cheese alternatives (PBCA) relative to dairy cheese...
Reliance on animal foods must be reduced to improve planetary and human well-being. This research studied plant-based cheese alternatives (PBCA) relative to dairy cheese in a consumer taste test with 157 consumers in New Zealand. A case study approach used cream cheese (commercially available) as the focal product category (2 PBCA, 2 dairy) and implemented a multi-response paradigm (hedonic, sensory, emotional, conceptual, situational). "Beyond liking" insights were established, including drivers of liking (sensory, non-sensory) and sensory drivers of non-sensory product associations. Two consumer segments were identified, of which the largest ( = 111) liked PBCA and dairy samples equally (6.5-6.7 of 9). In this cluster, the key sensory drivers of liking were 'creamy/smooth mouthfeel', 'dissolves quickly in mouth', and 'sweet', while a significant penalty was associated with 'mild/bland flavour'. The non-sensory data contributed additional consumer insights, including the four samples being perceived as differently appropriate for 9 of 12 use situations, with PBCA being regarded as less appropriate. In the limited confines of this case on cream cheese, the findings show that PBCA need not be inferior to their dairy counterparts despite a general narrative to the contrary. Of note, the results were obtained among participants who were open to eating a more PB diet but were not vegetarian or vegan.
PubMed: 38397544
DOI: 10.3390/foods13040567 -
Biology Feb 2024Diet has a key role in the reproductive axis both in males and females. This review aims to analyze the impacts of different dietary patterns on fertility. It appears... (Review)
Review
Diet has a key role in the reproductive axis both in males and females. This review aims to analyze the impacts of different dietary patterns on fertility. It appears that the Mediterranean diet has a predominantly protective role against infertility, while the Western diet seems to be a risk factor for infertility. Moreover, we focus attention also on dietary patterns in different countries of the World (Middle Eastern diet, Asian diet). In particular, when analyzing single nutrients, a diet rich in saturated fatty acids, cholesterol, animal proteins, and carbohydrates with high glycemic index is highly associated with male and female infertility. Finally, we evaluate the effects of vegetarian, vegan, and ketogenic diets on fertility, which seem to be still unclear. We believe that comprehension of the molecular mechanisms involved in infertility will lead to more effective and targeted treatments for infertile couples.
PubMed: 38392349
DOI: 10.3390/biology13020131 -
Journal of Eating Disorders Feb 2024Orthorexia nervosa, defined as a fixation on eating healthy according to subjective criteria, is recently being discussed as another variant of disordered eating...
BACKGROUND
Orthorexia nervosa, defined as a fixation on eating healthy according to subjective criteria, is recently being discussed as another variant of disordered eating behavior. Further characteristics are rigid adherence to nutritional rules, anxieties and avoidance behavior in the context of eating as well as a focus on health, not on body shape or weight loss, which is supposed to differentiate orthorexic from other disordered eating behavior. Although diagnostic criteria have been suggested, they have rarely been used in case reports published to date. Hence, the aim of this study was to present five individuals with supposed orthorexia nervosa, using preliminary diagnostic criteria to assess their eating behavior.
CASE PRESENTATION
The five cases (three females, two males) reveal the great variety of disordered eating behavior. Fear of unhealthy overweight (case A), supposed orthorexic eating behavior as a coping strategy for anorexia nervosa (case B), the exclusive consumption of animal products with a total exclusion of fruits and vegetables (case C), the fixation on exercise and athletic goals (case D) as well as a focus on a vegan diet and unprocessed foods (case E) are facets of orthorexia nervosa with varying degrees of impairment.
CONCLUSIONS
It is concluded that orthorexia nervosa manifests itself in very different ways and that more research is needed in order to determine whether it could be a useful additional category of disordered eating behavior.
PubMed: 38383470
DOI: 10.1186/s40337-024-00988-z -
BMC Pregnancy and Childbirth Feb 2024A healthy nutrition in pregnancy supports maternal health and fetal development, decreasing the risk for adverse pregnancy outcomes. Guidance by prenatal care...
BACKGROUND
A healthy nutrition in pregnancy supports maternal health and fetal development, decreasing the risk for adverse pregnancy outcomes. Guidance by prenatal care professionals can increase women's awareness regarding the importance of nutrition in pregnancy and thereby contribute to a reduced risk for adverse pregnancy outcomes. The aim of this study was to assess the needs, wishes and preferences of pregnant women regarding the interprofessional guidance on nutrition in pregnancy.
METHODS
Using a qualitative approach and a purposive maximum variation sampling strategy, 25 pregnant women were recruited to participate in six semi-structured, guideline-oriented online focus groups. In addition, two semi-structured, guideline-oriented interviews, with a midwife and an obstetrician, were conducted. The focus groups and interviews were audio-recorded and transcribed. Transcripts were analysed using a systematic deductive-inductive approach to qualitative content analysis according to Kuckartz.
RESULTS
Focus group participants covered diverse perspectives in terms of their age, different models of prenatal care as well as dietary forms from omnivorous to vegan. The majority of women perceived the guidance on nutrition during pregnancy as insufficient. Involved healthcare professionals, namely midwives and obstetricians, should provide more consistent information, especially to avoid uncertainties exacerbated by the internet and social media. There is a need for individual nutrition information regarding dietary supplements and the specifics of different dietary forms during pregnancy, such as a vegan diet. The majority of participants supported the integration of a free-of-charge professional nutrition counselling in prenatal care. Interviews with experts identified time pressure and the complexity of nutrition as a topic as the main obstacles in consultation settings. Both midwife and obstetrician emphasised the need for improved professional education on nutrition in pregnancy in their respective studies.
CONCLUSION
Professional guidance for pregnant women on nutrition and uncertainties going along with certain forms of diet during pregnancy could alleviate the burden and overwhelming amount of web-based information. Additionally, information adapted to the needs, wishes and preferences of pregnant women would improve prenatal care through a more personalised approach. The quality of nutrition guidance in pregnancy should be improved by the implementation of this topic in the education of involved healthcare professionals.
Topics: Female; Pregnancy; Humans; Prenatal Care; Pregnant Women; Qualitative Research; Midwifery; Focus Groups
PubMed: 38383376
DOI: 10.1186/s12884-024-06351-z