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Nutrients
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Vegetarian, Vegan Diets and Human Health
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Vegetarian, Vegan Diets and Human Health

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 October 2019) | Viewed by 367902

Special Issue Editors

Dr. Markus Keller

E-Mail Website
Guest Editor
Fachhochschule des Mittelstands (FHM) GmbH, University of Applied Sciences, Hohenstaufenring 62, 50674 Koln, Germany
Interests: vegan and vegetarian diets; sustainable nutrition
Dr. Kathryn E Bradbury

E-Mail Website
Guest Editor
National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland 1072, New Zealand
Interests: colorectal cancer; biomarkers; lipids; dietary assessment; nutritional epidemiology; vegetarian diets
Dr. Hana Kahleova

E-Mail Website
Guest Editor
Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave, NW, Suite 400, Washington, DC 20016, USA
Interests: diabetes, metabolism, plant-based nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The popularity of vegetarian and vegan diets is increasing. There are many reasons for people to choose to be vegetarian or vegan, including perceived health benefits, and concerns about animal welfare and the environmental impact of meat and animal source food production. Previous research has shown that as well as not eating meat, vegetarians and vegans tend to consume more fruits and vegetables, wholegrains, legumes, and nuts than meat-eaters. However, meat is a good source of amino acids and several micronutrients, and vegans particularly need to consume supplements or fortified foods to ensure adequate intake of vitamin B12. Vegetarians and vegans tend to have a lower body mass index and have a lower risk of diabetes, hypertension, ischaemic heart disease, and some cancers compared with meat-eaters, but there is little information about other non-communicable diseases. This Special Issue of Nutrients will address “Vegetarian, Vegan Diets and Human Health”. We welcome submissions of original research and review articles on dietary intakes and the nutritional status of vegetarians and vegans, and investigations of the association between vegetarian and vegan diets and body composition, nutrient status, and non-communicable diseases.

Prof. Dr. Markus Keller
Dr. Kathryn E Bradbury
Dr. Hana Kahleova
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vegetarian diets
  • Vegan diets
  • Nutrient status
  • Biomarkers
  • Non-communicable diseases
  • Body composition

Published Papers (18 papers)

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16 pages, 681 KiB  
Article
Vegetarian Diet during Pregnancy Is Not Associated with Poorer Cognitive Performance in Children at Age 6–7 Years
by Sarah R. Crozier, Keith M. Godfrey, Philip C. Calder, Sian M. Robinson, Hazel M. Inskip, Janis Baird, Catharine R. Gale, Cyrus Cooper, Charlene M. Sibbons, Helena L. Fisk and Graham C. Burdge
Nutrients 2019, 11(12), 3029; https://doi.org/10.3390/nu11123029 - 11 Dec 2019
Cited by 7 | Viewed by 7602
Abstract
Compared with omnivorous mothers, vegetarian mothers have lower intakes of some nutrients required for neurological development. However, there is a lack of information about the impact of vegetarianism during pregnancy on subsequent cognitive function in children. The aim of this study was to [...] Read more.
Compared with omnivorous mothers, vegetarian mothers have lower intakes of some nutrients required for neurological development. However, there is a lack of information about the impact of vegetarianism during pregnancy on subsequent cognitive function in children. The aim of this study was to investigate whether vegetarianism during pregnancy is associated with altered maternal nutritional status and with cognitive function in children at six to seven years of age. Women aged 20–34 years participating in a prospective observational study who provided dietary data and blood samples in early pregnancy (11 weeks; 78 vegetarians and 2144 omnivores) or late pregnancy (34 weeks; 91 vegetarians and 2552 omnivores). Compared with omnivorous women, vegetarian women had lower blood concentrations of arachidonic acid, docosahexaenoic acid, and cobalamin in early and late pregnancy. Vegetarianism in pregnancy was linked to higher maternal educational attainment, longer breastfeeding duration, lower incidence of smoking during pregnancy and a tendency towards higher IQ in the mothers. Concentrations of some nutrients required for neurodevelopment were lower in maternal blood during gestation; however, after controlling for confounders consuming a vegetarian diet during pregnancy was not associated with poorer neurocognitive development of the children in this study. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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10 pages, 252 KiB  
Article
If You Don’t Eat Meat… You’ll Die. A Mixed-Method Survey of Health-Professionals’ Beliefs
by Patrick McHugh, Morgen Smith, Nicholas Wright, Sarah Bush and Sue Pullon
Nutrients 2019, 11(12), 3028; https://doi.org/10.3390/nu11123028 - 11 Dec 2019
Cited by 6 | Viewed by 4843
Abstract
Despite an ever-increasing burden of non-communicable diseases and overwhelming evidence that good nutrition improves outcomes it is difficult to know whether this evidence is reaching the general population. The purpose of this study was to investigate whether health professionals in Tairāwhiti have sufficient [...] Read more.
Despite an ever-increasing burden of non-communicable diseases and overwhelming evidence that good nutrition improves outcomes it is difficult to know whether this evidence is reaching the general population. The purpose of this study was to investigate whether health professionals in Tairāwhiti have sufficient nutrition education for their roles in health education and promotion and whether nutrition beliefs held by health professionals were consistent with current literature. A particular interest was to enlist views on the harms, benefits, and possible barriers to following plant-based diets. A mixed-methods study involving health professionals completing a questionnaire and a subsequent focus group to collect data was used. Survey data were analysed using spreadsheet software, and thematic content analysis of focus group data was undertaken. Participants provided nutrition advice 2.4 times per day. Almost half of practitioners considered their nutrition knowledge to be inadequate, and most made poor use of references for provision of information. Plant-based diets were generally viewed as beneficial to health, improve quality of life, be filling, but were perceived as not as easy to follow. This study is in keeping with previous research that the health workforce would benefit from more formalised nutrition education and competencies to address common chronic disease. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
11 pages, 1001 KiB  
Article
Vitamin B12 Deficiency Is Prevalent Among Czech Vegans Who Do Not Use Vitamin B12 Supplements
by Eliška Selinger, Tilman Kühn, Magdalena Procházková, Michal Anděl and Jan Gojda
Nutrients 2019, 11(12), 3019; https://doi.org/10.3390/nu11123019 - 10 Dec 2019
Cited by 17 | Viewed by 10528
Abstract
As not much is known about the prevalence and predictors of nutritional deficiencies among vegans in the Czech Republic, we evaluated whether supplement use and duration of adherence to the vegan diet are associated with the risk of cobalamin and iron deficiencies. Associations [...] Read more.
As not much is known about the prevalence and predictors of nutritional deficiencies among vegans in the Czech Republic, we evaluated whether supplement use and duration of adherence to the vegan diet are associated with the risk of cobalamin and iron deficiencies. Associations between self-reported supplementation and duration of vegan diet with biomarkers of cobalamin (serum cobalamin, holotranscobalamin, homocysteine, folate) and iron status (serum ferritin, iron binding capacity, transferrin and saturation of transferrin) were assessed by cross-sectional analyses of medical data from a clinical nutrition center. Data from 151 (72 females) adult vegans (age 18–67 years), who were free of major chronic diseases and 85 (40 females) healthy non-vegans (age 21–47 years) were analyzed. Overall, vegans had significantly lower cobalamin, hemoglobin and ferritin levels, but higher folate and MCV values compared to non-vegans. Vegans not using cobalamin supplements were at higher risk of low plasma cobalamin than regularly supplementing vegans (OR: 4.41, 95% CI 1.2–16.16 for cobalamin, OR: 19.18, 95% CI 1.02–359.42 for holotranscobalamin), whereas no significant differences in cobalamin status related to duration of the vegan diet were observed. Regularly supplementing vegans had similar levels of cobalamin/holotranscobalamin as non-vegans. Despite lower ferritin and hemoglobin levels, there was no indication of a higher risk of iron-deficiency among vegans. To conclude cobalamin deficiency risk depends on supplementation status and not on the duration of an exclusive vegan diet, which underlines the need to integrate cobalamin status monitoring and counselling on supplement use in routine clinical care in the Czech Republic. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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10 pages, 513 KiB  
Article
A Comparison of Dietary Protein Digestibility, Based on DIAAS Scoring, in Vegetarian and Non-Vegetarian Athletes
by Corinne Ciuris, Heidi M. Lynch, Christopher Wharton and Carol S. Johnston
Nutrients 2019, 11(12), 3016; https://doi.org/10.3390/nu11123016 - 10 Dec 2019
Cited by 30 | Viewed by 19591
Abstract
Vegetarian diets provide an abundance of nutrients when carefully planned. However, vegetarian diets may have lower protein quality compared to omnivorous diets, a reflection of less favorable amino acid profiles and bioavailability. Hence, the current recommended dietary allowance for protein may not be [...] Read more.
Vegetarian diets provide an abundance of nutrients when carefully planned. However, vegetarian diets may have lower protein quality compared to omnivorous diets, a reflection of less favorable amino acid profiles and bioavailability. Hence, the current recommended dietary allowance for protein may not be adequate for some vegetarian populations. The purpose of this study was to determine dietary protein quality using the DIAAS (Digestible Indispensable Amino Acid Score) method in vegetarian and omnivore endurance athletes. DIAAS scores reflect the true ileal digestibility of the indispensable amino acids that are present in food items, and these scores can be used to compute the available protein in diet plans. Thirty-eight omnivores and 22 vegetarians submitted seven-day food records that were analyzed for nutrient content, and DIAAS scores were computed by diet group. Average available protein (g) was compared along with participants’ lean body mass and strength (quantified using the peak torque of leg extension). DIAAS scores and available protein were higher for omnivorous versus vegetarian athletes (+11% and +43%, respectively, p < 0.05). Omnivorous participants had significantly higher lean body mass than vegetarian participants (+14%), and significant correlations existed between available protein and strength (r = 0.314) and available protein and lean body mass (r = 0.541). Based upon available protein, as determined through the DIAAS, vegetarian athletes in this study would need to consume, on average, an additional 10 g protein daily to reach the recommended intake for protein (1.2 g/kg/d). An additional 22 g protein daily would be needed to achieve an intake of 1.4 g/kg/d, the upper end of the recommended intake range. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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25 pages, 3268 KiB  
Article
Vitamin B12 Status Upon Short-Term Intervention with a Vegan Diet—A Randomized Controlled Trial in Healthy Participants
by Ann-Kathrin Lederer, Luciana Hannibal, Manuel Hettich, Sidney Behringer, Ute Spiekerkoetter, Carmen Steinborn, Carsten Gründemann, Amy Marisa Zimmermann-Klemd, Alexander Müller, Thomas Simmet, Michael Schmiech, Andrea Maul-Pavicic, Yvonne Samstag and Roman Huber
Nutrients 2019, 11(11), 2815; https://doi.org/10.3390/nu11112815 - 18 Nov 2019
Cited by 40 | Viewed by 18612
Abstract
Vegans are at an increased risk for certain micronutrient deficiencies, foremost of vitamin B12. Little is known about the short-term effects of dietary change to plant-based nutrition on vitamin B12 metabolism. Systemic biomarkers of vitamin B12 status, namely, serum [...] Read more.
Vegans are at an increased risk for certain micronutrient deficiencies, foremost of vitamin B12. Little is known about the short-term effects of dietary change to plant-based nutrition on vitamin B12 metabolism. Systemic biomarkers of vitamin B12 status, namely, serum vitamin B12 and holotranscobalamin, may respond quickly to a reduced intake of vitamin B12. To test this hypothesis, 53 healthy omnivore subjects were randomized to a controlled unsupplemented vegan diet (VD, n = 26) or meat-rich diet (MD, n = 27) for 4 weeks. Vitamin B12 status was examined by measurement of serum vitamin B12, holotranscobalamin (holo-TC), methylmalonic acid (MMA) and total plasma homocysteine (tHcy). Holo-TC decreased significantly in the VD compared to the MD group after four weeks of intervention, whereas metabolites MMA and tHcy were unaffected. Body weight remained stable in both groups. VD intervention led to a significant reduction of cholesterol intake, and adequate profiles of nutrient and micronutrient status. Lower intake of vitamin B12 was observed in VD, which was mirrored by a lower concentration of serum vitamin B12 and reduced holo-TC after 4 weeks. Plasma holo-TC may be a fast-responding biomarker to monitor adequate supply of vitamin B12 in plant-based individuals. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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12 pages, 1043 KiB  
Article
Vegetarian Diets and Medical Expenditure in Taiwan—A Matched Cohort Study
by Chin-Lon Lin, Jen-Hung Wang, Chia-Chen Chang, Tina H.T. Chiu and Ming-Nan Lin
Nutrients 2019, 11(11), 2688; https://doi.org/10.3390/nu11112688 - 06 Nov 2019
Cited by 11 | Viewed by 6235
Abstract
Vegetarian diets and lifestyle have been shown to reduce the risk of many chronic non-communicable diseases, which now accounts for the major global burden of diseases. We aimed to determine the contribution of vegetarian diets and lifestyle to the actual direct medical cost [...] Read more.
Vegetarian diets and lifestyle have been shown to reduce the risk of many chronic non-communicable diseases, which now accounts for the major global burden of diseases. We aimed to determine the contribution of vegetarian diets and lifestyle to the actual direct medical cost in a population-based study. Through linkage to the National Health Insurance Research Database of Taiwan, we compared the health care utilization and medical expenditure of 2166 vegetarians and 4332 age-sex-matched omnivores recruited from the Buddhist Tzu Chi Foundation. Diet and lifestyle questionnaires were self-administered and prospectively collected. We used the general linear model to estimate the 5-year average medical expenditure in vegetarians versus omnivores while adjusting for age, sex, education, exercise habits, smoking, and alcohol drinking. Medical expenses related to non-diet associated lifestyle factors (smoking, alcohol drinking, active community volunteering, and religious emotional support) were estimated through a comparison with the published population medical cost data standardized to match the age and sex characteristics of the cohort. Tzu Chi vegetarians had significantly lower outpatient visits. This translated into 13% lower outpatient (p = 0.007) and 15% lower total medical expenditures (p = 0.008) when compared with the Tzu Chi omnivores, who had an additional 10% lower medical expenditure when compared with the general population. No difference in dental visits and expenses were found between diet groups. Vegetarian diets are associated with significantly lower medical care expenditure and could be an effective strategy to alleviate the medical–economic burden in selected populations. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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14 pages, 264 KiB  
Article
Plant-Based Meat Substitutes in the Flexitarian Age: An Audit of Products on Supermarket Shelves
by Felicity Curtain and Sara Grafenauer
Nutrients 2019, 11(11), 2603; https://doi.org/10.3390/nu11112603 - 30 Oct 2019
Cited by 226 | Viewed by 46099
Abstract
Demand for plant-based meat substitutes is growing globally for nutritional and environmental reasons, with Australia the third-fastest growing vegan market worldwide. This study aimed to profile and compare plant-based meat substitutes (mimicking meat) with equivalent meat products, and 2015 data. An audit undertaken [...] Read more.
Demand for plant-based meat substitutes is growing globally for nutritional and environmental reasons, with Australia the third-fastest growing vegan market worldwide. This study aimed to profile and compare plant-based meat substitutes (mimicking meat) with equivalent meat products, and 2015 data. An audit undertaken in May (updated in September 2019) from four metropolitan Sydney supermarkets (Coles, Woolworths, Aldi, IGA), collected nutrition information and Health Star Rating (HSR) from 137 products (50 burgers, 10 mince, 29 sausages, 24 chicken, 9 seafood, 15 other). Mean (± standard deviation (SD)) and median (range) was calculated for nutrients and HSR. Plant-based options were generally lower in kilojoules, total and saturated fat, higher in carbohydrate, sugars, and dietary fibre compared with meat. Only 4% of products were low in sodium (58–1200 mg/100 g). Less than a quarter of products (24%) were fortified with vitamin B12, 20% with iron, and 18% with zinc. HSR featured on 46% (3.6–4.4 stars). On-pack claims were vegetarian/vegan/plant-based (80%), protein (63%), non-genetically modified/organic (34%), gluten free (28%). Product numbers increased five-fold (↑429%) in four years. The plant protein trend has prompted innovation in meat substitutes, however wide nutrient ranges and higher sodium levels highlights the importance of nutrition guidelines in their development to ensure equivalence with animal-based proteins. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
12 pages, 226 KiB  
Article
Evaluation of an Eight-Week Whole-Food Plant-Based Lifestyle Modification Program
by Erin K. Campbell, Mohammad Fidahusain and Thomas M. Campbell II
Nutrients 2019, 11(9), 2068; https://doi.org/10.3390/nu11092068 - 03 Sep 2019
Cited by 26 | Viewed by 12914
Abstract
Poor diet quality is the leading cause of death both in the United States and worldwide, and the prevalence of obesity is at an all-time high and is projected to significantly worsen. Results from an eight-week group program utilizing an ad-libitum whole-food plant-based [...] Read more.
Poor diet quality is the leading cause of death both in the United States and worldwide, and the prevalence of obesity is at an all-time high and is projected to significantly worsen. Results from an eight-week group program utilizing an ad-libitum whole-food plant-based dietary pattern, were reviewed. There were 79 participants, all self-referred from the community, including 24 (30.4%) who were already vegetarian or vegan at baseline. Seventy-eight participants (98.7%) completed the eight-week program. Among completers, those with higher BMI at baseline lost a larger percentage of their body weight (total body weight loss of 3.0 ± SD 2.1%, 5.8 ± 2.8%, and 6.4 ± 2.5% for participants who had baseline BMI in normal, overweight, and obese range, respectively). The average weight loss for all the completers was 5.5 ± 3.0 kg (p < 0.0001). Final blood pressure and plasma lipids were reduced compared to baseline (SBP decreased 7.1 ± 15.5 mmHg (p = 0.0002), DBP decreased 7.3 ± 10.9 mmHg (p < 0.0001), total cholesterol decreased 25.2 ± 24.7 mg/dL (p < 0.0001), LDL decreased 15.3 ± 21.1 mg/dL (p < 0.0001)). Twenty-one (26.9%) participants were able to decrease or stop at least one chronic medication compared to two (2.6%) participants who required an increased dose of a chronic medication. Participants who were already vegetarian or vegan at baseline experienced statistically significant weight loss and reductions in total and LDL cholesterol. There was a non-significant trend toward less weight loss in these participants compared to participants who were non-vegetarian at baseline. Reductions in total and LDL cholesterol were not significantly different when comparing vegetarian or vegan and non-vegetarian participants. A whole-food plant-based dietary intervention may provide significant short-term benefits for both non-vegetarian, vegetarian, and vegan individuals. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
11 pages, 273 KiB  
Article
Physiological and Dietary Determinants of Iron Status in Spanish Vegetarians
by Angélica Gallego-Narbón, Belén Zapatera and M. Pilar Vaquero
Nutrients 2019, 11(8), 1734; https://doi.org/10.3390/nu11081734 - 26 Jul 2019
Cited by 15 | Viewed by 6676
Abstract
Vegetarian diets may compromise iron status, as they provide non-haem iron which has low bioavailability. Spanish lacto-ovo vegetarians (n = 49) and vegans (n = 55) were recruited and haematological and biochemical iron parameters were analysed. Food and supplements consumption, body [...] Read more.
Vegetarian diets may compromise iron status, as they provide non-haem iron which has low bioavailability. Spanish lacto-ovo vegetarians (n = 49) and vegans (n = 55) were recruited and haematological and biochemical iron parameters were analysed. Food and supplements consumption, body composition, physical activity, menstrual blood losses and hormonal contraceptive use were assessed. Four groups were studied: Iron deficiency anaemia (IDA), iron depletion (ferritin <15 ng/mL), iron deficiency (ferritin ≥15 to ≤30 ng/mL), and iron sufficiency (ferritin >30 ng/mL). IDA was uncommon (n = 5, 4.8%), 27.9% of participants were iron-depleted, and 30.8% were iron-deficient. Serum ferritin was lower in women than men (p < 0.001) and IDA and iron depleted individuals were all women. There were no differences attributed to diet type, time being vegetarian or physical activity. The menstrual period length was negatively associated with transferrin saturation (ρ = −0.364, p = 0.001) and hormonal contraceptive use (ρ = −0.276, p = 0.014). Iron supplements were consumed most frequently by IDA and iron-deficient subjects (p = 0.031). Conclusions: Iron status did not vary between lacto-ovo vegetarians and vegans and there was not an influence of the time following a vegetarian diet. Although men were iron-sufficient, iron deficiency was frequent in women, who should apply strategies to increase iron bioavailability, especially if they experience intense menstrual blood losses. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
6 pages, 1200 KiB  
Communication
Crohn’s Disease Remission with a Plant-Based Diet: A Case Report
by Kelsea Sandefur, Hana Kahleova, Alan N. Desmond, Eden Elfrink and Neal D. Barnard
Nutrients 2019, 11(6), 1385; https://doi.org/10.3390/nu11061385 - 20 Jun 2019
Cited by 10 | Viewed by 51521
Abstract
Crohn’s disease (CD) is a form of chronic inflammatory bowel disease (IBD). The etiology of CD is thought to be multi-factorial; genetic factors, dietary and environmental exposures, immune events, and dysfunction of the gut microbiome are all though to play a role. The [...] Read more.
Crohn’s disease (CD) is a form of chronic inflammatory bowel disease (IBD). The etiology of CD is thought to be multi-factorial; genetic factors, dietary and environmental exposures, immune events, and dysfunction of the gut microbiome are all though to play a role. The prevalence of CD is increasing globally and is higher in countries with a Westernized diet and lifestyle. Several human trials have demonstrated that plant-based dietary therapies may have utility in both the treatment of acute CD flares and the maintenance of remission. This case study describes a young adult male with newly diagnosed CD who failed to enter clinical remission despite standard medical therapy. After switching to a diet based exclusively on grains, legumes, vegetables, and fruits, he entered clinical remission without need for medication and showed no signs of CD on follow-up colonoscopy. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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16 pages, 459 KiB  
Article
Micronutrient Status of Recreational Runners with Vegetarian or Non-Vegetarian Dietary Patterns
by Josefine Nebl, Jan Philipp Schuchardt, Alexander Ströhle, Paulina Wasserfurth, Sven Haufe, Julian Eigendorf, Uwe Tegtbur and Andreas Hahn
Nutrients 2019, 11(5), 1146; https://doi.org/10.3390/nu11051146 - 22 May 2019
Cited by 29 | Viewed by 13808
Abstract
Vegetarian diets have gained popularity in sports. However, few data exist on the status of micronutrients and related biomarkers for vegetarian and vegan athletes. The aim of this cross-sectional study was to compare the micronutrient status of omnivorous (OMN, n = 27), lacto-ovo-vegetarian [...] Read more.
Vegetarian diets have gained popularity in sports. However, few data exist on the status of micronutrients and related biomarkers for vegetarian and vegan athletes. The aim of this cross-sectional study was to compare the micronutrient status of omnivorous (OMN, n = 27), lacto-ovo-vegetarian (LOV, n = 26), and vegan (VEG, n = 28) recreational runners. Biomarkers of vitamin B12, folate, vitamin D, and iron were assessed. Additionally, serum levels of calcium, magnesium, and zinc were examined. Lifestyle factors and supplement intake were recorded via questionnaires. About 80% of each group showed vitamin B12 adequacy with higher levels in supplement users. Mean red blood cell folate exceeded the reference range (>340 nmol/L) in all three groups (OMN: 2213 ± 444, LOV: 2236 ± 596, and VEG: 2354 ± 639 nmol/L; not significant, n.s.). Furthermore, vitamin D levels were comparable (OMN: 90.6 ± 32.1, LOV: 76.8 ± 33.7, and VEG: 86.2 ± 39.5 nmol/L; n.s.), and we found low prevalence (<20%) of vitamin D inadequacy in all three groups. Less than 30% of each group had depleted iron stores, however, iron deficiency anemia was not found in any subject. Our findings suggest that a well-planned, health-conscious lacto-ovo-vegetarian and vegan diet, including supplements, can meet the athlete’s requirements of vitamin B12, vitamin D and iron. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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18 pages, 1096 KiB  
Article
Energy, Macronutrient Intake, and Anthropometrics of Vegetarian, Vegan, and Omnivorous Children (1–3 Years) in Germany (VeChi Diet Study)
by Stine Weder, Morwenna Hoffmann, Katja Becker, Ute Alexy and Markus Keller
Nutrients 2019, 11(4), 832; https://doi.org/10.3390/nu11040832 - 12 Apr 2019
Cited by 59 | Viewed by 31530
Abstract
Due to the lack of current, large-scale studies examining their dietary intake and health, there are concerns about vegetarian (VG) and vegan (VN) diets in childhood. Therefore, the Vegetarian and Vegan Children Study (VeChi Diet Study) examined the energy and macronutrient intake as [...] Read more.
Due to the lack of current, large-scale studies examining their dietary intake and health, there are concerns about vegetarian (VG) and vegan (VN) diets in childhood. Therefore, the Vegetarian and Vegan Children Study (VeChi Diet Study) examined the energy and macronutrient intake as well as the anthropometrics of 430 VG, VN, and omnivorous (OM) children (1–3 years) in Germany. A 3-day weighed dietary record assessed dietary intake, and an online questionnaire assessed lifestyle, body weight (BW), and height. Average dietary intakes and anthropometrics were compared between groups using ANCOVA. There were no significant differences in energy intake or density and anthropometrics between the study groups. OM children had the highest adjusted median intakes of protein (OM: 2.7, VG: 2.3, VN: 2.4 g/kg BW, p < 0.0001), fat (OM: 36.0, VG: 33.5, VN: 31.2%E, p < 0.0001), and added sugars (OM: 5.3, VG: 4.5, VN: 3.8%E, p = 0.002), whereas VN children had the highest adjusted intakes of carbohydrates (OM: 50.1, VG: 54.1, VN: 56.2%E, p < 0.0001) and fiber (OM: 12.2, VG: 16.5, VN: 21.8 g/1,000 kcal, p < 0.0001). Therefore, a VG and VN diet in early childhood can provide the same amount of energy and macronutrients, leading to a normal growth in comparison to OM children. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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16 pages, 965 KiB  
Article
Comparison of Major Protein-Source Foods and Other Food Groups in Meat-Eaters and Non-Meat-Eaters in the EPIC-Oxford Cohort
by Keren Papier, Tammy YN Tong, Paul N Appleby, Kathryn E Bradbury, Georgina K Fensom, Anika Knuppel, Aurora Perez-Cornago, Julie A Schmidt, Ruth C Travis and Timothy J Key
Nutrients 2019, 11(4), 824; https://doi.org/10.3390/nu11040824 - 11 Apr 2019
Cited by 47 | Viewed by 14073
Abstract
Differences in health outcomes between meat-eaters and non-meat-eaters might relate to differences in dietary intakes between these diet groups. We assessed intakes of major protein-source foods and other food groups in six groups of meat-eaters and non-meat-eaters participating in the European Prospective Investigation [...] Read more.
Differences in health outcomes between meat-eaters and non-meat-eaters might relate to differences in dietary intakes between these diet groups. We assessed intakes of major protein-source foods and other food groups in six groups of meat-eaters and non-meat-eaters participating in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study. The data were from 30,239 participants who answered questions regarding their consumption of meat, fish, dairy or eggs and completed a food frequency questionnaire (FFQ) in 2010. Participants were categorized as regular meat-eaters, low meat-eaters, poultry-eaters, fish-eaters, vegetarians and vegans. FFQ foods were categorized into 45 food groups and analysis of variance was used to test for differences between age-adjusted mean intakes of each food group by diet group. Regular meat-eaters, vegetarians and vegans, respectively, consumed about a third, quarter and a fifth of their total energy intake from high protein-source foods. Compared with regular meat-eaters, low and non-meat-eaters consumed higher amounts of high-protein meat alternatives (soy, legumes, pulses, nuts, seeds) and other plant-based foods (whole grains, vegetables, fruits) and lower amounts of refined grains, fried foods, alcohol and sugar-sweetened beverages. These findings provide insight into potential nutritional explanations for differences in health outcomes between diet groups. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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17 pages, 723 KiB  
Article
Fat Quantity and Quality, as Part of a Low-Fat, Vegan Diet, Are Associated with Changes in Body Composition, Insulin Resistance, and Insulin Secretion. A 16-Week Randomized Controlled Trial
by Hana Kahleova, Adela Hlozkova, Rebecca Fleeman, Katie Fletcher, Richard Holubkov and Neal D. Barnard
Nutrients 2019, 11(3), 615; https://doi.org/10.3390/nu11030615 - 13 Mar 2019
Cited by 46 | Viewed by 12046
Abstract
Macronutrient composition of the diet influences the development of obesity and insulin resistance. The aim of this study was to assess the role of dietary fat quantity and fatty acid composition in body composition, insulin resistance, and insulin secretion. An open parallel randomized [...] Read more.
Macronutrient composition of the diet influences the development of obesity and insulin resistance. The aim of this study was to assess the role of dietary fat quantity and fatty acid composition in body composition, insulin resistance, and insulin secretion. An open parallel randomized trial design was used. Overweight participants (n = 75) were randomized to follow a low-fat vegan (n = 38) or control diet (n = 37) for 16 weeks. Dual X-ray absorptiometry was used to measure body composition. Insulin resistance was assessed with the Homeostasis Model Assessment (HOMA-IR) index. Insulin secretion was assessed after stimulation with a liquid breakfast (Boost Plus, Nestle, Vevey, Switzerland). Self-reported 3-day diet records were used to assess dietary intake. A linear regression model was used to test the relationship between fat intake and body composition, insulin resistance, and insulin secretion. Changes in fat intake expressed as percent of total energy consumed correlated positively with changes in fat mass (r = 0.52; p < 0.001; and 0.347; p = 0.006, respectively), even after adjustment for changes in body-mass index (BMI) and energy intake (0.33; p = 0.01). Decreased intakes of C18:0 (r = 0.37, p = 0.004) and CLA-trans-10-cis12 (r = 0.40, p = 0.002), but increased intake of C18:2 (r = −0.40, p = 0.002) and C18:3 (p = −0.36, p = 0.006), were associated with a decrease in HOMA-IR, independent on changes in BMI and energy intake. The main fatty acids associated with changes in fasting insulin secretion were C12:0 (r = −0.31, p = 0.03), and TRANS 16:1 (r = −0.33, p = 0.02), both independent on changes in BMI and energy intake. Our findings demonstrate that, in the context of a low-fat vegan diet, decreased intake of saturated and trans fats and increased relative content of polyunsaturated fatty acids, particularly linoleic and α-linolenic acids, are associated with decreased fat mass and insulin resistance, and enhanced insulin secretion. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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27 pages, 333 KiB  
Review
The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States
by Samara R. Sterling and Shelly-Ann Bowen
Nutrients 2019, 11(12), 2915; https://doi.org/10.3390/nu11122915 - 02 Dec 2019
Cited by 20 | Viewed by 8954
Abstract
Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney [...] Read more.
Plant-based diets are associated with reduced risks of various chronic diseases in the general population. However, it is unclear how these benefits translate to Blacks living in the United States, who are disproportionately burdened with heart disease, cancer, diabetes, obesity, and chronic kidney disease. The objectives of this study were to: (1) review the general evidence of plant-based diets and health outcomes; (2) discuss how this evidence translates to Blacks following a plant-based diet; and (3) provide recommendations and considerations for future studies in this area. Interestingly, although the evidence supporting plant-based diets in the general population is robust, little research has been done on Blacks specifically. However, the available data suggests that following a plant-based diet may reduce the risk of heart disease and possibly cancer in this population. More research is needed on cardiovascular disease risk factors, cancer subtypes, and other chronic diseases. Further, attention must be given to the unique individual, familial, communal, and environmental needs that Blacks who follow plant-based diets may have. Interventions must be culturally appropriate in order to achieve long-term success, and providing low-cost, flavorful, and nutritious options will be important. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
19 pages, 1078 KiB  
Review
Plant-Based Diets in the Reduction of Body Fat: Physiological Effects and Biochemical Insights
by Rami S. Najjar and Rafaela G. Feresin
Nutrients 2019, 11(11), 2712; https://doi.org/10.3390/nu11112712 - 08 Nov 2019
Cited by 56 | Viewed by 17131
Abstract
Obesity affects over one-third of Americans and increases the risk of cardiovascular disease and type II diabetes. Interventional trials have consistently demonstrated that consumption of plant-based diets reduces body fat in overweight and obese subjects, even when controlling for energy intake. Nonetheless, the [...] Read more.
Obesity affects over one-third of Americans and increases the risk of cardiovascular disease and type II diabetes. Interventional trials have consistently demonstrated that consumption of plant-based diets reduces body fat in overweight and obese subjects, even when controlling for energy intake. Nonetheless, the mechanisms underlying this effect have not been well-defined. This review discusses six major dietary mechanisms that may lead to reduced body fat. These include (1) reduced caloric density, (2) improved gut microbiota symbiosis, (3) increased insulin sensitivity, (4) reduced trimethylamine-N-oxide (TMAO), (5) activation of peroxisome proliferator-activated receptors (PPARs), and (6) over-expression of mitochondrial uncoupling proteins. Collectively, these factors improve satiety and increase energy expenditure leading to reduced body weight. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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19 pages, 3094 KiB  
Review
Dietary Protein and Amino Acids in Vegetarian Diets—A Review
by François Mariotti and Christopher D. Gardner
Nutrients 2019, 11(11), 2661; https://doi.org/10.3390/nu11112661 - 04 Nov 2019
Cited by 184 | Viewed by 62952
Abstract
While animal products are rich in protein, the adequacy of dietary protein intake from vegetarian/vegan diets has long been controversial. In this review, we examine the protein and amino acid intakes from vegetarian diets followed by adults in western countries and gather information [...] Read more.
While animal products are rich in protein, the adequacy of dietary protein intake from vegetarian/vegan diets has long been controversial. In this review, we examine the protein and amino acid intakes from vegetarian diets followed by adults in western countries and gather information in terms of adequacy for protein and amino acids requirements, using indirect and direct data to estimate nutritional status. We point out that protein-rich foods, such as traditional legumes, nuts and seeds, are sufficient to achieve full protein adequacy in adults consuming vegetarian/vegan diets, while the question of any amino acid deficiency has been substantially overstated. Our review addresses the adequacy in changes to protein patterns in people newly transitioning to vegetarian diets. We also specifically address this in older adults, where the issues linked to the protein adequacy of vegetarian diets are more complex. This contrasts with the situation in children where there are no specific concerns regarding protein adequacy because of their very high energy requirements compared to those of protein. Given the growing shifts in recommendations from nutrition health professionals for people to transition to more plant-based, whole-food diets, additional scientific evidence-based communications confirming the protein adequacy of vegetarian and vegan diets is warranted. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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25 pages, 627 KiB  
Review
Alpha-Linolenic and Linoleic Fatty Acids in the Vegan Diet: Do They Require Dietary Reference Intake/Adequate Intake Special Consideration?
by Bonny Burns-Whitmore, Erik Froyen, Celine Heskey, Temetra Parker and Gregorio San Pablo
Nutrients 2019, 11(10), 2365; https://doi.org/10.3390/nu11102365 - 04 Oct 2019
Cited by 80 | Viewed by 15445
Abstract
Good sources of the long-chain n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) include cold-water fish and seafood; however, vegan diets (VGNs) do not include animal-origin foods. Typically, US omnivores obtain enough dietary EPA and DHA, but unless VGNs consume algal [...] Read more.
Good sources of the long-chain n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) include cold-water fish and seafood; however, vegan diets (VGNs) do not include animal-origin foods. Typically, US omnivores obtain enough dietary EPA and DHA, but unless VGNs consume algal n-3 supplements, they rely on endogenous production of long-chain fatty acids. VGN diets have several possible concerns: (1) VGNs have high intakes of linoleic acid (LA) as compared to omnivore/non-vegetarian diets. (2) High intakes of LA competitively interfere with the endogenous conversion of alpha-linolenic acid (ALA) to EPA and DHA. (3) High somatic levels of LA/low ALA indicate a decreased ALA conversion to EPA and DHA. (4) Some, not all VGNs meet the Dietary Reference Intake Adequate Intake (DRI-AI) for dietary ALA and (5) VGN diets are high in fiber, which possibly interferes with fat absorption. Consequently, health professionals and Registered Dietitians/Registered Dietitian Nutritionists working with VGNs need specific essential fatty acid diet guidelines. The purpose of this review was: (1) to suggest that VGNs have a DRI-AI Special Consideration requirement for ALA and LA based on VGN dietary and biochemical indicators of status and (2) to provide suggestions to ensure that VGNs receive adequate intakes of LA and ALA. Full article
(This article belongs to the Special Issue Vegetarian, Vegan Diets and Human Health)
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