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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (5 April 2024) | Viewed by 38656

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Special Issue Editors

Dr. Luciana Baroni

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Guest Editor

Scientific Society for Vegetarian Nutrition, Scientific Committee, Via Verdi 10/9, 30171 Mestre, VE, Italy
Interests: plant-based nutrition; vegetarian diets; lifestyle medicine; plant food; environmental impact; public health prevention; vitamin b12; cobalamin; homocysteine; Parkinson’s disease

Dr. Gianluca Rizzo

E-Mail Website
Guest Editor

Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
Interests: vegetarian diet; vegan diet; plant-based diet; soy; soy foods; phytoestrogens; isoflavones; vitamin B12; cobalamins; homocysteine; B vitamins; polyunsaturated fatty acids; vitamin D; dietary supplements; oxidative stress; antioxidants
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Special Issue Information

Dear Colleagues,

In this Special Issue dedicated to “Vegetarian Nutrition in Health Improvement”, we aim to expand the knowledge on the importance of a plant-based diet for public health.

The current literature suggests that vegetarian diets could be beneficial for the prevention and management of some chronic conditions, including metabolic diseases.

Vegetarian diets (i.e., lacto-ovo-vegetarian and vegan) have been recognized as adequate and healthy, but their effect on human health is still debated due to the limited available data.

In this context, your research represents an important source of evidence to detect healthy diets which are also globally sustainable. This could stimulate better prevention policies for the population.

It is therefore important to rigorously describe the health effects of these diets, for the benefit of human health, environment, and sustainability, which are deeply interdependent.

Accepted article types are human-based original research, reviews, perspectives, systematic reviews, and meta-analyses. We encourage the submission of human clinical studies or reviews based on them, avoiding preclinical and in vitro studies, with a margin of tolerance of studies on human cells.

Dr. Luciana Baroni
Dr. Gianluca Rizzo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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
lacto-ovo-vegetarian diets
vegan diets
plant-based diets
non-communicable chronic diseases
cardiovascular
diabetes
hypertension
obesity
sustainability

Published Papers (10 papers)

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Research

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18 pages, 332 KiB

Open AccessArticle

Associations of Dietary Intake with Cardiovascular Risk in Long-Term “Plant-Based Eaters”: A Secondary Analysis of a Cross-Sectional Study

by Boštjan Jakše, Uroš Godnov, Zlatko Fras and Nataša Fidler Mis

Nutrients 2024, 16(6), 796; https://0-doi-org.brum.beds.ac.uk/10.3390/nu16060796 - 11 Mar 2024

Viewed by 1128

Abstract

A plant-based diet rich in whole foods and fiber is beneficial for cardiovascular (CV) health. This impact is often linked to specific food groups and their preparation methods, reflecting the overall dietary pattern. However, research on the long-term effects of a carefully designed plant-based diet on adults transitioning from a typical Western lifestyle is limited. Notably, studies on people managing CV risk factors effectively are scarce. As part of a cross-sectional study, we examined 151 individuals committed to a long-term, well-designed plant-based diet and active lifestyle. We investigated how specific food groups and macronutrient intake are related to various CV health markers. In this secondary analysis, our comprehensive approach encompassed several methods: 3-day weighted dietary records, fasting blood lipid and blood pressure measurements, body composition assessments, and evaluations of lifestyle status. We adjusted our analysis for multiple variables, such as age, sex, current body mass index, smoking status, physical activity, and time (years) following the plant-based diet. Our findings revealed several associations between macronutrient intake (per 50 g) and CV risk markers, although these associations were generally weak. Individuals who consumed more whole grains and fruits had lower levels of total, low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) cholesterol. We also found associations between the intake of legumes and nuts/seeds and reduced HDL-C levels. These findings suggested that these food groups might influence the lipid profile, contributing to CV health in a plant-based diet. A greater intake of spices/herbs was associated with lower uric acid levels, while diets rich in plant-based fast food and pasta (made from white flour) were associated with higher uric acid levels. A greater intake of various macronutrients, such as fiber, carbohydrates (from whole-food sources), proteins, and different types of fats (saturated fatty acids [SFAs], monounsaturated fatty acids [MUFAs], and polyunsaturated fatty acids [PUFAs]), was associated with lower levels of total cholesterol, LDL-C (only for carbohydrates), and HDL-C. We found a unique negative correlation between PUFA intake and LDL-C, suggesting that PUFAs might significantly affect LDL-C levels. In contrast, increased fiber, protein and SFA consumption were associated with increased uric acid levels. These findings support the impact of dietary patterns on CV risk factors, highlighting that even small amounts of unhealthy food groups can significantly influence specific CV risk markers, regardless of the overall diet. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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16 pages, 915 KiB

Open AccessArticle

A Comprehensive Examination of Vegan Lifestyle in Italy

by Annachiara Stenico, Diana Zarantonello, Fabio Vittadello and Michael Kob

Nutrients 2024, 16(1), 86; https://0-doi-org.brum.beds.ac.uk/10.3390/nu16010086 - 26 Dec 2023

Viewed by 1321

Abstract

The popularity of veganism and plant-based diets is rapidly increasing worldwide, including in Italy, where more individuals and families are adopting this lifestyle. However, medical and health professionals often lack the necessary knowledge and are skeptical about this diet despite the scientific evidence. It is important for them to provide support and expertise to those following this diet. The survey evaluated various aspects of the lifestyle of Italian vegans living in Italy and abroad, including food frequency, vitamin and mineral supplementation, relationship with medical and health professionals, and perceived difficulties in daily life. The emphasis was on potentially critical aspects for those following this dietary choice. A cross-sectional survey was conducted in Italy between March and April 2022. A questionnaire was distributed through social media platforms such as Instagram, Facebook, and Telegram, and 2180 Italian adults who follow a vegan diet completed it. The survey found that most of the vegan population surveyed were female, showed a greater sensitivity to ethical issues, were aware of the need for vitamin B12 supplementation, and followed healthy-eating guidelines. It is evident that despite the increasing popularity of plant-based diets, many medical and health professionals remain cautious and hesitant to recommend them. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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13 pages, 1243 KiB

Open AccessArticle

Plant-Based Diet Indices and Their Association with Frailty in Older Adults: A CLHLS-Based Cohort Study

by Ran Qi, Yun Yang, Baihe Sheng, Huiping Li and Xinyu Zhang

Nutrients 2023, 15(24), 5120; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15245120 - 15 Dec 2023

Viewed by 1175

Abstract

Within the realm of aging, the nexus between diet and health has garnered considerable attention. However, only select studies have amalgamated insights into the correlation between plant and animal food consumption and frailty. Our aim was to appraise the connections between the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) and frailty in the elderly, utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cohort study drew upon CLHLS data spanning from 2008 to 2018. The PDI, hPDI, and uPDI were gauged using a simplified food frequency questionnaire (FFQ). A frailty index, encompassing 35 variables across major health domains, was formulated. Cox proportional hazard models were employed to scrutinize the associations between the three plant-based dietary indices and frailty in older adults, including an exploration of gender disparities in these associations. A cohort of 2883 study participants was encompassed, with 1987 (68.9%) observed to be either frail or in the pre-frail stage. The Cox model with penalized spline exhibited linear associations of PDI, hPDI, and uPDI with the frailty index. Following covariate adjustments, it was discerned that older adults situated in the highest quartiles of PDI (HR = 0.86, 95% CI: 0.77–0.95) and hPDI (HR = 0.83, 95% CI: 0.74–0.93) experienced a 14% and 17% diminished risk of frailty compared to those in the lowest quartiles of PDI and hPDI, respectively. Conversely, when contrasted with those in the lowest quartile of uPDI, older adults adhering to the highest tertile of uPDI exhibited a 21% elevated risk of frailty (HR = 1.21, 95% CI: 1.08–1.36), with both associations achieving statistical significance (p < 0.01). Moreover, additional subgroup analyses revealed that the protective effects of PDI and hPDI against frailty and the deleterious effects of uPDI were more conspicuous in men compared to women. To forestall or decelerate the progression of frailty in the elderly, tailored dietary interventions are imperative, particularly targeting male seniors. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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13 pages, 439 KiB

Open AccessArticle

The Role of a Plant-Only (Vegan) Diet in Gastroesophageal Reflux Disease: Online Survey of the Italian General Population

by Gianluca Rizzo, Luciana Baroni, Chiara Bonetto, Pierfrancesco Visaggi, Mattia Orazzini, Irene Solinas, Giada Guidi, Jessica Pugliese, Giulia Scaramuzza, Filippo Ovidi, Irene Buselli, Massimo Bellini, Edoardo V. Savarino and Nicola de Bortoli

Nutrients 2023, 15(22), 4725; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15224725 - 08 Nov 2023

Cited by 1 | Viewed by 1973

Abstract

The relationship between food and the pathophysiological mechanisms of gastroesophageal reflux disease (GERD) is unclear. There are few data on the impact of dietary habits on GERD symptoms and on the incidence of GERD in subjects undergoing plant-based diets. In this study, we investigated the association between diet and GERD, using data collected through an online survey of the Italian general population. In total, 1077 subjects participated in the study. GERD was defined according to the Montreal Consensus. For all subjects age, gender, body mass index (BMI), marital status, education, occupation, alcohol consumption, and smoking habits were recorded. All participants also completed the SF-36 questionnaire on Quality of Life. A total of 402 subjects (37.3%) were vegans and 675 (62.7%) non-vegans. The prevalence of GERD in the total population was 9%. Subjects with GERD-related symptoms recorded a worse quality of life according to SF-36 analysis (p < 0.05 for all dimensions). In multivariate analysis, after adjusting for confounders, participants undergoing a vegan diet had a significantly lower risk of GERD (OR = 0.47, 95% CI 0.28–0.81, p = 0.006). These findings should be taken into account to inform the lifestyle management of GERD. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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10 pages, 763 KiB

Open AccessArticle

Nitrogen Balance at the Recommended Dietary Allowance for Protein in Minimally Active Male Vegans

by Eric Bartholomae and Carol S. Johnston

Nutrients 2023, 15(14), 3159; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15143159 - 16 Jul 2023

Cited by 3 | Viewed by 8460

Abstract

Vegan diets have gained popularity in recent years for reasons including health benefits and concerns for animal welfare. Although these diets are considered to be nutritionally adequate, questions remain over whether the current protein recommendation (0.8 g/kg/d) is sufficient. Protein status is determined through a nitrogen balance analysis when the protein content of the diet is known. A negative balance indicates a catabolic state, and a positive nitrogen balance indicates an anabolic state. In healthy adults, nitrogen equilibrium is the expectation reflecting the net synthesis and breakdown of proteins. Currently, there are no known studies measuring nitrogen balance in strict vegan men fed the protein requirement. Eighteen minimally active vegan men received a 5-day eucaloric diet (protein content: 0.8 g/kg/d). On day five, 24 h urine was collected for nitrogen analysis. Both the mean absolute nitrogen balance (−1.38 ± 1.22 g/d) and the mean relative nitrogen balance (−18.60 ± 16.96 mg/kg/d) were significantly lower than zero (equilibrium) (p < 0.001). There were no correlations seen between nitrogen balance and age, years as vegan, or fat-free mass. Consuming 0.8 g/kg/d of protein is not adequate to produce nitrogen balance in men adhering to typical strict vegan diets for at least one year. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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16 pages, 4696 KiB

Open AccessArticle

Anti-Adipogenic Activity of Rhaponticum carthamoides and Its Secondary Metabolites

by Velislava Todorova, Martina S. Savova, Stanislava Ivanova, Kalin Ivanov and Milen I. Georgiev

Nutrients 2023, 15(13), 3061; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15133061 - 07 Jul 2023

Cited by 1 | Viewed by 1655

Abstract

Besides their common use as an adaptogen, Rhaponticum carthamoides (Willd.) Iljin. rhizome and its root extract (RCE) are also reported to beneficially affect lipid metabolism. The main characteristic secondary metabolites of RCE are phytoecdysteroids. In order to determine an RCE’s phytoecdysteroid profile, a novel, sensitive, and robust high-performance thin-layer chromatography (HPTLC) method was developed and validated. Moreover, a comparative analysis was conducted to investigate the effects of RCE and its secondary metabolites on adipogenesis and adipolysis. The evaluation of the anti-adipogenic and lipolytic effects was performed using human Simpson–Golabi–Behmel syndrome cells, where lipid staining and measurement of released glycerol and free fatty acids were employed. The HPTLC method confirmed the presence of 20-hydroxyecdysone (20E), ponasterone A (PA), and turkesterone (TU) in RCE. The observed results revealed that RCE, 20E, and TU significantly reduced lipid accumulation in human adipocytes, demonstrating their anti-adipogenic activity. Moreover, RCE and 20E were found to effectively stimulate basal lipolysis. However, no significant effects were observed with PA and TU applications. Based on our findings, RCE and 20E affect both lipogenesis and lipolysis, while TU only restrains adipogenesis. These results are fundamental for further investigations. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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13 pages, 745 KiB

Open AccessArticle

Soy Milk Consumption in the United States of America: An NHANES Data Report

by Maximilian Andreas Storz, Maria Brommer, Mauro Lombardo and Gianluca Rizzo

Nutrients 2023, 15(11), 2532; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15112532 - 29 May 2023

Cited by 4 | Viewed by 2168

Abstract

With the increasing adoption of plant-based diets in the United States, more and more individuals replace cow milk with plant-based milk alternatives. Soy milk is a commonly used cow milk substitute, which is characterized by a higher content of polyunsaturated fatty acids and fibers. Despite these favorable characteristics, little is known about the current prevalence of soy milk consumption the United States. We used data from the National Health and Nutrition Examination Surveys (NHANES) to assess soy milk usage in the United States and identified potential predictors for its consumption in the US general population. The proportion of individuals reporting soy milk consumption in the NHANES 2015–2016 cycle was 2%, and 1.54% in the NHANES 2017–2020 cycle. Non-Hispanic Asian and Black ethnicities (as well as other Hispanic and Mexican American ethnicities in the 2017–2020 cycle) significantly increased the odds for soy milk consumption. While a college degree and weekly moderate physical activity were associated with significantly higher odds for consuming soy milk (OR: 2.21 and 2.36, respectively), sex was not an important predictor. In light of the putative health benefits of soy milk and its more favorable environmental impact as compared to cow milk, future investigations should attempt to identify strategies that may help promote its consumption in selected populations. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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11 pages, 1386 KiB

Open AccessArticle

Impact of Reducing Intake of Red and Processed Meat on Colorectal Cancer Incidence in Germany 2020 to 2050—A Simulation Study

by Tobias Niedermaier, Thomas Gredner, Michael Hoffmeister, Ute Mons and Hermann Brenner

Nutrients 2023, 15(4), 1020; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15041020 - 17 Feb 2023

Cited by 1 | Viewed by 4034

Abstract

Background: According to the International Agency for Research on Cancer (IARC), there is sufficient evidence for the carcinogenicity of processed meat consumption in humans, specifically regarding colorectal cancer (CRC) risk. Evidence for the carcinogenicity of red meat consumption is more limited but points in the same direction. Methods: A macro-simulation approach was used to calculate age- and sex-specific potential impact fractions in a 30-year period (2020–2050). Aims: We estimated numbers and proportions of future CRC cases preventable under different scenarios of reducing the intake of processed and red meat in the German population. Results: Eliminating processed meat intake could reduce the burden of CRC by approximately 205,000 cases in Germany (9.6%) in 2020–2050, 2/3 among males (145,000) and 1/3 among females (60,000). Without red meat intake, approximately 63,000 CRC cases could be avoided (2.9%), 39,000 among males and 24,000 among females. Reductions in the mean consumption of both processed and red meat by one or two servings (each 11 or 22 g) per day would be expected to reduce CRC case numbers by 68,000 (3.1%) and 140,000 (6.5%), respectively. Conclusion: A reduction in red and processed meat intake might substantially reduce the incidence of CRC in Germany. The means of achieving such a reduction might include price and taxation policies, food labeling, and clearer risk communication aiming to reduce individual intake. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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Review

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18 pages, 1597 KiB

Open AccessReview

Vegetarian Nutrition in Chronic Kidney Disease

by Yoko Narasaki, Kamyar Kalantar-Zadeh, Connie M. Rhee, Giuliano Brunori and Diana Zarantonello

Nutrients 2024, 16(1), 66; https://0-doi-org.brum.beds.ac.uk/10.3390/nu16010066 - 25 Dec 2023

Cited by 1 | Viewed by 7366

Abstract

There is rising interest globally with respect to the health implications of vegetarian or plant-based diets. A growing body of evidence has demonstrated that higher consumption of plant-based foods and the nutrients found in vegetarian and plant-based diets are associated with numerous health benefits, including improved blood pressure, glycemic control, lipid levels, body mass index, and acid–base parameters. Furthermore, there has been increasing recognition that vegetarian and plant-based diets may have potential salutary benefits in preventing the development and progression of chronic kidney disease (CKD). While increasing evidence shows that vegetarian and plant-based diets have nephroprotective effects, there remains some degree of uncertainty about their nutritional adequacy and safety in CKD (with respect to protein-energy wasting, hyperkalemia, etc.). In this review, we focus on the potential roles of and existing data on the efficacy/effectiveness and safety of various vegetarian and plant-based diets in CKD, as well as their practical application in CKD management. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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Other

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21 pages, 7140 KiB

Open AccessSystematic Review

The Relationship between Vegetarian Diet and Sports Performance: A Systematic Review

by Juan Hernández-Lougedo, José Luis Maté-Muñoz, Pablo García-Fernández, Edurne Úbeda-D’Ocasar, Juan Pablo Hervás-Pérez and Blanca Pedauyé-Rueda

Nutrients 2023, 15(21), 4703; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15214703 - 06 Nov 2023

Cited by 2 | Viewed by 7973

Abstract

Introduction: In recent years, the vegetarian diet has increased in popularity among athletes. The aim of this review is to ascertain the differences in variables related to performance, nutritional intake, and health in athletes according to whether they are omnivores or vegetarians. Methodology: A literature search was carried out in different databases: PubMed, Web of Science, Dialnet, and Cochrane. The keywords used were “vegetarian diet”, “vegan diet”, “exercise”, “sport”, and “performance”. After applying different inclusion criteria, six studies were included in the review. Results: No significant differences were obtained in variables related to physical performance (adherence exercise, Vo2Máx, muscle power, and sprint test) or health (body composition, psychological well-being, and social relationships), but dietary intake was significantly higher in carbohydrates and lower in proteins in vegetarian athletes (p < 0.05). Conclusions: It cannot be affirmed that vegetarian subjects have a higher sports performance, for which more research should be carried out. Full article

(This article belongs to the Special Issue Vegetarian Nutrition in Health Improvement)

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