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This field study set out to test whether consumers' history of making decisions in a particular choice context moderated the effectiveness of a nudge intervention to reduce meat consumption. In a Danish hospital canteen that served both staff members and visitors, a combination of nudges (Chef's recommendation sticker + prominent positioning) was implemented to promote vegetarian sandwiches. The sales of these sandwiches increased from 16.45% during the baseline period to 25.16% during the nudge intervention period. Most notably, this increase was caused by the visitors, who had weak location-bound preferences. Hospital staff members (who had strong location-bound preferences) were unaffected by the nudge in their choice. This is an important finding because the two consumer groups did not differ on their person-bound preferences for meat. It seems that behaviour change is best predicted by location-bound preferences, whereas the behaviour itself is best predicted by person-bound preferences. These findings can help organizations in estimating whether a nudge intervention has enough potential for behaviour change, or whether more directive policies are required. [ABSTRACT FROM AUTHOR]

Purpose: Metabolic health phenotypes exist across the body mass index spectrum. Diet may be an important modifiable risk factor, yet limited research exists on dietary patterns in this context. We investigated associations between dietary patterns, reflecting dietary quality, healthfulness and inflammatory potential, and metabolic health phenotypes in adults living with and without obesity. Methods: This cross-sectional study included 2,040 middle- to older-aged men and women randomly selected from a large primary care centre. The Dietary Approaches to Stop Hypertension score, Healthy Eating Index, Dietary Inflammatory Index, overall, healthful and unhealthful plant-based dietary indices and Nutri-Score were derived from validated food frequency questionnaires. Descriptive and logistic regression analyses were used to examine diet score relationships with metabolic health phenotypes (Metabolically Healthy/Unhealthy Obese (MHO/MUO) and Non-Obese (MHNO/MUNO)), defined using three separate metabolic health definitions, each capturing different aspects of metabolic health. Results: In fully adjusted models, higher unhealthful plant-based dietary scores were associated with a lower likelihood of MHO (OR = 0.96, 95% CI: 0.93–1.00, p = 0.038) and MHNO (OR = 0.97, 95% CI: 0.95–0.99, p = 0.006). Higher Nutri-Score values were associated with an increased likelihood of MHNO (OR = 1.06, 95% CI: 1.01–1.13, p = 0.033). Conclusion: These findings provide evidence that more unhealthful plant-based diets may be linked with unfavourable metabolic health status, irrespective of BMI. [ABSTRACT FROM AUTHOR]

The American College of Lifestyle Medicine recommends eating a predominantly plant-based diet with a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts and seeds. At any level, adoption of a plant-based diet can improve one's health through a variety of mechanisms. Increasing intake of plant-based foods often results in increases in fiber intake, decreases in saturated fat intake, and increased intake of essential vitamins and minerals, among other healthful benefits. Despite such potential benefits, many individuals are reluctant or resistant to change their usual dietary behaviors or unable to sustain diet changes over time. This is largely because an individual's decision to adopt a plant-based diet is influenced by a diverse array of motivating factors, priorities, and/or misconceptions about nutrient adequacy of plant-based diets. Here, we discuss key points from a session at the American College of Lifestyle Medicine's annual conference LM2023. Specifically, we review common preconceptions about plant-based diets, provide guidance on removing the barriers to adopting and adhering to plant-based diets, and highlight key literature findings supporting the health benefits of plant-based diets. Last, we discuss how plant-based diets are increasingly being implemented within health care and clinical practice to support Food is/as Medicine approaches. [ABSTRACT FROM AUTHOR]

The process of urban development and the migration of rural inhabitants to cities resulted in the loss of direct contact with the production of food of animal origin among the non-agricultural population, who associate its origin with the place of purchase. At the same time, the loosening of social bonds typical of city man (Homo civitas), reduced fertility and, consequently, unmet social needs, resulted in an increase in the number of kept companion animals that fulfill people's instinctive need for socialization. In many cases, dogs and cats have been given the status of family members. This shortening of the distance between humans and animals led to the humanization of animals and popularization of veganism and vegetarianism. [ABSTRACT FROM AUTHOR]

Background: Given the growing popularity of plant‐based diets, this study investigated the dietary habits and self‐reported health outcomes of health‐conscious adults consuming plant‐based diets. Methods: A cross‐sectional online survey (n = 315) was distributed to members of Plant‐Based Health Professionals UK, a community interest company. Dietary intake was assessed through a food frequency questionnaire. Data were summarised descriptively. Dietary habits among respondents following a whole food plant‐based (WFPB) and vegan diet were compared using hypothesis tests. Results: Respondents reported following a WFPB (61%), vegan (28%) and semi plant‐based (11%) diet. Median time on current dietary pattern was 5 years. Daily or more frequent consumption was reported for the following foods: fruits 77%, berries 51%, green vegetables 48%, cruciferous vegetables 45%, other vegetables 64%, beans/legumes 41%, whole grains 62%, nuts and all seeds 63%. Consumption of ultra‐processed foods and plant‐based meat alternatives was low. About 93% of those on a WFPB or vegan diet supplemented with vitamin B12 and 61% with vitamin D. The median body mass index was 22.4 kg/m2. Fifty per cent of participants reported weight loss after adopting a plant‐based diet, with a median loss of 6.4 kg. Thirty‐five per cent reported reversing or improving an underlying health condition, and 15% were able to stop or reduce prescribed medication use as a result of dietary changes. Conclusions: This study suggests that a well‐planned plant‐based diet is achievable and sustainable in a community setting and can be associated with health benefits. How to best encourage such sustainable diets among the broad population requires further research. Key points: Dietary intakes were consistent with a high‐quality diet, with a variety of whole plant foods consumed and minimal ultraprocessed foods, refined grains, sugar‐sweetened beverages and meat alternatives.Whole food plant‐based (WFPB) participants followed, on average, healthier diets than vegan participants and engaged in more physical activity.In this plant‐based population, there were indicators of favourable health outcomes such as low body mass index (BMI) and low levels of common chronic conditions.Participants reported improvements in a range of health conditions and a reduction in medication as a result of adopting plant‐based diets, with some requiring further research.This study suggests that a well‐planned plant‐based diet is achievable and sustainable in a community setting and can be associated with health benefits. [ABSTRACT FROM AUTHOR]

Introduction: Vegetarianism is an eating pattern centred on plant-based food. It encompasses many diets that differ in terms of whether they contain goods originating from animals, like milk and eggs. Nowadays, vegetarianism is increasing in popularity in developed nations, particularly in Europe. Individuals choose vegetarian diets for reasons related to health, ethics, or ecology. The rising popularity of vegetarian diets is not limited to adults but is also increasing among children. This trend can be linked to both parental choices and the personal decisions of adolescents. Aim of the study: Vegetarian diets are generally considered to be beneficial for health. However, there are concerns over the ability to meet the dietary requirements necessary during infancy, youth, and adolescence on a vegetarian diet. Therefore, the primary aim of this systematic review is to answer questions about the efficacy of a plant-based diet in meeting the nutritional requirements of children and how to avoid the risk of nutritional deficiencies among vegetarian children. Material and methods: This article provides an overview of the current literature about the vegetarian diet in children. The information has been collected from a comprehensive search of electronic databases, scientific journals, and statement papers published by nutrition and paediatric organisations. Results: Following a vegetarian diet can be a beneficial decision for all children, assuming that it is properly organised and well balanced. It is important to be aware of the higher risk of deficiency in plant-based diet compared to an omnivorous. The majority of paediatric and nutrition organisations do not recommend more strict diets for children, such as a vegan diet, which fully excludes not only meat but all animal products. While it is possible to plan a vegan diet that meets children's requirements for nutrients, it is challenging, and mistakes might result in significant and long-term health consequences. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is a metabolic chronic disease in which insulin resistance and insufficient insulin production lead to elevated blood glucose levels. The prevalence of T2D is growing worldwide, mainly due to obesity and the adoption of Western diets. Replacing animal foods with healthy plant foods is associated with a lower risk of T2D in prospective studies. In randomized controlled trials, the consumption of healthy plant foods in place of animal foods led to cardiometabolic improvements in patients with T2D or who were at high risk of the disease. Dietary patterns that limit or exclude animal foods and focus on healthy plant foods (eg, fruits, vegetables, whole grains, nuts, legumes), known as healthy, plant-based diets, are consistently associated with a lower risk of T2D in cohort studies. The aim of this review is to examine the differential effects of plant foods and animal foods on T2D risk and to describe the existing literature about the role of healthy, plant-based diets, particularly healthy vegan diets, in T2D prevention and management. The evidence from cohort studies and randomized controlled trials will be reported, in addition to the potential biological mechanisms that seem to be involved. [ABSTRACT FROM AUTHOR]

The Complete Health Improvement Program (CHIP) is an intensive therapeutic lifestyle modification program (ITLMP) with well-documented success in decreasing risk factors for cardiovascular disease (CVD). Plant-based diets and physical activity are components of the program that contribute to these improvements. Yet, there are few studies on how ITLMPs affect risk factors specifically for the geriatric population. The goal of this study was to examine results of CHIP participants with a focus on the older (greater than 65 years) population in Athens, Ohio. Retrospective data from 2011 to 2017 were analyzed for 26 CHIP classes. Recorded variables included body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), blood glucose (BG), and exercise level. Among geriatric participants, significant changes were found in BMI, BP, TC, LDL, HDL, BG, and exercise level (P <.001). As compared to the younger population, changes in variables were equivalent in the geriatric population in all variables (P >.05). These improvements in CVD risk factors among the elderly support the hypothesis that CHIP should be considered for CVD prevention and treatment in the geriatric population. [ABSTRACT FROM AUTHOR]

Purpose: The potential benefits of vegetarian diets in reducing cognitive impairment have garnered attention due to existing mixed results; hence, our study aims to examine the impact of vegetarianism on cognitive function and neuropsychological status among urban community-dwelling adults from Telangana. Methods: The dietary patterns were self-reported and dietary data collected using a Food Frequency Questionnaire while cognitive function was assessed using Mini-Mental State Examination (MMSE) and depression, anxiety, and stress (DASS-21) questionnaire for psychological measures. Adults (N = 304) aged 40 years and above, who followed either a vegetarian or non-vegetarian diet for at least 6 months prior to data collection, scored MMSE ≥ 19 indicating mild cognitive impairment, and were recruited using convenience sampling. Results: Among the participants, vegetarians (n = 155) exhibited significantly better mood states compared to non-vegetarians (n = 149), as indicated by lower scores on the DASS subscales for depression (10.0 ± 0.06 vs. 17.0 ± 0.07, p = < 0.001), anxiety (4.0 ± 0.05 vs. 6.0 ± 0.07, p = 0.005), and stress (8.0 ± 0.02 vs. 10.0 ± 0.05, p = 0.007). Vegetarians also demonstrated superior cognitive functioning compared to non-vegetarians, as indicated by higher MMSE scores (26.0 ± 0.04 vs. 24.0 ± 0.03, p = < 0.001). MMSE scores were inversely correlated with depression, anxiety, and stress for vegetarians (ρ = − 0.371, p = 0.000; ρ = − 0.027, p = 0.734; and ρ = − 0.105, p = 0.914), respectively. Similar to the vegetarians group, MMSE scores were negatively correlated with depression (ρ = − 0.059), but the correlation is not significant. Conclusion: Vegetarianism exerted a positive influence on the cognitive and neuropsychological status of the investigated population. Nevertheless, additional research is required to comprehend the underlying mechanisms that elucidate the long-term effects of vegetarianism and plant-based nutritional interventions on brain health. [ABSTRACT FROM AUTHOR]

With a significant portion of the population adopting veganism and conflicting views among nutrition professionals regarding the necessity of vitamin B12 supplementation, this review aims to explore existing studies evaluating interventions through food supplementation. It focuses on the impact of vitamin B12 deficiency across different demographics. The present study seeks to understand how research has addressed the relationship between the rise in veganism and vitamin B12 deficiency over the past decade. A scoping review was conducted following the PRISMA flow diagram. Studies from 2010 to 2023 were identified using Boolean operators and key terms in electronic databases such as PubMed/MEDLINE, Web of Science, and EBSCO (Library, Information Science & Technology Abstracts, and Academic Search Complete). Out of 217 articles identified, 70 studies were included. The topical analysis categorized the studies into three groups: those associating vitamin B12 deficiency with diseases (n = 14), those analyzing the dietary habits of vegetarian individuals (vegan or not) without a specific focus on vitamin B12 (n = 49), and those addressing food guides and nutrition institution positions (n = 7). The authors concluded that vitamin B12 deficiency is prevalent among vegans due to limited consumption of animal products. For vegetarians, supplementation is an efficient means of treating and preventing deficiency; a daily dose of 50 to 100 micrograms is advised. There are still significant gaps in the research, nevertheless, such as the absence of randomized controlled trials evaluating various forms or dosages of vitamin B12 among vegetarians and the requirement for more information and awareness of the vitamin's significance in vegan diets. [ABSTRACT FROM AUTHOR]

Background Substantial evidence supports the inverse association between adherence to healthy dietary patterns and frailty risk. However, the role of plant-based diets, particularly their quality, is poorly known. Objective To examine the association of two plant-based diets with incidence of physical frailty in middle-aged and older adults. Design Prospective cohort. Setting United Kingdom Subjects 24,996 individuals aged 40–70 years, followed from 2009–12 to 2019–22. Methods Based on at least two 24-h diet assessments, we built two diet indices: (i) the healthful Plant-based Diet Index (hPDI) and (ii) the unhealthful Plant-based Diet Index (uPDI). Incident frailty was defined as developing ≥3 out of 5 of the Fried criteria. We used Cox models to estimate relative risks (RR), and their 95% confidence interval (CI), of incident frailty adjusted for the main potential confounders. Results After a median follow-up of 6.72 years, 428 cases of frailty were ascertained. The RR (95% CI) of frailty was 0.62 (0.48–0.80) for the highest versus lowest tertile of the hPDI and 1.61 (1.26–2.05) for the uPDI. The consumption of healthy plant foods was associated with lower frailty risk (RR per serving 0.93 (0.90–0.96)). The hPDI was directly, and the uPDI inversely, associated with higher risk of low physical activity, slow walking speed and weak hand grip, and the uPDI with higher risk of exhaustion. Conclusions In British middle-age and older adults, greater adherence to the hPDI was associated with lower risk of frailty, whereas greater adherence to the uPDI was associated with higher risk. [ABSTRACT FROM AUTHOR]

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IntroductionThe association between a plant-based diet and weight loss and atherosclerotic cardiovascular disease (ASCVD) has not been fully elucidated. We performed a pooled analysis and Mendelian randomization (MR) analysis to investigate this question.MethodsWe searched for randomized controlled trials on the effects of a plant-based diet on weight loss compared with a non-plant-based diet. In addition, a two-sample MR study was conducted. IVs were obtained from the genome-wide association studies (GWAS) on the exposures, and we obtained summary statistics on the outcomes. The inverse-variance weighted (IVW) method was used as the main analysis and other MR methods were performed as supplementary analyses.ResultsIndividuals on the plant-based diet lost more weight than the non-plant-based diet group (WMD −0.96 kg; 95% CI: −1.32 to −0.60). Population conditions and energy restriction were identified as the study-level factors that influenced the pooling results in the subgroup analyses. Increased consumption of raw vegetables was significantly associated with lower BMI (IVW, β −0.35, 95% CI: −0.62 to −0.08, p = 0.012) and lower risk of obesity (IVW, OR 0.11, 95% CI: 0.01 to 0.99, p = 0.048), coronary heart disease (IVW, OR 0.44, 95% CI: 0.21 to 0.92, p = 0.029) and myocardial infarction (IVW, OR 0.39,95% CI: 0.15 to 0.98, p = 0.045) and a higher HDL-C (IVW, β 0.47, 95% CI: 0.24 to 0.70, p = 4×10−5).DiscussionThe present findings suggest that raw vegetable intake is beneficial for weight loss and prevention of ASCVD.

This editorial explores the topic of alternative protein sources for sustainable and healthy nutrition. It acknowledges the challenges faced by the global food supply in providing adequate nutrition while minimizing harm to the planet. Alternative proteins, including those from insects, cultured meat, and plant-based alternatives, are being considered as more sustainable options. However, their environmental impact and animal welfare implications are still being debated. Additionally, alternative proteins may offer health benefits but may also have lower levels of certain nutrients. The adoption of alternative proteins requires consideration of factors such as consumer acceptance and technological advancements. The article also highlights the difficulties faced by rural and marginalized communities in accessing basic foods like lentils or tofu, and the affordability of alternative proteins is identified as a major challenge. The acceptance of alternative proteins varies among different populations, with evidence suggesting that consumers in China, Japan, and Europe are more willing to embrace these foods compared to consumers in the US. Factors such as healthiness, taste, environmental attributes, and individual dietary preferences influence acceptance. Efforts to make alternative proteins more similar to traditional meat products could facilitate their adoption among diverse consumer groups. [Extracted from the article]

Plant-based diets have emerged as athletic performance enhancers for various types of exercise. Therefore, the present study evaluated the effectiveness of plant-based diets on aerobic and strength/power performances, as well as on BMI of physically active individuals. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science and SPORTDiscus, was performed. On the basis of the search and inclusion criteria, four and six studies evaluating the effects of plant-based diets on aerobic and strength/power performances in humans were, respectively, included in the systematic review and meta-analysis. Plant-based diets had a moderate but positive effect on aerobic performance (0·55; 95 % CI 0·29, 0·81) and no effect on strength/power performance (–0·30; 95 % CI −0·67, 0·07). The altogether analyses of both aerobic and strength/power exercises revealed that athletic performance was unchanged (0·01; 95 % CI −0·21, 0·22) in athletes who adopted plant-based diets. However, a small negative effect on BMI (–0·27; 95 % CI −0·40, –0·15) was induced by these diets. The results indicate that plant-based diets have the potential to exclusively assist aerobic performance. On the other hand, these diets do not jeopardise strength/power performance. Overall, the predicted effects of plant-based diets on physical performance are impactless, even though the BMI of their adherents is reduced. [ABSTRACT FROM AUTHOR]

Purpose: Diet-related diseases are advancing as the leading cause of death globally. As self-reporting of diet by patients can be associated with errors, stable isotopes of human tissues can be used to diagnose diseases, understand physiology, and detect change in diet. This study investigates the effect of type and amount of food on the nitrogen and carbon concentration (Nconc and Cconc) and isotopic composition (δ15N and δ13C) in human scalp hair and fingernails. Methods: A total of 100 residents participated in the study whereas only 74 individuals provided complete diet history. Sixty-six food items majorly available to them were also collected. The Nconc, Cconc, δ15N and δ13C values of human hair, nails and food items were determined. Results: The Nconc, Cconc, δ15N and δ13C values between plant-sourced and animal-sourced food items, as well as human hair and nail tissue were significantly different (p < 0.05). The δ15N value of human tissues was distinct between lacto-vegetarians and omnivores by 0.9‰. The δ15N and δ13C values of human tissues increased by 0.4–0.5‰ with every 5% increase in the consumption of animal protein. Conclusions: The study helps to demarcate lacto-vegetarians from omnivores, and estimate the percentage of animal protein in diet based on the dual isotope values of human tissues. It also acts as a reference to determine isotopic composition of hair tissue provided the isotope value of nail tissue is known and vice versa. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence suggests that dietary factors may affect sleep, but the associations between dietary patterns and insomnia risk have been poorly explored. The aim of this study was to investigate if plant-based diets are associated with reduced insomnia risks in a cohort study design. Methods: Tzu Chi Health Study participants (N = 5821) recruited from 2007 to 2009 without insomnia were followed until 2018. A traditional classification method (vegetarians vs. non-vegetarians) and a healthful plant-based index (hPDI) were used to define adherence to plant-based dietary patterns. Incident cases of insomnia were ascertained by linking with the National Health Insurance Research Database (NHIRD). Associations between plant-based diets and insomnia were estimated using Cox proportional hazard models. Results: A total of 464 incident cases of insomnia were identified in the 55,562 person-years of follow up. Insomnia risk was lower in vegetarians when compared to non-vegetarians, hazard ratios (HR) 0.47 (95% CI: 0.27, 0.81) and 0.71 (95% CI: 0.55, 0.91) for males and females respectively. Male participants with the highest hPDI were associated with a significant lower risk of insomnia (HR 0.50 [95% CI: 0.30, 0.85]) when compared to those in the lowest quintile. No association between adherence to hPDI and insomnia in female participants was observed. Conclusions: Our study showed that vegetarians are associated with a lower risk of insomnia, but there may be sex-specific associations between adherence to hPDI and insomnia risk. These favorable associations are important when considering plant-based diets for their potential additional sleep benefits. [ABSTRACT FROM AUTHOR]

This secondary analysis assessed the association of a plant-based index (PDI), healthful (hPDI), and unhealthful (uPDI), with weight loss in overweight adults. Participants (n = 244) were randomly assigned to a vegan (n = 122) or control group (n = 122) for 16 weeks. Three-day dietary records were analyzed and PDI indices were calculated. A repeated measure ANOVA was used for statistical analysis. All three scores increased in the vegan group; the effect sizes were: PDI +10.6 (95% CI +8.6 to +12.6; p < 0.001); hPDI +10.9 (95% CI +8.4 to +13.4; p < 0.001); and uPDI +5.4 (95% CI +3.4 to +7.4; p < 0.001). The change in all three scores significantly correlated with change in body weight: PDI (r = −0.40; p < 0.001); hPDI (r = −0.37; p < 0.001); and uPDI (r = −0.21; p = 0.002). These findings suggest that minimizing the consumption of animal products and oil may be an effective weight loss strategy in overweight adults. ClinicalTrials.gov number, NCT02939638. [ABSTRACT FROM AUTHOR]

BACKGROUND: In recent years, plant-based diets and their effects on health have gained attention. This diet has become a preferred dietary style for managing obesity. Weight gain is influenced by various factors, such as low body image perception and obesity prejudice. OBJECTIVE: The purpose of the study is to evaluate the prevalence of plant-based diets among female students and their associations with obesity prejudice and body self-perception. METHODS: The research was conducted with 450 female university students. The anthropometric measurements were obtained based on self-reporting. the GAMS-27 Obesity Prejudice Scale and the Multidimensional Body-Self Relationship Questionnaire (MBSRQ) were applied to evaluate obesity prejudice and body self-perception, respectively. RESULTS: The study found no significant differences in anthropometric measurements between omnivores and vegetarians (p > 0.05). However, 78.6% of the students showed some level of tendency toward prejudice or prejudice against obesity. There was no significant relationship between body weight, BMI, and obesity prejudice in both dietary groups (p > 0.05). Yet, vegetarians had significantly lower mean scores on the MBRSQ, indicating body image dissatisfaction (p < 0.05). CONCLUSIONS: While the anthropometric measurement and prejudice against obesity did not yield notable results, significantly lower scores on the MBSRQ indicated greater dissatisfaction with body image in vegetarians. [ABSTRACT FROM AUTHOR]

Prostate cancer (PCa) is a prevalent malignancy affecting men worldwide, and plant-based diets have been widely advocated for their health benefits. The aim of this study was to test the association between general, healthy, and unhealthy pro-vegetarian plant-based diets and PCa severity on 118 consecutive patients undergoing prostatectomy in a university hospital in Italy. Food frequency questionnaires were used to calculate scores for dietary patterns. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to test the associations. A general plant-based diet was not associated with cancer severity, while patients reporting a higher adherence to a healthy plant-based diet were less likely to have a more severe PCa (for medium/high vs. low-risk PCa, OR = 0.27, 95% CI: 0.08, 0.88; for high vs. medium/low-risk PCa, OR = 0.09, 95% CI: 0.02, 0.39). Patients resulting in higher adherence to an unhealthy plant-based diet were more likely to be diagnosed with more severe PCa (OR = 6.15, 95% CI: 1.70, 22.24). In conclusion, plant-based dietary patterns may have a different impact on PCa severity depending on the quality of the foods included. [ABSTRACT FROM AUTHOR]

Background: Tools for measuring adherence to sustainable healthy diets among children and adolescents are lacking. Objective: To advance methods for measuring adherence to sustainable healthy diets among children and adolescents by adapting an existing index, compare scores obtained using the original and adapted versions of the index in a sample of Chilean children, and describe the adapted index association with diet characteristics. Methods: The Planetary Health Diet Index (PHDI) was adapted to better reflect children's and adolescents' nutritional requirements. The adapted index (PHDI-C) comprises 16 components with a maximum score of 150 points. PHDI-C was piloted among a sample of 958 Chilean children (3–6 years) using dietary data collected in 2016 through single 24-h recalls. A decision tree and food disaggregation methodology were developed to guide the calculation of scores. Scores obtained using the original and adapted versions of the index were compared. Linear regression models adjusted by child's gender and age were fitted to explore associations between total PHDI-C score, dietary recall characteristics and nutritional composition of children's diets. Results: PHDI accounted for 75.7% of children's total caloric intake, whereas PHDI-C accounted for 99.6%. PHDI & PHCI-C scores were low among this sample of children; however, mean total score was lower when using PHDI compared to PHDI-C [40.7(12.1) vs 50.1(14.6)]. Children's scores were very low for nuts & peanuts, legumes, dark green vegetables, whole cereals, tubers & potatoes, and added sugars components across both indices, but were higher for dairy products and eggs & white meats components when using the PHDI-C due to adjustments made to ensure nutritional adequacy. Mean total PHDI-C score was significantly lower on weekends and special occasions, and significantly higher when children reported having a special diet (e.g., vegetarian). Total PHDI-C score was negatively associated with total sugars, saturated fats, trans fats, and animal-based protein intake, and positively associated with total protein, plant-based protein, total carbohydrates, and total fibre intake. Conclusions: This study provides a replicable method for measuring adherence to sustainable healthy diets among children and adolescents that can be used to monitor trends and measure the effectiveness of actions targeting improving children's diets. [ABSTRACT FROM AUTHOR]

Purpose: There is increasing interest in the health benefits of plant-based diets (PBDs). Evidence reports favourable associations with inflammatory profiles and reduced cardiovascular disease risk. However, limited studies have examined relationships between PBD indices (PDIs) and inflammatory biomarkers. We explored overall PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI) associations with inflammatory biomarker profiles. Methods: This cross-sectional analysis included 1986 middle- to older-aged adults from the Mitchelstown Cohort. PDI scores were calculated using validated food frequency questionnaires. PDI score associations with inflammatory biomarkers were assessed via linear regression analysis, with adjustment for potential confounders. Results: Comparison of quintiles (Q5 vs Q1) revealed lower concentrations of C-reactive protein (CRP), interleukin 6 (IL-6), white blood cells (WBCs), neutrophils and monocytes, and the leptin-to-adiponectin ratio (PDI and hPDI P < 0.05); lower leptin (PDI, P < 0.05), and complement component 3 (C3), tumour necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1, lymphocytes and eosinophils (hPDI, P < 0.05); and higher concentrations of adiponectin (PDI and hPDI, P < 0.05). Conversely, higher concentrations of C3, CRP, IL-6, TNF-α, resistin, WBCs, neutrophils, lymphocytes, monocytes and eosinophils, and the neutrophil-to-lymphocyte ratio, and lower adiponectin concentrations were observed comparing uPDI quintiles (P < 0.05). In fully adjusted regression models, higher hPDI scores were associated with lower concentrations of C3, TNF-α, WBCs, neutrophils and monocytes (all P < 0.01). Higher uPDI scores were associated with higher C3 and TNF-α concentrations (all P < 0.01). Conclusion: This study provides evidence that a more healthful PBD is associated with a more favourable inflammatory profile and that a more unhealthful PBD is associated with the reverse. [ABSTRACT FROM AUTHOR]

Purpose: Populations following a plant-based diet may be at particular risk of thyroid dysfunction due to low iodine and selenium intakes. The main purpose was to assess thyroid function and urinary concentration of iodine, selenium, and arsenic, in subjects following a vegan, lacto-ovo vegetarian, or pescatarian diet. Methods: In Norway, a country without mandatory dietary iodine fortification, 205 adults, following vegan (n = 115), lacto-ovo vegetarian (n = 55) and pescatarian diet (n = 35) were included. Thyroglobulin (Tg), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and serum anti-TPO (S-anti-TPO) were measured in a venous blood sample and concentrations of iodine (UIC), creatinine (UCC), selenium, and arsenic were measured from single spot urine samples. Results: Subclinical hypothyroidism (TSH > 4.0 mU/L) was observed in 3% of subjects. The overall median (p25, p75) Tg was 17 (9, 30) µg/L and vegans had higher Tg compared to pescatarians. Vegans not consuming iodine-containing supplements (n = 43) had higher Tg, than supplement users (n = 72), 27 (11, 44) vs. 16 (8, 25) µg/L and higher fT4, 16 (15, 17) vs. 15 (14, 17) pmol/L, respectively. The overall median UIC was 57 (28, 130) µg/L, all dietary groups had median UIC below WHO thresholds. Median urinary selenium and arsenic concentration was 13 (6, 22) and 3 (2, 8) µg/L, respectively. Conclusion: The prevalence of subclinical hypothyroidism was low and fT4 and fT3 were within the normal range for all dietary groups. Vegans had significantly increased Tg compared to pescatarians. [ABSTRACT FROM AUTHOR]

Background: Immediate action is needed to stabilise the climate. Dietitians require knowledge of how the therapeutic diets they prescribe may contribute to climate change. No previous research has quantified the climate footprint of therapeutic diets. This study sought to quantify and compare the climate footprint of two types of therapeutic diets for people with chronic kidney disease (CKD) with two reference diets. Methods: A usual diet for an individual with CKD and a novel plant‐based diet for CKD were compared with the current Australian diet and the Australian‐adapted EAT Lancet Planetary Health Diet (PHD). The climate footprint of these diets was measured using the Global Warming Potential (GWP*) metric for a reference 71‐year‐old male. Results: No diets analysed were climate neutral, and therefore, all contribute to climate change. The novel plant‐based diet for CKD (1.20 kg carbon dioxide equivalents [CO2e] per day) produced 35% less CO2e than the usual renal diet for an individual with CKD (1.83 kg CO2e per day) and 50% less than the current Australian diet (2.38 kg CO2e per day). The Australian‐adapted EAT Lancet PHD (1.04 kg CO2e per day) produced the least amount of CO2e and 56% less than the current Australian diet. The largest contributors to the climate footprint of all four diets were foods from the meats and alternatives, dairy and alternatives and discretionary food groups. Conclusions: Dietetic advice to reduce the climate footprint of therapeutic diets for CKD should focus on discretionary foods and some animal‐based products. Future research is needed on other therapeutic diets. Key points/highlights: The climate footprint of a plant‐based diet was superior to the usual renal diet.Key drivers of emissions were animal‐based foods such as beef, dairy and discretionary foods such as processed meat products.All diets examined contribute to climate warming, including the Australian‐adapted EAT Lancet Planetary Health Diet. [ABSTRACT FROM AUTHOR]

Plant-based diets are growing in popularity worldwide due to the importance of reducing the population's ecological footprint as well as an emerging role in the prevention and treatment of chronic human diseases. In adults, plant-based diets have been shown to be beneficial for preventing and controlling conditions that are common in patients with chronic kidney disease (CKD), such as obesity, hypertension, type 2 diabetes, dyslipidemia, and metabolic acidosis. Emerging evidence suggests that the higher fiber content of plant-based diets may help to modulate production of uremic toxins through beneficial shifts in the gut microbiome. The effects of the plant-based diet on progression of CKD remain controversial, and there are no data to support this in children. However, knowledge that the bioavailability of potassium and phosphorus from plant-based foods is reduced has led to recent changes in international kidney-friendly diet recommendations for children with CKD. The new guidelines advise that high potassium fruits and vegetables should no longer be automatically excluded from the kidney-friendly diet. In fact, a plant-based diet can be safely implemented in children with CKD through building the diet around whole, high fiber foods, avoiding processed foods and using recommended cooking methods to control potassium. The health benefits of the plant-based diet compared to omnivorous diets in children with CKD need investigation. [ABSTRACT FROM AUTHOR]

With a significant portion of the population adopting veganism and conflicting views among nutrition professionals regarding the necessity of vitamin B12 supplementation, this review aims to explore existing studies evaluating interventions through food supplementation. It focuses on the impact of vitamin B12 deficiency across different demographics. The present study seeks to understand how research has addressed the relationship between the rise in veganism and vitamin B12 deficiency over the past decade. A scoping review was conducted following the PRISMA flow diagram. Studies from 2010 to 2023 were identified using Boolean operators and key terms in electronic databases such as PubMed/MEDLINE, Web of Science, and EBSCO (Library, Information Science & Technology Abstracts, and Academic Search Complete). Out of 217 articles identified, 70 studies were included. The topical analysis categorized the studies into three groups: those associating vitamin B12 deficiency with diseases (n = 14), those analyzing the dietary habits of vegetarian individuals (vegan or not) without a specific focus on vitamin B12 (n = 49), and those addressing food guides and nutrition institution positions (n = 7). The authors concluded that vitamin B12 deficiency is prevalent among vegans due to limited consumption of animal products. For vegetarians, supplementation is an efficient means of treating and preventing deficiency; a daily dose of 50 to 100 micrograms is advised. There are still significant gaps in the research, nevertheless, such as the absence of randomized controlled trials evaluating various forms or dosages of vitamin B12 among vegetarians and the requirement for more information and awareness of the vitamin’s significance in vegan diets.

Background: Dietary patterns play an important role in regulating serum uric acid levels in the body, but evidence for the association between different kinds of plant-based and animal-based dietary patterns and individual serum uric acid levels is scarce and inconsistent. Methods: We analyzed data from the sixth wave of the China Health and Nutrition Survey. The plant-based diet of 7,806 participants was determined using three consecutive 24-hour dietary recalls, and latent profile analysis was used to identify dietary patterns among participants. Serum uric acid levels were analyzed using the enzymatic colorimetric method. The association between intakes of different types of dietary pattern and individual serum uric acid levels was analyzed using linear regression analysis, after adjusting for confounding variables. Results: We identified three types of plant-based dietary patterns, namely, low tuber starches and vegetable plant-based diet (LTVP), high cereal, tuber starches and vegetable plant-based diet (HCTVP), and high legume and fruit plant-based diet (HLFP). We also identified three types of animal-based dietary patterns, namely, high milk and egg animal-based diet (HMiEA), low egg and fish animal-based diet, and high meat and fish animal-based diet (HMeFA). Significant coefficients for participant serum uric acid levels were observed for the HCTVP diet (β = −0.022, P = 0.031) and HMeFA diet (β = 0.061, P < 0.001). The median intake of foods in the HCTVP diet was as follows: cereals and cereal products, 444.83 g/d; tubers and starch products, 166.67 g/d; dried legumes and legume products, 8.33 g/d; vegetables and vegetable products, 333.33 g/d; and fruits and fruit products, 0 g/d. The median intake of foods in the HMeFA diet was as follows: meat and meat products, 73.33 g/d; poultry and poultry products, 0 g/d; milk and milk products, 0 g/d; eggs and egg products, 26.67 g/d; and fish, shellfish, and mollusks, 180.00 g/d. Conclusion: We showed that individual serum uric acid levels (1) might decrease under the plant-based HCTVP diet, (2) might increase under the animal-based HMeFA diet, (3) might not decrease under the plant-based HLFP diet, and (4) might not increase under the animal-based HMiEA diet. Further studies are needed to confirm these associations. [ABSTRACT FROM AUTHOR]

(1) Background: This paper aims to assess the existence of significant differences between two dietary regimes (omnivorous vs. semi-vegetarian) with reference to some oxidative stress markers (SOD, GPx, TRxR, GR, AGEs, and AOPPs) using non-parametric combination methodology based on a permutation test. (2) Methods: At the endocrinology unit of Messina University Hospital, two hundred subjects were asked to fill out a questionnaire about their dietary habits. None were under any pharmacological treatment. Using the NPC test, all comparisons were performed stratifying patients according to gender, age (≤40 or >40 years), BMI (normal weight vs. overweight), physical activity (sedentary vs. active lifestyle), TSH, FT4 levels in quartiles, and diagnosis of Hashimoto's thyroiditis. We evaluated differences in oxidative stress parameters in relation to two examined dietary regimes (omnivorous vs. semi-vegetarian). (3) Results: The antioxidant parameters GPx and TRxR were significantly lower in subjects with an omnivorous diet than in semi-vegetarians, particularly in females, both age groups, subjects with normal weight, those not affected by Hashimoto's thyroiditis, and both the sedentary and active lifestyle groups. Finally, the AGE and AOPP markers were significantly lower in semi-vegetarians. (4) Conclusion: Thanks to the NPC methodology, we can state that dietary patterns exert a significant influence on some oxidative stress parameters. [ABSTRACT FROM AUTHOR]

Purpose: While the benefits of adopting a more plant-based diet for sustainability and animal welfare are clear, its long-term health impacts, including the impact on cognitive ageing, are limited studied. Therefore, we investigated the associations between plant-based diet adherence and cognitive ageing. Methods: Data from a previous intervention study involving community-dwelling adults aged ≥ 65 years were analysed at baseline (n = 658) and after 2-year follow-up (n = 314). Global and domain-specific cognitive functioning were assessed at both timepoints. Overall, healthful and unhealthful plant-based dietary indices were calculated from a 190-item food frequency questionnaire. Multivariate-adjusted linear regression models were applied to test for associations. Results: After full-adjustment, higher overall adherence to a plant-based diet was not associated with global cognitive function (difference in Z-score, tertile 1 versus 3 [95% CI]: 0.04 [− 0.05, 0.13] p = 0.40) or cognitive change (− 0.04 [− 0.11, 0.04], p = 0.35). Similarly, healthful and unhealthful plant-based diet indices were not associated with cognitive functioning (respectively p = 0.48; p = 0.87) or change (respectively p = 0.21, p = 0.33). Interestingly, we observed fish consumption to influence the association between plant-based diet adherence and cognitive functioning (p-interaction = 0.01), with only individuals with a fish consumption of ≥ 0.93 portion/week benefitting from better overall plant-based diet adherence (β per 10-point increment [95% CI]: 0.12 [0.03, 0.21] p = 0.01). Conclusion: We did not demonstrate associations of a more plant-based diet with cognitive ageing. However, possibly such association exists in a subpopulation with higher fish intake. This would be in line with earlier observations that diets rich in plant foods and fish, such as the Mediterranean diet, may be beneficial for cognitive ageing. Trial registration: Registered at clinicaltrials.gov (NCT00696514) on June 12, 2008. [ABSTRACT FROM AUTHOR]

The topic of "alternative proteins," a field comprised of both plant-based animal product alternatives and the nascent field of cellular agriculture (eg, cultivated meat), has become a flashpoint for contemporary food system debate. This article introduces the "alternative protein ideological circle" as a framework for understanding the nature of this contestation, as well as the key stakeholder groups who animate the landscape. It argues that perspectives on alternative proteins coalesce around 2 primary ideological poles: (1) meat attachment or carnism, the extent to which people believe or do not believe that eating animals is a natural, normal, and necessary part of contemporary life; and (2) sociotechnical imaginaries, divided between techno-optimistic "wizards" and technoskeptical "prophets." From there, 4 key stakeholder groups emerge: (1) the "high-tech vegans" (techno-optimists with low levels of carnism); (2) the "ecomodernists" (technooptimists with high levels of carnism); (3) the "good foodies" (technoskeptics with low levels of carnism); and (4) the "carnivore traditionalists" (technoskeptics with high levels of carnism). The article offers illustrative examples of these groups, drawing from popularmedia and advocacy. It concludes with reflections on the implications of this framework for nutrition research and practice. [ABSTRACT FROM AUTHOR]

The aim of this term paper is to investigate the extent to which Covid-19 has influenced the gastronomy and food sector regarding fresh food counters and the to-go assortment in terms of vegetarian and vegan offerings. An extensive literature and internet research was conducted for this thesis. In addition, this included a study of vegan- and vegetarian-friendly food offerings in ten different randomly selected restaurants in the city of Trier, Germany. The results show that on average a good selection of vegetarian dishes (33.6%) and a small selection of vegan dishes (11.8%) can be found in the individual restaurants. The trend towards a plant-based diet has been evident for years but accelerated during the COVID-19 pandemic as society began to doubt the safety precautions of the meat industry and awareness of animal, environmental and health issues increased. This has led to many restaurants and food retailers expanding their range of vegetarian and vegan options to meet this demand. More and more vegan products can also be found in food retail, and the range of vegan alternative products in the to-go area or at fresh food counters for actual meat, sausage, cheese and fish products is expanding, as can be seen at pioneer REWE Group, for example. [ABSTRACT FROM AUTHOR]

Purpose: We studied to what extent plant-based meat substitutes could improve the nutritional adequacy and healthiness of dietary patterns, depending on their nutrient composition. Methods: From diets observed in French adults (INCA3, n = 1125), modeled diets were identified by allowing various dietary changes, between and within food categories, when two plant-based meat substitutes were made available: an average substitute (from 43 market substitutes) and a theoretical nutritionally designed substitute, fortified or not with zinc and iron at 30% or 50% of Nutrient Reference Values. Under each scenario, healthier but acceptable modeled diets were identified using multi-criteria optimization, by maximizing a health criteria related to Dietary Guidelines while minimizing deviation from the observed diets, under constraints for nutrient adequacy. Results: Without fortification, the average substitute was hardly introduced into modeled diets, whereas the optimized substitute was preferentially introduced, in large amounts, yet together with a moderate reduction of red meat (− 20%). The comparative advantages of the optimized substitute were its higher contribution to vitamins B6 and C, fiber and α-linolenic acid (ALA) intakes, and its lower contribution to sodium intake. When fortified with iron and zinc, substitutes were introduced in larger amounts into modeled diets, with much higher red meat reductions (down to − 90%). The optimized substitute continued to be preferred, leading to healthier modeled diets that deviated less from the observed. Conclusion: Plant-based meat substitutes can be levers for healthy diets only when well nutritionally designed with enough zinc and iron for a substantial red meat reduction. [ABSTRACT FROM AUTHOR]

Vegan dietary patterns are increasingly being adopted by endurance athletes, yet research examining the influence of this dietary pattern on exercise‐related physiology is limited. This pilot study, therefore, aimed to explore nutrient status, diet quality and cardiovascular and inflammatory responses in aerobically trained adult males following vegan and omnivorous dietary patterns during aerobic exercise. An incremental ramp running test was used to assess peak oxygen consumption (VO2peak) in males aged 18–55 years, engaging in >4 h training/week. Exercise testing was performed during walking and steady‐state running conditions (60% and 90% of VO2peak). Participants were grouped by dietary pattern type and were equivalent for age, training volume and VO2peak. When compared to the omnivorous group (n = 8, age 35.6 years, VO2peak 55.7 mL/kg/min), the vegan group (n = 12, age 33.4 years, VO2peak 56.4 m/kg/min) consumed more energy from carbohydrates (p = 0.007), and less energy from protein (p = 0.001) while exhibiting a higher overall diet quality score (p = 0.008). No differences in inflammatory biomarkers were observed before or after running. Total red blood cell count, haemoglobin and haematocrit levels were lower in the vegan dietary group. In summary, aerobically trained males, following a long‐term vegan diet, can tolerate a short bout of running broadly comparatively to their omnivore counterparts. More arduous endurance exercise conditions should be explored to further uncover potential outcomes of consuming a vegan dietary pattern and exercise‐related physiology. [ABSTRACT FROM AUTHOR]

"How do vegetarians compare with omnivores in their views of animal welfare?" In 2020, this simple question was made more timely by the COVID-19 pandemic. Here, in this pre-COVID survey in 2019; a standardized scale (Takooshian, 1988) was updated, for an analysis of 194 surveys, to compare the views of 33 vegetarians with 161 omnivores on four brief standardized scales: animal welfare (0-10 points, a = .58), animal research (0-10, a = .56), science (0-10, a = .65), and humans' uses of animals (0-22, a = .82). As expected, vegetarians are significantly more proanimal and antivivisection across all 25 of 25 comparisons. Future post-COVID research possibilities are discussed, to probe the likely future of plantbased diets and whether the COVID pandemic impacted these attitudes. [ABSTRACT FROM AUTHOR]

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Purpose: This paper aims to present an overview of the definitions of "plant-based and "vegetarian diets" adopted by different organizations worldwide, proposing new standard definitions and discussing the notion of vegetarianism as a restrictive dietary pattern. Methods: An extensive literature review on the different definitions of vegetarian and plant-based diets was conducted. Definitions of different international vegetarian and vegan organizations were also taken into account. Objective definitions for vegetarian and plant-based diets, as well as for their subcategories, were proposed. Other aspects related to how vegetarian diets are viewed and defined were also discussed. Results: We proposed that a vegetarian diet should be defined as "a dietary pattern that excludes meat, meat-derived foods, and, to different extents, other animal products". This definition would include, among others, ovolactovegetarian and vegan diets. The proposed definition for a plant-based diet was "a dietary pattern in which foods of animal origin are totally or mostly excluded". Other types of diets, such as flexitarian and pescetarian diets, could be considered plant-based. A vegetarian diet should not be considered restrictive. Instead, terms such as alternative or non-conventional could be used to define it and to distinguish it from the conventional diet adopted by most of the Western population. Conclusion: This paper was able to elaborate objective definitions of vegetarian and plant-based diets. Standardizing nomenclatures may reduce misinterpretation and confusion in this field of study. [ABSTRACT FROM AUTHOR]

Vitamin B12 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 B12 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 B12 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 B12 deficiency with increased risk to a range of neuro, vascular, immune, and inflammatory disorders. However, the current UK recommended nutrient intake for vitamin B12 does not adequately consider the vitamin B12 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 B12 deficits for those individuals choosing a plant-based diet and the health professionals advising them. [ABSTRACT FROM AUTHOR]

Vegetarianism improves human and planetary health in addition to animal welfare. Motivations for meat-reduced diets include health-related and ethical reasons, with the latter being the main driver for eschewing meat. However, evidence on vegetarian happiness is inconclusive and the results reported are mixed. This constitutes a challenge for policy aiming to encourage people to shift toward plant-based diets. In this research, we aim to provide some evidence on this question: to what extent is there a link between the different moral codes related to ideas of happiness and vegetarianism? To do so, we apply the happiness moral codes from the Conceptual Referent Theory, and assess vegetarianism from the perspective of the psychological aspect of vegetarian identity (flexitarian, pescatarian, lacto-ovo vegetarian, and vegan) and dietary behavior (vegetarian self-assessment scale). Analyzing a sample of university students in Spain, we discover that some happiness constructs (tranquility, fulfilment, and virtue) are positively related to vegetarianism while others are inversely related (enjoyment and stoicism). In terms of policy implications, we find that ethical grounds one holds on happiness in relation to vegetarianism may play a role in fostering or hindering plant-based lifestyles. [ABSTRACT FROM AUTHOR]

This commentary on a case suggests why health care organizations have responsibilities to serve food to their patients, guests, and employees that is ethically, nutritionally, culturally, and religiously appropriate. This article also investigates how inclusive, equitable, sustainable food services are key dimensions of health care organizations' civic and stewardship responsibilities to individuals and communities. [ABSTRACT FROM AUTHOR]