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International Journal of Environmental... May 2021Fibromyalgia (FM) is a chronic non-degenerative disease characterized by the presence of multiple symptoms such as chronic pain, which negatively influence the quality... (Review)
Review
Fibromyalgia (FM) is a chronic non-degenerative disease characterized by the presence of multiple symptoms such as chronic pain, which negatively influence the quality of life of sufferers, most of whom are women. Currently, there is no effective treatment to limit the impact of these symptoms. The aim of this research is to review the scientific evidence on the effect of following a vegetarian or vegan diet on fibromyalgia patients. A systematic review included the original articles that answered the research question. These articles were in 2021 in the PubMed, Web of Science and Scopus databases. The research used the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. No time restriction was applied, and grey literature was not included. The evaluation of the methodological quality of the articles was carried out using the following different scales: STROBE (strengthening the reporting of observational studies in epidemiology), PEDro (Physiotherapy Evidence Database), and MMAT (Mixed Methods Appraisal Tool) scales. A total of 88 studies were analyzed, of which 6 investigations were included in this systematic review ( = 4 clinical trials and = 2 cohort studies). These investigations show significant improvements in biochemical parameters, quality of life, quality of sleep, pain at rest and general health status when following mainly plant-based dietary patterns. In conclusion, these findings are promising but interpretation of the findings is limited due to the methodological quality of the studies. Well-designed clinical trials are needed to consolidate these dietary recommendations in FM patients.
Topics: Diet; Diet, Vegan; Female; Fibromyalgia; Humans; Male; Quality of Life; Vegetarians
PubMed: 34066603
DOI: 10.3390/ijerph18094955 -
Nutrition Reviews May 2022Mental health may be influenced by some dietary patterns. Among common elements of beneficial patterns is high fruit and vegetable intake. However, no systematic review...
CONTEXT
Mental health may be influenced by some dietary patterns. Among common elements of beneficial patterns is high fruit and vegetable intake. However, no systematic review has been conducted to date, to our knowledge, that has assessed the influence of fruit and vegetable dietary patterns on a broad spectrum of mental health.
OBJECTIVE
We conducted a systematic review, using the PRISMA guidelines, of the observational studies analyzing the association between the dietary pattern of fruit and vegetables and the broad aspects of mental health in adult women.
DATA SOURCES
The databases PubMed and Web of Science were searched, and additional manual search for observational peer-reviewed studies was conducted for studies published until June 2019.
DATA EXTRACTION
A total of 5911 studies were extracted and verified based on title and abstract for the inclusion criteria. All procedures were conducted independently by 2 researchers. The final number of included studies was 30. The review was structured around the type of observed outcome.
DATA ANALYSIS
The included studies had defined habitual intake associated with dietary patterns with the intake of specific fruit and/or vegetables, and/or fruit or vegetable products (eg, juices), as well as any aspect of the broad spectrum of general mental health. The Newcastle-Ottawa Scale was used to assess bias. The observed association was not stated in all the included studies; some of them revealed a reverse relationship, but only for the vegetarian/vegan diet. A vegetarian diet may be characterized by high consumption of fruits and vegetables, but it sometimes may not be properly balanced, due to excluded products. This may be the reason of observed situation.
CONCLUSIONS
A general positive influence was observed for the dietary patterns characterized by high consumption of fruit and vegetables and of fruit or vegetable products by women.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD42019138148.
Topics: Adult; Diet; Diet, Vegetarian; Female; Fruit; Humans; Mental Health; Vegetables
PubMed: 34041545
DOI: 10.1093/nutrit/nuab007 -
Critical Reviews in Food Science and... 2022We aimed to examine the association between adherence to plant-based diets (PBDs) and the risk of mortality among the general population. Relevant investigations were... (Meta-Analysis)
Meta-Analysis
We aimed to examine the association between adherence to plant-based diets (PBDs) and the risk of mortality among the general population. Relevant investigations were identified through PubMed, Scopus, Embase, and ISI Web of Knowledge. Data were pooled using a random-effects or a fixed-effects model. Twelve prospective cohort studies with 42,697 deaths among 508,861 participants were included. The hazard ratios (HRs) for the highest compared to the lowest category of adherence to the PBDs were 0.90 (95% confidence interval [CI]: 0.82, 0.99; I = 91%, n = 12) for all-cause and 0.77 (95% CI: 0.70, 0.86; I = 36%, n = 8) for coronary heart disease (CHD) mortality. Among PBDs subtypes, there was an inverse association between healthy plant-based 0.92 (95% CI: 0.88, 0.96; I = 0%, n = 2), Pesco-vegetarian 0.81 (95% CI: 0.70, 0.92; I = 0%, n = 2), and Pro-vegetarian 0.74 (95% CI: 0.55, 0.88; I = 61.2%, n = 2) diets and the risk of all-cause mortality. A vegetarian diet was also associated with lower risk of mortality due to cardiovascular 0.92 (95% CI: 0.85, 0.99; I = 0%, n = 5) and CHD 0.76 (95% CI: 0.68, 0.85; I = 35%, n = 7). Our findings show the potential protective role of PBDs against chronic disease mortality. As there were certain limitations in some of the studies included in this systematic review and meta-analysis, further research is necessary to confirm our findings.
Topics: Cardiovascular Diseases; Cohort Studies; Diet; Diet, Vegetarian; Humans; Prospective Studies; Vegetarians
PubMed: 33951994
DOI: 10.1080/10408398.2021.1918628 -
Environmental Research Letters : ERL... Dec 2020The adoption of healthy diets with low environmental impact has been widely promoted as an important climate change mitigation strategy. Typically, these diets are high...
Climate change mitigation through dietary change: a systematic review of empirical and modelling studies on the environmental footprints and health effects of 'sustainable diets'.
The adoption of healthy diets with low environmental impact has been widely promoted as an important climate change mitigation strategy. Typically, these diets are high in plant-sourced and low in animal-sourced and processed foods. Despite the fact that their environmental impacts vary, they are often referred to as 'sustainable diets'. Here we systematically review the available published evidence on the effect of 'sustainable diets' on environmental footprints and human health. Eight databases (OvidSP-Medline, OvidSP-Embase, EBSCO-GreenFILE, Web of Science Core Collection, Scopus, OvidSP-CAB-Abstracts, OvidSP-AGRIS, and OvidSP-Global Health) were searched to identify literature (published 1999-2019) reporting health effects and environmental footprints of 'sustainable diets'. Available evidence was mapped and pooled analysis was conducted by unique combinations of diet pattern, health and environmental outcome. Eighteen studies (412 measurements) met our inclusion criteria, distinguishing twelve non-mutually exclusive sustainable diet patterns, six environmental outcomes, and seven health outcomes. In 87% of measurements (n = 151) positive health outcomes were reported from 'sustainable diets' (average relative health improvement: 4.09% [95% CI -0.10-8.29]) when comparing 'sustainable diets' to current/baseline consumption patterns. Greenhouse gas emissions associated with 'sustainable diets' were on average 25.8%[95%CI -27.0 to -14.6] lower than current/baseline consumption patterns, with vegan diets reporting the largest reduction in GHG-emissions (-70.3% [95% CI: -90.2 to -50.4]), however, water use was frequently reported to be higher than current/baseline diets. Multiple benefits for both health and the environment were reported in the majority (n = 315[76%]) of measurements. We identified consistent evidence of both positive health effects and reduced environmental footprints accruing from 'sustainable diets'. The notable exception of increased water use associated with 'sustainable diets' identifies that co-benefits are not universal and some trade-offs are likely. When carefully designed, evidence-based, and adapted to contextual factors, dietary change could play a pivotal role in climate change mitigation, sustainable food systems, and future population health.
PubMed: 33897807
DOI: 10.1088/1748-9326/abc2f7 -
The Journal of Nutrition Jun 2021Plant-based diets are gaining attention globally due to their environmental benefits and perceived health-protective role. A vegan diet may have cardiovascular benefits;...
BACKGROUND
Plant-based diets are gaining attention globally due to their environmental benefits and perceived health-protective role. A vegan diet may have cardiovascular benefits; however, evidence remains conflicting and insufficiently assessed.
OBJECTIVES
We evaluated the utility of the vegan diet in cardiovascular disease (CVD) prevention.
METHODS
We conducted a systematic review of studies evaluating the association between vegan diets and cardiovascular outcomes. We searched 5 databases (Ovid MEDLINE, EMBASE, Web of Science, Scopus, and OpenGrey) through 31 October 2020. Four investigators independently screened the full texts for inclusion, assessed quality, and extracted data from published reports.
RESULTS
Out of the 5729 identified records, 7 were included, comprising over 73,000 participants, of whom at least 7661 were vegans. Three studies, with at least 73,426 individuals (including at least 7380 vegans), examined risks of primary cardiovascular events (total CVD, coronary heart disease, acute myocardial infarction, total stroke, hemorrhagic stroke, and ischemic stroke) in individuals who followed a vegan diet compared to those who did not. None of the studies reported a significantly increased or decreased risk of any cardiovascular outcome. One study suggested that vegans were at greater risk of ischemic stroke compared to individuals who consumed animal products (HR, 1.54; 95% CI, 0.95-2.48). Yet in another study, vegans showed lower common carotid artery intima-media thickness (0.56 ± 0.1 mm vs. 0.74 ± 0.1 mm in controls; P < 0.001), and in 3 studies of recurrent CVD events, vegans had 0-52% lower rates. Furthermore, endothelial function did not differ between vegans and nonvegans. Using the Grading of Recommendations Assessment, Development and Evaluation approach, evidence was deemed to be of low to very low strength/quality.
CONCLUSIONS
Among the Western populations studied, evidence weakly demonstrates associations between vegan diets and risk of CVDs, with the direction of associations varying with the specific CVD outcome tested. However, more high-quality research on this topic is needed. This study was registered at PROSPERO as CRD42019146835.
Topics: Cardiovascular Diseases; Carotid Intima-Media Thickness; Diet, Vegan; Heart Disease Risk Factors; Humans; Stroke
PubMed: 33831953
DOI: 10.1093/jn/nxab037 -
The Cochrane Database of Systematic... Feb 2021Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets have gained popularity and there is a need to synthesise existing clinical trial evidence for their potential in CVD prevention.
OBJECTIVES
To determine the effectiveness of following a vegan dietary pattern for the primary and secondary prevention of CVD.
SEARCH METHODS
We searched the following electronic databases on 4 February 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Web of Science Core Collection. We also searched ClinicalTrials.gov in January 2021. We applied no language restrictions.
SELECTION CRITERIA
We selected randomised controlled trials (RCTs) in healthy adults and adults at high risk of CVD (primary prevention) and those with established CVD (secondary prevention). A vegan dietary pattern excludes meat, fish, eggs, dairy and honey; the intervention could be dietary advice, provision of relevant foods, or both. The comparison group received either no intervention, minimal intervention, or another dietary intervention. Outcomes included clinical events and CVD risk factors. We included only studies with follow-up periods of 12 weeks or more, defined as the intervention period plus post-intervention follow-up.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed studies for inclusion, extracted data and assessed risks of bias. We used GRADE to assess the certainty of the evidence. We conducted three main comparisons: 1. Vegan dietary intervention versus no intervention or minimal intervention for primary prevention; 2. Vegan dietary intervention versus another dietary intervention for primary prevention; 3. Vegan dietary intervention versus another dietary intervention for secondary prevention.
MAIN RESULTS
Thirteen RCTs (38 papers, 7 trial registrations) and eight ongoing trials met our inclusion criteria. Most trials contributed to primary prevention: comparisons 1 (four trials, 466 participants randomised) and comparison 2 (eight trials, 409 participants randomised). We included only one secondary prevention trial for comparison 3 (63 participants randomised). None of the trials reported on clinical endpoints. Other primary outcomes included lipid levels and blood pressure. For comparison 1 there was moderate-certainty evidence from four trials with 449 participants that a vegan diet probably led to a small reduction in total cholesterol (mean difference (MD) -0.24 mmol/L, 95% confidence interval (CI) -0.36 to -0.12) and low-density lipoprotein (LDL) cholesterol (MD -0.22 mmol/L, 95% CI -0.32 to -0.11), a very small decrease in high-density lipoprotein (HDL) levels (MD -0.08 mmol/L, 95% CI -0.11 to -0.04) and a very small increase in triglyceride levels (MD 0.11 mmol/L, 95% CI 0.01 to 0.21). The very small changes in HDL and triglyceride levels are in the opposite direction to that expected. There was a lack of evidence for an effect with the vegan dietary intervention on systolic blood pressure (MD 0.94 mmHg, 95% CI -1.18 to 3.06; 3 trials, 374 participants) and diastolic blood pressure (MD -0.27 mmHg, 95% CI -1.67 to 1.12; 3 trials, 372 participants) (low-certainty evidence). For comparison 2 there was a lack of evidence for an effect of the vegan dietary intervention on total cholesterol levels (MD -0.04 mmol/L, 95% CI -0.28 to 0.20; 4 trials, 163 participants; low-certainty evidence). There was probably little or no effect of the vegan dietary intervention on LDL (MD -0.05 mmol/L, 95% CI -0.21 to 0.11; 4 trials, 244 participants) or HDL cholesterol levels (MD -0.01 mmol/L, 95% CI -0.08 to 0.05; 5 trials, 256 participants) or triglycerides (MD 0.21 mmol/L, 95% CI -0.07 to 0.49; 5 trials, 256 participants) compared to other dietary interventions (moderate-certainty evidence). We are very uncertain about any effect of the vegan dietary intervention on systolic blood pressure (MD 0.02 mmHg, 95% CI -3.59 to 3.62) or diastolic blood pressure (MD 0.63 mmHg, 95% CI -1.54 to 2.80; 5 trials, 247 participants (very low-certainty evidence)). Only one trial (63 participants) contributed to comparison 3, where there was a lack of evidence for an effect of the vegan dietary intervention on lipid levels or blood pressure compared to other dietary interventions (low- or very low-certainty evidence). Four trials reported on adverse events, which were absent or minor.
AUTHORS' CONCLUSIONS
Studies were generally small with few participants contributing to each comparison group. None of the included studies report on CVD clinical events. There is currently insufficient information to draw conclusions about the effects of vegan dietary interventions on CVD risk factors. The eight ongoing studies identified will add to the evidence base, with all eight reporting on primary prevention. There is a paucity of evidence for secondary prevention.
Topics: Adult; Bias; Blood Pressure; Cardiovascular Diseases; Cholesterol; Diet, Vegan; Female; Humans; Male; Middle Aged; Primary Prevention; Randomized Controlled Trials as Topic; Recurrence; Secondary Prevention; Triglycerides
PubMed: 33629376
DOI: 10.1002/14651858.CD013501.pub2 -
Clinical Nutrition (Edinburgh, Scotland) May 2021Vegan diets, where animal- and all their by-products are excluded from the diet, have gained popularity, especially in the last decade. However, the evaluation of this...
BACKGROUND
Vegan diets, where animal- and all their by-products are excluded from the diet, have gained popularity, especially in the last decade. However, the evaluation of this type of diet has not been well addressed in the scientific literature. This study aimed to investigate the adequacy of vegan diets in European populations and of their macro- and micronutrient intakes compared to World Health Organization recommendations.
METHODS
A systematic search in PubMed, Web of Science, IBSS, Cochrane library and Google Scholar was conducted and 48 studies (12 cohorts and 36 cross-sectional) were included.
RESULTS
Regarding macronutrients, vegan diets are lower in protein intake compared with all other diet types. Veganism is also associated with low intake of vitamins B, Niacin (B), B, D, iodine, zinc, calcium, potassium, selenium. Vitamin B intake among vegans is significantly lower (0.24-0.49 μg, recommendations are 2.4 μg) and calcium intake in the majority of vegans was below recommendations (750 mg/d). No significant differences in fat intake were observed. Vegan diets are not related to deficiencies in vitamins A, B, Β, C, E, iron, phosphorus, magnesium, copper and folate and have a low glycemic load.
CONCLUSIONS
Following a vegan diet may result in deficiencies in micronutrients (vitamin B, zinc, calcium and selenium) which should not be disregarded. However, low micro- and macronutrient intakes are not always associated with health impairments. Individuals who consume a vegan diet should be aware of the risk of potential dietary deficiencies.
Topics: Adolescent; Adult; Aged; Diet, Vegan; Europe; Female; Humans; Male; Middle Aged; Nutrients; Nutritive Value; Vitamins; Young Adult
PubMed: 33341313
DOI: 10.1016/j.clnu.2020.11.035 -
Scientific Reports Dec 2020Plant-based diets like vegetarian or vegan diets might influence circulating levels of inflammatory biomarkers, thereby reducing the risk of chronic diseases. This... (Comparative Study)
Comparative Study Meta-Analysis
Plant-based diets like vegetarian or vegan diets might influence circulating levels of inflammatory biomarkers, thereby reducing the risk of chronic diseases. This systematic review and meta-analysis aimed to investigate the associations of veganism and vegetarianism with circulating inflammatory biomarkers in comparison to omnivores. Literature search was conducted in Pubmed and EMBASE until April 2020 and mean differences of biomarkers were assessed for: C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-18 (IL-18), interleukin-1 receptor antagonist (IL-1 RA), tumor necrosis factor-alpha (TNF-ɑ), E-selectin, intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein-1 (MCP-1), adiponectin, omentin-1 and resistin. Of initially identified 1073 publications, 21 cross-sectional studies met the inclusion criteria and were included in the systematic review and meta-analysis. Vegan diet was associated with lower levels of CRP compared to omnivores [mean difference - 0.54 mg/l, 95%-CI: - 0.79 to - 0.28, p < 0.0001]. This association was less pronounced in vegetarians [mean difference - 0.25 mg/l, 95%-CI: - 0.49 to 0.00, p = 0.05]. In patients with impaired kidney function, the association between vegetarian nutrition and CRP was much stronger with - 3.91 mg/l (95%-CI: - 5.23 to - 2.60; p < 0.0001). No substantial effects were observed for all other inflammatory biomarkers. Despite strong associations between CRP and a vegan or vegetarian diet were seen, further research is needed, as most inflammatory biomarkers were investigated only in single studies so far.
Topics: Biomarkers; C-Reactive Protein; Chronic Disease; Diet, Vegan; Diet, Vegetarian; Inflammation; Inflammation Mediators; Interleukin 1 Receptor Antagonist Protein; Interleukin-18; Interleukin-6
PubMed: 33303765
DOI: 10.1038/s41598-020-78426-8 -
Journal of Hypertension Jan 2021The consumption of strict vegetarian diets with no animal products is associated with low blood pressure (BP). It is not clear whether less strict plant-based diets... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The consumption of strict vegetarian diets with no animal products is associated with low blood pressure (BP). It is not clear whether less strict plant-based diets (PBDs) containing some animal products exert a similar effect. The main objective of this meta-analysis was to assess whether PBDs reduce BP in controlled clinical trials.
METHODS
We searched Cumulative Index to Nursing and Allied Health Literature, Medline, Embase, and Web of Science to identify controlled clinical trials investigating the effect of PBDs on BP. Standardized mean differences in BP and 95% confidence intervals were pooled using a random effects model. Risk of bias, sensitivity, heterogeneity, and publication bias were assessed.
RESULTS
Of the 790 studies identified, 41 clinical trials met the inclusion criteria (8416 participants of mean age 49.2 years). In the pooled analysis, PBDs were associated with lower SBP [Dietary Approach to Stop Hypertension -5.53 mmHg (95% confidence intervals -7.95,-3.12), Mediterranean -0.95 mmHg (-1.70,-0.20), Vegan -1.30 mmHg (-3.90,1.29), Lacto-ovo vegetarian -5.47 mmHg (-7.60,-3.34), Nordic -4.47 mmHg (-7.14,-1.81), high-fiber -0.65 mmHg (-1.83,0.53), high-fruit and vegetable -0.57 mmHg (-7.45,6.32)]. Similar effects were seen on DBP. There was no evidence of publication bias and some heterogeneity was detected. The certainty of the results is high for the lacto-ovo vegetarian and Dietary Approach to Stop Hypertension diets, moderate for the Nordic and Mediterranean diets, low for the vegan diet, and very low for the high-fruit and vegetable and high-fiber diets.
CONCLUSION
PBDs with limited animal products lower both SBP and DBP, across sex and BMI.
Topics: Blood Pressure; Diet; Fruit; Humans; Hypertension; Middle Aged; Vegetables
PubMed: 33275398
DOI: 10.1097/HJH.0000000000002604 -
Pain Medicine (Malden, Mass.) Mar 2021The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is limited research on how these adverse metabolic drivers may be associated with maladaptive neuroplasticity seen in chronic pain and whether this could be attenuated by a targeted nutritional approach. The aim of this study was to review the evidence for whole-food dietary interventions in chronic pain management.
METHOD
A structured search of eight databases was performed up to December 2019. Two independent reviewers screened studies and evaluated risk of bias by using the National Institutes of Health assessment tool for controlled or pre-post studies and the Joanna Briggs checklist for case reports. A meta-analysis was performed in Review Manager.
RESULTS
Forty-three studies reporting on 48 chronic pain groups receiving a whole-food dietary intervention were identified. These included elimination protocols (n = 11), vegetarian/vegan diets (n = 11), single-food changes (n = 11), calorie/macronutrient restriction (n = 8), an omega-3 focus (n = 5), and Mediterranean diets (n = 2). A visual analog scale was the most commonly reported pain outcome measure, with 17 groups reporting a clinically objective improvement (a two-point or 33% reduction on the visual analog scale). Twenty-seven studies reported significant improvement on secondary metabolic measures. Twenty-five groups were included in a meta-analysis that showed a significant finding for the effect of diet on pain reduction when grouped by diet type or chronic pain type.
CONCLUSION
There is an overall positive effect of whole-food diets on pain, with no single diet standing out in effectiveness. This suggests that commonalities among approaches (e.g., diet quality, nutrient density, weight loss) may all be involved in modulating pain physiology. Further research linking how diet can modulate physiology related to pain (such as inflammation, oxidative stress, and nervous system excitability) is required.
Topics: Chronic Pain; Diet; Humans; United States
PubMed: 33202007
DOI: 10.1093/pm/pnaa378