Risk of Incident Stroke among Vegetarians Compared to Nonvegetarians: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.

Vegetarian dietary patterns provide health benefits for cardiovascular health; however, the studies examining the association of vegetarian diets with stroke incidence showed inconsistent findings. We systematically evaluated the risk of incident stroke among vegetarians (diets excluding meat, poultry, fish, and seafood) compared among nonvegetarians. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was performed until 20 May 2021. Prospective cohort studies comparing the risk estimates for incident stroke between vegetarians and nonvegetarians were included. Of 398 articles identified in the database search, data from seven cohort studies (408 total stroke cases in 29,705 vegetarians and 13,026 total stroke cases in 627,728 nonvegetarians) were included. The meta-analysis revealed no significant association between adhering to the vegetarian dietary patterns and the risk of incident stroke (HR = 0.86; 95% CI = 0.67-1.11; I2 = 68%, n = 7). Subgroup analyses suggested that studies conducted in Asia and those with a mean baseline age of participants 50-65 years showed a lower risk of stroke in vegetarians. Moreover, no significant association between vegetarian diets and the risk of ischemic stroke (HR = 0.56; 95% CI = 0.22-1.42; I2 = 82%, n = 3) or hemorrhagic stroke (HR = 0.77; 95% CI = 0.19-3.09; I2 = 85%, n = 2) was found. To be conclusive, no strong relationship between vegetarian diets and the incidence of stroke was observed. Given the limited certainty of evidence from NutriGrade, future well-designed studies are warranted to provide solid evidence on this topic.

Iron Deficiency in Vegetarian and Omnivorous Individuals: Analysis of 1340 Individuals.

The objective of this study was to evaluate the serum levels of ferritin and the prevalence of iron deficiency in vegan and omnivorous individuals by taking into account the presence of elements that cause an elevation of ferritin levels, such as increased homeostatic model assessment of insulin resistance (HOMA-IR), body mass index (BMI), and high-sensitivity C-reactive protein (hs-CRP) values. The parameters were evaluated in 1340 individuals, i.e., 422 men and 225 women who do not menstruate and 693 women who do menstruate, based on omnivorous or vegetarian eating habits. The progressive increase in BMI, HOMA-IR, and inflammation caused an elevation in ferritin concentration, regardless of the eating habits in the groups studied. In the overall sample, omnivores had a higher prevalence of obesity, higher ferritin levels, and a lower prevalence of iron deficiency (ferritin < 30 ng/mL). However, after the exclusion of individuals with inflammation (with overweight/obesity and elevated hs-CRP levels), the actual iron deficiency was assessed and was not higher among vegetarians, except in women with regular menstrual cycles. Our data show that nutritional status and inflammation levels affect ferritin levels and may interfere with the correct diagnosis of iron deficiency in both vegetarian and omnivorous individuals. Compared to vegetarians, women who do not menstruate and men had the same prevalence of iron deficiency when following an omnivorous diet.

Supplement Intake in Recreational Vegan, Vegetarian, and Omnivorous Endurance Runners-Results from the NURMI Study (Step 2).

Nutrient deficiency is a common cause of underperformance in endurance athletes, and supplement intake is frequently considered compensatory for vegan and vegetarian athletes specifically. This study aimed to investigate the patterns of supplement intake among vegan, vegetarian, and omnivorous distance (>10 km) runners and its association with age, sex, and race distance. From a total of 317 runners who participated in an online survey, 220 distance runners (mean age: 38.5 years; mean BMI: 21.75 kg/m2) were selected for the final sample after data clearance and assigned to 100 omnivores, 40 vegetarians, or 80 vegans. Sociodemographic information, racing experience, and patterns of supplement intake, including type, frequency, dosage, etc., were collected using a questionnaire. Macronutrient intake was assessed using a food frequency questionnaire. ANOVA and logistic regression were used for data analysis. The prevalence of supplement intake was 51% for total runners and 72% among vegan runners. Age, sex, and race distance had no significant effect on the type of supplement intake (p > 0.05). Compared to omnivores and vegetarians, vegan runners reported consuming more vitamin (but not carbohydrate/protein or mineral) supplements (p < 0.05). Vitamin B12, magnesium, and multivitamin had the most prevalent use amongst micronutrient supplements. This study points to a central role for supplementary nutritional strategies in different groups of distance runners. The present findings may help future investigations by design to identify specific requirements of endurance runners when adhering to specific kinds of diet particularly plant-based diets.

Quality of Life of Vegetarians during the COVID-19 Pandemic in Brazil.

Health emergencies such as the COVID-19 pandemic can negatively impact quality of life (QoL) due to higher levels of stress, social isolation, and uncertainties. In this scenario, distinct population groups might react differently. Vegetarians, who follow a non-conventional dietary pattern, could be more vulnerable to the abrupt changes in normal life routine and economic instability. Therefore, this study aimed at evaluating if the current pandemic situation somehow affected vegetarians' QoL. A cross-sectional study was carried out in Brazil between 28 July and 14 September 2020 to evaluate the QoL in vegetarians during the pandemic period. Vegetarian adults replied to an online survey that included the VEGQOL and WHOQOL-BREF instruments to evaluate QoL and questions related to the COVID-19 pandemic. A total of 1282 individuals participated. Only 3.8% had tested positive for COVID-19, but 39.9% affirmed having a family member who tested positive for the disease. Almost half (46.3%) of the sample had an income drop due to the pandemic. Results of QoL scores in the different subcategories of vegetarians were similar to previously published data. Individuals who had already tested positive for COVID-19 had lower QoL scores than those who did not test positive, but only in the VEGQOL. QoL was lower for the participants who declared that Sars-Cov-2 had already infected a family member for almost all the parameters evaluated. On the other hand, an income drop affected QoL only partially. Studying how vegetarians are influenced by such conditions contributes to the generation of relevant data that can be used to support healthcare and public policies in the future.

Quality of Life of Brazilian Vegetarians Measured by the WHOQOL-BREF: Influence of Type of Diet, Motivation and Sociodemographic Data.

This study aimed to evaluate the general quality of life (QoL) of Brazilian vegetarians. A cross-sectional study was conducted with Brazilian vegetarian adults (18 years old and above). Individuals were recruited to participate in a nationwide online survey that comprised the WHOQOL-BREF as well as sociodemographic and characterization questions related to vegetarianism. The WHOQOL-BREF is composed of 24 items which are divided into four domains (domain 1: physical health; domain 2: psychological well-being; domain 3: social relationships; and domain 4: environment), plus two general items which were analyzed separately, totaling 26 items. The answers from the questionnaire were converted into scores with a 0-100 scale range, with separate analyses for each domain. Results were compared among groups based on the different characteristics of the vegetarian population. A total of 4375 individuals completed the survey. General average score results were 74.67 (domain 1), 66.71 (domain 2), 63.66 (domain 3) and 65.76 (domain 4). Vegans showed better scores when compared to the other vegetarians, except in domain four, where the statistical difference was observed only for semi-vegetarians (lower score). Individuals adopting a vegetarian diet for longer (>1 year) showed better results for domains one and two, with no difference for the other domains. Having close people also adopting a vegetarian diet positively influenced the results for all domains. On the other hand, it was not possible to distinguish any clear influence of the motivation for adopting a vegetarian diet on the scores' results. Adopting a vegetarian diet does not have detrimental effects on one's QoL. In fact, the more plant-based the diet, and the longer it was adopted, the better the results were.

Vitamin B6 Status among Vegetarians: Findings from a Population-Based Survey.

Vitamin B6 from plant foods may have lower bioavailability than vitamin B6 from animal foods, but studies on objectively measured vitamin B6 status among vegetarians compared to non-vegetarians are lacking. Thus, the vitamin B6 status among vegetarians, but also pescatarians, and flexitarians, compared to meat-eaters was assessed in the population-based NHANES study (cycles 2007-2008 and 2009-2010). Data on serum pyridoxal-5'-phosphate (PLP) and 4-pyridoxic acid (4-PA) measured by high-performance liquid chromatography (HPLC) as well as dietary intakes from 24-h recalls were available for 8968 adults aged 20-80 years. Geometric mean (±standard error) PLP concentrations were 58.2 ± 6.0, 52.1 ± 3.7, 49.2 ± 4.6 and 51.0 ± 1.1 nmol/L among vegetarians, pescatarians, flexitarians, and meat-eaters. The 4-PA concentrations were 32.7 ± 4.0, 29.0 ± 2.5, 34.8 ± 5.6 and 33.0 ± 0.7, respectively. There were no statistically significant differences in PLP, 4-PA, and their ratio across the groups in multivariable linear regression models. Overall, the use of vitamin B6 supplements was the strongest predictor of the vitamin B6 status, followed by the dietary vitamin B6 intake. Interestingly, several other covariates were significantly associated with vitamin B6 biomarker levels, particularly serum albumin, creatinine and alkaline phosphatase, and should be considered when assessing the vitamin B6 status. In summary, our findings suggest that a vegetarian diet does not pose a risk for vitamin B6 deficiency.

Depression and Vegetarians: Association between Dietary Vitamin B6, B12 and Folate Intake and Global and Subcortical Brain Volumes.

Deficiency of vitamin B6 and vitamin B12, mostly in vegetarians, is found to be associated with depression and adverse neurological function. We investigated whether vitamin B6, B12, and folate have an effect on brain structure, especially among depressed people who follow a specific diet. The study sample comprised 9426 participants from the UK Biobank cohort with a mean age of 62.4 years. A generalized linear model controlling for age, sex, body mass index, ethnicity, town send deprivation index, educational qualification, smoking, and alcohol intake was used to test the association between study groups and structural brain volumes. Depression was more prevalent, and intake of vitamin B6 and B12 was lower among vegetarians, while non-vegetarians had a lower intake of folate. Overall, no significant association was observed between vitamin B6, B12, and folate intakes and both global and subcortical brain volumes among participants with depression. However, vitamin B12 intake was positively associated with right pallidum among non-depressed participants, and a significant interaction between vitamin B12 intake and depression status on the right pallidum was observed. Also, a significant interaction between folate intake and depression status on grey matter (GM) volume and left thalamus was observed. Upon diet stratification, folate intake is associated with total brain volume and GM volume among vegetarians with depression. Furthermore, no significant associations were observed for subcortical regions. Our findings suggest that dietary intake of vitamin B6 and B12 might have an effect on brain structure. Vegetarians, particularly those who suffer from depression may benefit from supplementing their diets with vitamins B6, B12, and folate to ensure brain health. Further studies, especially with a larger sample size and longitudinal design, are needed to confirm these findings.

Iron Status of Vegans, Vegetarians and Pescatarians in Norway.

Although plant-based diets provide well-established physical and environmental health benefits, omitting meat or meat products has also been associated with a risk of being deficient in specific nutrients, such as iron. As data on the iron status among Norwegian vegans, vegetarians and pescatarians are lacking, the present study aimed to assess iron status in these groups of healthy adults. Blood markers for iron status were measured in 191 participants (18-60 years old) comprising 106 vegans, 54 vegetarians and 31 pescatarians: serum-ferritin (S-Fe), serum-iron (S-Iron) and serum-total iron binding capacity (S-TIBC). Serum-transferrin-saturation (S-TSAT) was estimated (S-Iron/S-TIBC × 100). The median concentration of blood markers for iron status were within the normal range with no difference between the different dietary practices. In total, 9% reported iron supplement use the last 24 h. S-Fe concentrations below reference (<15 µg/L) were found in 8% of the participating women, of which one participant reported iron supplement use. In multiple regression analysis, duration of adherence to dietary practices and the female gender were found to be the strongest predictors for decreased S-Fe concentration. In conclusion, although the participants were eating a plant-based diet, the majority had sufficient iron status. Female vegans and vegetarians of reproductive age are at risk of low iron status and should have their iron status monitored.

Distribution of Antibiotic Resistance Genes in the Saliva of Healthy Omnivores, Ovo-Lacto-Vegetarians, and Vegans.

Food consumption allows the entrance of bacteria and their antibiotic resistance (AR) genes into the human oral cavity. To date, very few studies have examined the influence of diet on the composition of the salivary microbiota, and even fewer investigations have specifically aimed to assess the impact of different long-term diets on the salivary resistome. In this study, the saliva of 144 healthy omnivores, ovo-lacto-vegetarians, and vegans were screened by nested PCR for the occurrence of 12 genes conferring resistance to tetracyclines, macrolide-lincosamide-streptogramin B, vancomycin, and ß-lactams. The tet(W), tet(M), and erm(B) genes occurred with the highest frequencies. Overall, no effect of diet on AR gene distribution was seen. Some differences emerged at the recruiting site level, such as the higher frequency of erm(C) in the saliva of the ovo-lacto-vegetarians and omnivores from Bologna and Turin, respectively, and the higher occurrence of tet(K) in the saliva of the omnivores from Bologna. A correlation of the intake of milk and cheese with the abundance of tet(K) and erm(C) genes was seen. Finally, when the occurrence of the 12 AR genes was evaluated along with geographical location, age, and sex as sources of variability, high similarity among the 144 volunteers was seen.

Health, environmental, and animal rights motives for vegetarian eating.

Health, the environment, and animal rights represent the three main reasons people cite for vegetarian diet in Western societies. However, it has not been shown that these motives can be distinguished empirically, and little is known about what kind of people are likely to be compelled by these different motives. This study had three goals. First, we aimed to use construct validation to test whether develop health, environmental, and animal rights motives for a vegetarian diet could be distinguished. Second, we evaluated whether these motivations were associated with different demographic, behavioral, and personality profiles in three diverse samples. Third, we examined whether peoples' motivations were related to responses to vegetarian advocacy materials. We created the Vegetarian Eating Motives Inventory, a 15-item measure whose structure was invariant across three samples (N = 1006, 1004, 5478) and two languages (English and Dutch). Using this measure, we found that health was the most common motive for non-vegetarians to consider vegetarian diets and it had the broadest array of correlates, which primarily involved communal and agentic values. Correlates of environmental and animal rights motives were limited, but these motives were strong and specific predictors of advocacy materials in a fourth sample (N = 739). These results provide researchers with a useful tool for identifying vegetarian motives among both vegetarian and non-vegetarian respondents, offer useful insights into the nomological net of vegetarian motivations, and provide advocates with guidance about how to best target campaigns promoting a vegetarian diet.

On Meat, Butter, and Fudge.

Was the Annals of Internal Medicine recently acting as a mouthpiece for meat-industry propaganda? Five papers underpinned recommendations on meat consumption; their central deceit was to review only randomized controlled trials and cohort studies, which, in research on the associations between common foods and disease outcomes, are nearer to the bottom than the top of the evidence hierarchy. Despite concluding that their own recommendations were "weak and based on low certainty evidence", the authors were happy to recommend that there is "No need to reduce red or processed meat consumption for good health." What we actually know is that: red meat consumption is an order of magnitude higher now than through most of human history; red meat is a probable, and processed meat is a definite, human carcinogen; saturated fat increases risk of heart disease; and vegans and vegetarians have better lipid profiles, lower risk of chronic disease, and greater longevity than meat eaters. There are other consequences of meat consumption too, including: altered sexual development; widespread antimicrobial resistance; and disrupted planetary health, including depletion of aquifers, groundwater pollution, and increased greenhouse gases. The pseudoscience presented in the Annals of Internal Medicine appears to have been written solely to create doubt and confusion in the wider population. Scientists and journals should hold themselves to a higher standard.

Vegetarianismo entre ingressantes de uma universidade pública no sul do Brasil, 2018 / Vegetarianismo entre estudiantes de primer año en una universidad pública del sur de Brasil, 2018 / Vegetarianism among first-year students at a public university in Southern Brazil, 2018

Objetivo: Analisar a prevalência de vegetarianismo e fatores associados em estudantes de uma universidade pública no sul do Brasil. Métodos: Estudo transversal realizado em 2017-2018, incluindo ingressantes universitários. Questionário foi aplicado para avaliar o tipo de dieta (onívora ou vegetariana). Regressão logística foi utilizada para estimar razões de odds (RO) e intervalos de confiança de 95% (IC95%). Resultados: De 2.706 indivíduos elegíveis, 1.841 fizeram parte da amostra. O tipo de dieta predominante foi a onívora (93,6%), seguida por ovolactovegetariana (5,4%), vegetariana estrita (0,7%), ovovegetariana (0,2%) e lactovegetariana (0,1%). Mulheres (RO=0,58 - IC95% 0,38;0,89), ingressantes que referiram uso prejudicial de álcool (RO=2,02 - IC95% 1,34;3,04) e matriculados na área de Linguística, Letras e Artes - comparados aos matriculados em Ciências Sociais Aplicadas e Humanas (RO=2,59 - IC95% 1,42;4,71) - tiveram maior chance de serem vegetarianos. Conclusão: A dieta vegetariana associou-se ao sexo feminino, uso de álcool e ingresso em cursos de linguística, letras e artes.

Objetivos: Identificar la prevalencia del vegetarianismo y factores asociados entre estudiantes de una universidad pública en el sur del Brasil. Métodos: Estudio transversal realizado entre 2017-2018, incluyendo a estudiantes de primer año de una universidad pública. Se aplicó el cuestionario para evaluar el tipo de dieta (omnívora o vegetariana). Se utilizó la regresión logística para verificar factores asociados (demográficos, socioeconómicos, curso, comportamientos relacionados con la salud y estado nutricional) e intervalos de confianza de 95% (IC95%). Resultados: De 2,706 individuos elegibles, 1,841 hicieron parte de la muestra. El tipo de dieta predominante fue omnívora (93.6%), seguida de ovolactovegetariana (5.4%), vegetariana estricta (0.7%), ovo vegetariana (0.2%) y lactovegetariana (0.1%). Mujeres (RO=0,58 - IC95% 0,38;0,89), estudiantes que relataron uso perjudicial de alcohol (RO=2.02 - IC95% 1.34;3.04) e inscritos en Lingüística, Letras y Artes fueron más propensos a ser vegetarianos comparados con los inscritos en Ciencias Sociales Aplicadas y Humanas (RO=2,59 - IC95% 1,42;4,71). Conclusión: la dieta vegetariana se asoció al sexo femenino, consumo de alcohol y al ingreso a cursos de Lingüística, Letras y Artes.

Objective: To identify vegetarianism prevalence and associated factors among students at a public university in Southern Brazil. Methods: This was a cross-sectional study carried out in 2017-2018 with first-year university students. A questionnaire was administered to assess diet type (omnivorous or vegetarian). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). Results: Of 2,706 eligible individuals, 1,841 formed part of the sample. The predominant type of diet was omnivorous (93.6%), followed by lacto-ovo vegetarian (5.4%), strict vegetarian (0.7%), ovo vegetarian (0.2%) and lacto vegetarian (0.1%). Females (OR=0.58 - 95%CI 0.38;0.89), students reporting harmful use of alcohol (OR=2.02 - 95%CI 1.34;3.04) and students enrolled in Linguistics, Modern Languages and Arts courses - compared to those enrolled in Applied Social Sciences and Humanities courses (OR=2.59 - 95%CI 1.42;4.71) - were more likely to be vegetarians. Conclusion: Vegetarian diet was associated with the female sex, alcohol use, and taking linguistics, modern language and arts courses.

Impact of increasing vegetarian availability on meal selection and sales in cafeterias.

Shifting people in higher income countries toward more plant-based diets would protect the natural environment and improve population health. Research in other domains suggests altering the physical environments in which people make decisions ("nudging") holds promise for achieving socially desirable behavior change. Here, we examine the impact of attempting to nudge meal selection by increasing the proportion of vegetarian meals offered in a year-long large-scale series of observational and experimental field studies. Anonymized individual-level data from 94,644 meals purchased in 2017 were collected from 3 cafeterias at an English university. Doubling the proportion of vegetarian meals available from 25 to 50% (e.g., from 1 in 4 to 2 in 4 options) increased vegetarian meal sales (and decreased meat meal sales) by 14.9 and 14.5 percentage points in the observational study (2 cafeterias) and by 7.8 percentage points in the experimental study (1 cafeteria), equivalent to proportional increases in vegetarian meal sales of 61.8%, 78.8%, and 40.8%, respectively. Linking sales data to participants' previous meal purchases revealed that the largest effects were found in the quartile of diners with the lowest prior levels of vegetarian meal selection. Moreover, serving more vegetarian options had little impact on overall sales and did not lead to detectable rebound effects: Vegetarian sales were not lower at other mealtimes. These results provide robust evidence to support the potential for simple changes to catering practices to make an important contribution to achieving more sustainable diets at the population level.

Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study.

OBJECTIVE: To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke. DESIGN: Prospective cohort study. SETTING: The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001. PARTICIPANTS: 48 188 participants with no history of ischaemic heart disease, stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364). MAIN OUTCOME MEASURES: Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified through record linkage until 2016. RESULTS: Over 18.1 years of follow-up, 2820 cases of ischaemic heart disease and 1072 cases of total stroke (519 ischaemic stroke and 300 haemorrhagic stroke) were recorded. After adjusting for sociodemographic and lifestyle confounders, fish eaters and vegetarians had 13% (hazard ratio 0.87, 95% confidence interval 0.77 to 0.99) and 22% (0.78, 0.70 to 0.87) lower rates of ischaemic heart disease than meat eaters, respectively (P<0.001 for heterogeneity). This difference was equivalent to 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in vegetarians than in meat eaters per 1000 population over 10 years. The associations for ischaemic heart disease were partly attenuated after adjustment for self reported high blood cholesterol, high blood pressure, diabetes, and body mass index (hazard ratio 0.90, 95% confidence interval 0.81 to 1.00 in vegetarians with all adjustments). By contrast, vegetarians had 20% higher rates of total stroke (hazard ratio 1.20, 95% confidence interval 1.02 to 1.40) than meat eaters, equivalent to three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke. The associations for stroke did not attenuate after further adjustment of disease risk factors. CONCLUSIONS: In this prospective cohort in the UK, fish eaters and vegetarians had lower rates of ischaemic heart disease than meat eaters, although vegetarians had higher rates of haemorrhagic and total stroke.

A comparison of L-carnitine and several cardiovascular-related biomarkers between healthy vegetarians and omnivores.

OBJECTIVE: A plant-based diet has been associated with a reduced risk of cardiovascular (CV) diseases. This study aimed to determine the levels and correlations of CV-related biomarkers and the beneficial role of dietary habits. METHODS: A total of 63 healthy vegetarians (n = 32) and omnivores (n = 31) were recruited. The baseline characteristics were recorded and measured (including lipid profiles, blood glucose, etc.). Liquid chromatography-mass spectrometry method was developed for the simultaneous determination of seven circulating CV-related biomarkers. RESULTS: L-carnitine (L-Car), L-methionine, and ascorbic acid (AA) were significantly higher in vegetarians than in omnivores. In the vegetarians, L-Car had a negative correlation with triacylglycerols (P = 0.042) and blood glucose (P = 0.048) and a positive correlation with high-density lipoprotein cholesterol (P = 0.049). L-Car was also positively correlated with L-lysine (P = 0.009), L-methionine (P = 0.006), and AA (P = 0.035). The vegetarians' AA also had a negative correlation with L-homocysteine (P = 0.028). In the omnivores, L-Car was negatively correlated with total cholesterol (P = 0.008), low-density lipoprotein cholesterol (P = 0.004), and high-density lipoprotein cholesterol (P = 0.038). Omnivores' body mass index was positively correlated with L-homocysteine (P = 0.033), and age was positively correlated with trimethylamine N-oxide (P < 0.001) and blood glucose (P = 0.007), but not in vegetarians. CONCLUSIONS: Our results suggest that vegetarians have an elevated level of L-Car, which might be associated with endogenous biosynthesis and diet composition. Circulating L-Car might play an important role in CV protection, especially in vegetarians.

Young adult vegetarians in Shanghai have comparable bone health to omnivores despite lower serum 25(OH) vitamin D in vegans: a cross-sectional study.

BACKGROUND AND OBJECTIVES: The association between a vegetarian diet and bone mineral density (BMD) remains unclear, particularly in young adults. This study was designed to compare the bone health status of young vegetarians and omnivores in Shanghai, China. METHODS AND STUDY DESIGN: A total of 246 vegetarians (following a vegan or lacto-ovo-vegetarian diet for at least 1 year) and 246 age- and sex-matched omnivores were recruited among young adult residents of Shanghai, China. The ultrasound bone mineral density analyser CM-200 was employed to measure calcaneus mineral densities, and blood samples were collected to determine serum 25- hydroxyvitamin D status. Intakes of protein, calcium and vitamin D were assessed by the 24-hour dietary recall method. RESULTS: The average age of the vegetarians was 32.7±6.5 years, 83.3% of whom were female; 71.3% of the participants had been vegetarians for no more than 5 years. After adjusting for some potential cofounding factors, the serum 25-hydroxyvitamin D concentration of vegans (15.0±13.4 µg/L) was significantly lower than that of omnivores (17.6±8.8 µg/L, p<0.05). The protein, calcium and vitamin D intakes of vegetarians were all lower than those of omnivores (p<0.05). However, there was no significant difference in calcaneus mineral density between vegetarians and omnivores or between vegans and lacto-ovo vegetarians. CONCLUSIONS: Serum 25- hydroxyvitamin D concentrations in vegans, but not in lacto-ovo vegetarians, were slightly lower than those in omnivores. However, short-term vegetarian diets did not result in adverse effects on bone mineral density in young Chinese adults.

Estudio exploratorio del vegetarianismo en restauración colectiva / An exploratory study of vegetarianism in catering establishment

Introducción: el interés por las dietas vegetarianas está en auge, pero siguen existiendo muchas dudas y controversia al respecto. Temas como sus posibles deficiencias nutricionales, o si son adecuadas o saludables, podrían no ser ampliamente conocidos. Objetivos: explorar estas dietas, ver el nivel de conocimiento que existe sobre ellas y analizar y mejorar nutricionalmente los menús vegetarianos de un restaurante con opciones vegetarianas. Métodos: el diseño del estudio fue de tipo descriptivo, transversal y exploratorio. Se entregaron cuestionarios con 17 preguntas y un cuestionario de frecuencia de consumo de alimentos entre los clientes del restaurante. Participaron un total de 155 personas, con un rango de edad de 18-62 años. Se analizaron un total de 30 menús y se hicieron sugerencias para mejorarlos. Resultados: de la muestra total, 138 personas eran omnívoras, 12 eran vegetarianas y dos, veganas. Más de la mitad de los vegetarianos no sabían que la única suplementación necesaria por defecto es la B12 y el ≈60% de ellos dijo no suplementarse nunca con ella. Los menús vegetarianos analizados aportaban de media 1.195 kcal y cubrían el 89% de la ingesta recomendada de fibra, el 212% de vitamina C, ≈30% de calcio y zinc, el 86% de hierro y el 38% de B12. Se observaron niveles insuficientes de vitamina D. Conclusiones: existe un gran desconocimiento sobre muchos aspectos de las dietas vegetarianas, incluso entre los propios vegetarianos. Informar al público es primordial, tanto para evitar deficiencias nutricionales potencialmente peligrosas (B12), como para atraer a más personas hacia este tipo de dietas, con los beneficios que esto acarrearía. Se observaron niveles muy adecuados de nutrientes en los menús vegetarianos de Foodtopía. Las principales sugerencias de mejora fueron: reducir las calorías totales y la cantidad de aceite de girasol y aumentar la cantidad de legumbres, frutos secos y semillas

Introduction: interest in vegetarian diets is rising, however, it remains a very controversial topic, and with many reservations regarding it. Questions like their conceivable nutritional deficiencies, or if they are adequate or healthy, might be widely unknown. Objectives: exploring vegetarian diets, examining the current level of knowledge about them, and analyzing and improving, from a nutritional standpoint, the vegetarian menus of a restaurant with vegetarian options. Methods: this study was designed as an exploratory, crossover, descriptive study. Surveys with 17 items and a food frequency questionnaire were given among the customers of the restaurant. A total of 155 people, aged between 18 and 62, took part in it. A total of 30 menus were analyzed, and some suggestions were made in order to improve them. Results: out of the total sample, 138 people were omnivores, 12 people were vegetarians and two were vegans. More than half of the vegetarians did not know vitamin B12 is the only required supplement by default, and almost 60% of them stated never taking B12 supplements. The vegetarian menus which were analyzed provided a mean of 1,195 kcal, and covered 89% of the requirements of fiber, 212% of vitamin C, ≈30% of both calcium and zinc, 86% of iron, and 38% of B12. Conclusion: a great lack of knowledge regarding several aspects of vegetarian diets was found, even among vegetarian themselves. Informing the general public is essential for both avoiding dangerous nutritional deficiencies (like B12), and attracting more people towards this kind of diets, with all the benefits this would provide. In the vegetarian menus of Foodtopía, adequate levels of nutrients were observed. The main suggestions to improve the menus were: reducing the total calories and the amount of sunflower oil, and increasing the amount of legumes, nuts and seeds

Which Is a Good Diet-Veg or Non-veg? Faith-Based Vegetarianism for Protection From Obesity-a Myth or Actuality?

INTRODUCTION: India ranks first among nations with the largest population of vegetarians, and 40% of Asian Indians are vegetarian. There seems to occur a "nutrition transition" among vegetarians in India with a decline in the consumption of whole plant food content and replacement with processed foods, fried foods, and refined carbohydrates. This study evaluates the association between the consumption of a vegetarian diet and the prevalence of morbid obesity necessitating bariatric surgery in Asian Indians. MATERIAL AND METHODS: This is a retrospective cohort study analyzing records of 235 Indian patients suffering from morbid obesity and who underwent bariatric surgery at our center through the years 2015 to 2017. Pearson's chi-square test for independence of attributes was applied to analyze the difference between a number of vegetarians versus non-vegetarians undergoing bariatric surgery. RESULTS: The difference in the number of vegetarians versus non-vegetarians undergoing bariatric surgery was not significant for years 2015 and 2017, but the number was numerically higher for vegetarians. The difference was significantly higher for vegetarians in the year 2016. The difference in female vegetarians versus female non-vegetarians undergoing bariatric surgery was not significant for the year 2017 but was significantly higher for vegetarians during the years 2015 and 2016. The difference in male vegetarians versus non-vegetarians undergoing bariatric surgery was not significant for all the years. CONCLUSION: In an Asian Indian cohort, we found that vegetarian dietary patterns were associated with a higher incidence of morbid obesity culminating in bariatric surgery. Our study is a myth breaker that all vegetarian diets are healthy diets. Our findings can be utilized to discourage refined and processed food consumption and promote healthy vegetarian food choices.

Distinguishing vegan-, vegetarian-, and omnivorous diets by hair isotopic analysis.

BACKGROUND: Dietary risks contribute heavily to disability-adjusted life years (DALYs), being more important than hypertension, obesity, or smoking. To measure dietary exposure remains a challenge in nutrition research. AIMS: The aim of the present study was to test the hypothesis that isotope ratios of 15N and 13C in human hair could distinguish between subjects adhering to different habitual diets. METHODS: 20 male and 29 female subjects average 31 years old (range 19-53), with stable dietary habits volunteered. Diets were vegan, vegetarian and omnivorous. Hair samples were processed on an elemental analyser coupled to isotope-ratio mass spectrometry. RESULTS: δ15N differed between vegan, vegetarian and omnivorous diets, p < 0.05 for all. δ13C differed between vegan and omnivorous diets, p < 0.05, but neither of these diets were separated from the vegetarian diet. CONCLUSION: Elemental Analysis of δ13C and especially δ15N with isotope ratio mass spectrometry seems to be a promising, non-invasive and objective way to distinguish groups of subjects on different habitual diets, at least if n=>10.