The co-benefits of climate change mitigation strategies on cardiovascular health: a systematic review.

Background: Climate change is a significant threat to global human health and a leading cause of premature death. Global warming, leading to more extreme weather (in particular extreme heat events), and air pollution has been associated with increased cardiovascular disease (CVD) morbidity and mortality. According to the Global Burden of Disease Study 2019, 62% of the deaths attributable to climate change were from CVD. Climate change mitigation is a slow, steady process, and the concept of co-benefits has arisen to promote climate action. This systematic review examines how numerous mitigation strategies, such as plant-based diets, increasing green spaces, increasing active transport, using renewable energy sources, and smoking cessation, may have the co-benefit of reducing CVD. Methods: A mixed methods systematic review with narrative synthesis was conducted on four databases, according to the PRISMA guidelines. The articles retrieved (published between 2012 and 2022) had a mitigation strategy as the exposure, and CVD related morbidity or mortality reduction as an outcome. Findings: The review found that renewable energy has a stronger association with cardiovascular co-benefits compared to emission reduction targets. Multimodal transport is more beneficial for both the climate and cardiac health than zero emission vehicles. Diet modification, such as Mediterranean and plant-based-diets, is positively associated with CVD reduction. Proximity to green spaces and reducing urbanisation may also improve cardiac health. Interpretation: This systematic review demonstrates that implementing four mitigation strategies - increasing renewable energy use, active transport, green spaces, and plant-based diets; could lead to the co-benefit of reducing CVD morbidity and mortality. Furthermore, it illustrates the importance of plant-based diets and active transport to improve cardiovascular health. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Validity and reliability of the Sustainable HEalthy Diet (SHED) index by comparison with EAT-Lancet diet, Mediterranean diet in Turkish adults.

Background: Food consumption and diet are strongly associated with sustainability. The Sustainable HEalthy Diet index was developed to measure the nutritional, environmental, and sociocultural components of sustainable diets and healthy eating patterns. However, a methodological approach has yet to be proposed for Turkish adults. This study aimed to determine the validity and reliability of the SHED index in Turkish adults. Methods: Data were collected from 558 healthy adults using a web-based questionnaire. Internal consistency reliability was evaluated using Cronbach's alpha coefficient, and repeatability was evaluated using the test-retest method. Construct validity was investigated using the EAT-Lancet diet and the Mediterranean Diet Adherence Screener (MEDAS), and the adapted SHED index structures' accordance was evaluated with confirmatory factor analysis. Results: Good reliability and repeatability were found (r = 0.758 and 0.795, respectively). A higher SHED index score was related to a greater intake of grains, fruits, and vegetables and a lower intake of meat, eggs, and dairy compared to EAT-Lancet diet food groups. A higher SHED index score was associated with a lower saturated fat and added sugar intake. While the SHED index was associated with greater adherence to the Mediterranean diet (r = 0.334, p < 0.001), it was negatively associated with non-alcoholic and diet non-alcoholic beverage consumption (r = -0.257 and -0.264, respectively; p < 0.001). Conclusion: The SHED index showed good validity and reliability in Turkish adults. Our results suggest that the SHED index can be used in epidemiological and intervention studies because it allows the measurement of diets in terms of health and sustainability to propose adaptations accordingly.

Purified diets containing high levels of soluble fiber and grain-based diets promote similar gastrointestinal morphometry yet distinct microbial communities.

Dietary fibers play a crucial role in shaping the gut microbiome and influencing gastrointestinal (GI) physiology. Grain-based diets (GBDs) are widely used in rodent studies, but their utility is limited due to batch-to-batch variability resulting from inconsistent ingredients. Purified diets (PDs) are composed of only known and refined ingredients and offer a solution to the constraints of GBDs. This study aimed to identify a combination of dietary fibers in a purified diet (PD) that promotes optimal murine gut morphometry and a diverse intestinal microbial community. Male C57BL/6J mice were fed either two grain-based diets (GBDs) or four PDs with varying fiber compositions for 28 days. Mice consuming PDs lacking soluble fiber had more gonadal fat (P < 0.05), shorter small intestines (P < 0.05), and lighter ceca (P < 0.05) compared with those fed the LabDiet 5001 GBD. Increasing the proportion of soluble fibers in PDs progressively reduced microbial diversity in the cecum and colon. Multidimensional scaling analysis revealed distinct microbial communities in the cecum and colon between mice fed GBDs and PDs (P < 0.05). Differential abundance analysis identified relatively more Family XII UCG 001 and less Lactococcus in mice fed GBDs relative to mice consuming PDs (P < 0.05). While no PD recapitulated the gut microbial composition of GBDs, PDs with high soluble fiber content best preserved GI morphometry. These findings underscore the importance of considering diet as an experimental variable and highlight the need for a PD formulation that combines the benefits of GBDs on GI health and microbial richness. IMPORTANCE: Dietary fibers are essential for maintaining gut health. Insoluble fibers aid in fecal bulking and water retention while soluble fiber is a fermentative substrate for intestinal microbial communities. Grain-based diets (GBDs) are commonly used in preclinical research but the variability in ingredients across batches impedes reproducibility. Purified diets (PDs), which are composed of highly refined ingredients, pose a potential solution but the most widely used low-fat control PDs contain no soluble fiber. This study intended to identify a PD with a combination of fibers that promotes murine gut health and microbial diversity. A PD with optimal fiber composition would aid in the standardization and reproducibility of studies investigating intestinal physiology and the gut microbiota.

Nutritional Psychology: Review the Interplay Between Nutrition and Mental Health.

Nutritional psychology is a burgeoning field that examines the intricate relationship between nutrition and mental health. This concept, its historical development, and its current significance in understanding the complex interplay between diet and psychological well-being are explored in this article. The influence of various nutrients on mental health, the role of dietary patterns, and the impact of nutrition on specific mental disorders are examined. Highlighted are the potential mechanisms underlying the nutrition-mental health connection, and the implications for clinical practice and public health interventions are discussed. The discussion in this article underscores the importance of considering nutrition as essential in mental health promotion and treatment.

Contrasting Effects of an Atherogenic Diet and High-Protein/Unsaturated Fatty Acids Diet on the Accelerated Aging Mouse Model SAMP8 Phenotype.

Background/Objectives: Aging has been extensively studied, with a growing interest in memory impairment by a neurobiological approach. Mitochondrial dysfunction is a hallmark of aging, contributing to the aging phenotype; therefore, mitochondrial interventions seem fundamental. The diet is a physiological approximation for modifying mitochondria, which could impact the age-related phenotype. Methods: We studied two diets with low-carbohydrate and high-fat compositions, differing in the amount of protein and the fat type disposable-the atherogenic diet Cocoa (high protein/high saturated fat/high cholesterol) and the South Beach diet (very high-protein/high-unsaturated fat)-on oxidative stress, mitochondrial state, and hippocampus-dependent memory in 3-month-old Senescence-Accelerated Mouse Model (SAMP8) seed over 3 months to determine their pro- or anti-aging effects. Results: Despite its bad reputation, the Cocoa diet reduces the reactive oxygen species (ROS) content without impacting the energy state and hippocampus-dependent spatial acuity. In contrast to the beneficial impact proposed for the South Beach diet, it induced a pro-aging phenotype, increasing oxidative damage and the levels of NR2B subunit of the NMDA, impairing energy and spatial acuity. Surprisingly, despite the negative changes observed with both diets, this led to subtle memory impairment, suggesting the activation of compensatory mechanisms preventing more severe cognitive decline. Conclusions: Our results demonstrated that diets usually considered good could be detrimental to the onset of aging. Also, probably due to the brain plasticity of non-aged animals, they compensate for the damage, preventing a more aggravated phenotype. Nevertheless, these silent changes could predispose or increase the risk of suffering pathologies at advanced age.

Environmental sustainability and nutritional quality of different diets considering nutritional adequacy.

This study examines how four diets change nutritionally and environmentally when the diets are nutritionally adjusted. Data on individual Belgian diets of omnivores (n = 131), pescovegetarians (n = 159), vegetarians (n = 494), and vegans (n = 78) were obtained, called non-adjusted diets. We assessed if diets met energy and nutrient intake requirements and calculated the Alternative Healthy Eating Index (AHEI)-2010. The environmental impact was evaluated by a cradle-to-grave life cycle assessment considering all midpoint indicators of the Environmental Footprint 3.0 and expressing the impact per "daily food and supplement intake by one Belgian adult". The individual dietary intakes were adjusted nutritionally to meet the recommended energy and nutrition intakes using a quadratic programming algorithm. All diets had a significantly improved AHEI score but also a significantly increased water use (WU) when adjusting. The omnivore's diet demonstrated a significantly decreased carbon footprint (CF) while it significantly (except for vegans) raised for the restrictive diets due to adjustment. The omnivorous diet had the greatest improvements in AHEI (15.4), while WU increased the most among all diets (3.7 m3), primarily due to elevated fruit intake. The CF was reduced with 1.2 kg CO2 due to decreased red meat consumption. The AHEI of the vegan diet improved the second most of all diets (13.2) due to the intake of omega-3 supplements, while its WU rose the least of all diets (2.4 m3), and its CF barely increased (0.1 kg CO2-eq). The AHEI improvements of the vegetarian diet were similar to those of the vegan diet (12.5), while the one of the pescovegetarian diet was limited (3.5). The (pesco)vegetarian diet had an increase in WU (2.5 and 2.7 m3) and the highest increase in the CF (0.3 kg CO2-eq). Since nutritionally adjusted diets do not lead to similar nutritional and environmental improvements, this research highlights the need to assess both metrics.

The EAT-Lancet diet associated cardiovascular health parameters: evidence from a Brazilian study.

BACKGROUND: The EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil. METHODS: This is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from "Brazilian Usual Consumption Assessment" study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little's MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet's sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson's chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters. RESULTS: The mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p < 0.05). Notably, among the most consumed UPF, the following stand out: "packaged snacks, shoestring potatoes, and crackers" (16.94%), followed by margarine (14.14%). The PHDI exhibited a significant association with diabetes and dyslipidemia, as well as with systolic blood pressure, total cholesterol, and LDL-C. CONCLUSIONS: The results suggest that adopting the EAT-Lancet diet is associated with the improvement of key cardiovascular health indicators.

Growth performance and carcass characteristics of bulls fed tannins associated or not with monensin.

This study aimed to evaluate the effect of tannin (a mix of hydrolyzable and condensed) and its association with monensin on feed efficiency, growth performance, and carcass of bulls fed high-grain diets with 14% and 13% crude protein (CP). Bulls (64 Nellore and 96 crossbred Angus × Nellore; initial body weight (BW) = 342 ±â€…25 kg; 20 ±â€…1 months) were allocated into 20 pens (8 from the same breed per pen). The treatments were T14 - 1.5 g of tannin/kg of dry matter (DM) (Bypro; Silva Team Brasil, Estância Velha, Brazil) in a diet with 14% of CP; M14 - 25 ppm monensin (Rumensin; Elanco Saúde Animal, São Paulo, Brazil) in a diet with 14% of CP; TM14 - 1.5 g of tannin/kg of DM and 25 ppm monensin in a diet with 14% of CP; TM13 - 1.5 g of tannin/kg of DM and 25 ppm monensin in a diet with 13% of CP. Data were analyzed using a randomized block design with pens as experimental units. Supplementation with tannin resulted in greater final BW, average daily gain (ADG), and dry matter intake (DMI) compared with Monensin (P < 0.05). The association between Tannin and Monensin decreased (P < 0.05) DMI without affecting growth performance, consequently improving the gain-to-feed ratio compared to the Tannin-alone treatment. When Tannin was combined with Monensin, there was an increase (P < 0.05) in net energy for gain and net energy for maintenance compared with Tannin supplementation alone. Bulls supplemented with Tannin in their diet exhibited greater (P < 0.05) hot carcass weight, carcass gain, and gluteus medius area compared with those supplemented with Monensin alone. Final BW, ADG, and DMI were lower (P < 0.05) when the CP content of the diet was decreased from 14% to 13%. The optimal combination for achieving maximum growth and feed efficiency was observed when bulls were fed with tannin and monensin combined in a diet containing 14% CP.

Introducing menus of three weekly insect- or plant-based dinner meals slightly reduced meat consumption in Danish families: Results of a randomized intervention study.

The environmental concerns associated with excess meat consumption have emphasized the need for sustainable alternatives. Edible insects offer a promising alternative due to their environmental efficiency and nutritious profile, but their widespread adoption in Western diets remains a challenge. The objective of the study was to investigate the impact of exposing families (parents and children) to insect-based or plant-based dinner menus on dietary pattern, meat intake, and protein intake over a six-week intervention period. The study was a two-arm randomized equivalence trial comparing an insect-based menu to a plant-based control. Families received either an insect or plant-based menu to replace meat in dinner meals three times a week for six weeks, aiming to replace 20% of their meat protein intake. Dietary changes were assessed through dietary registrations and daily questionnaires. Both adults and children maintained their estimated daily total protein intake, while reducing daily meat protein intake. Neither group met the 20% weekly meat replacement goal. In the insect-based menu group, adults and children reached an average 5.5% and 2.3% weekly meat replacement, respectively. In the plant-based menu group, adults and children replaced 9.0% and 4.3%, respectively. Meat attachment had an effect on meat protein intake. The menus slightly reduced meat protein intake. The weekly frequency of meat meals slightly declined, but portions remained the same. By enhancing insect and plant-based food quality and understanding consumer behavior, insect- and plant-based products have the potential to be a complementary alternative in a sustainable dietary transition without sacrificing nutrition. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov: NCT05156853; clinicaltrials. gov/study/NCT05156853.

Serum Biochemical Profile, Intestinal and Liver Histomorphometry of Captive Broad-Snouted Caiman (Caiman latirostris) Fed With a Diet Enriched With Soybean (Glycine max).

The impact of plant-based diets on crocodilians is unclear. Serum profiles and histomorphometry provide valuable insights into their nutritional and physiological status. This study aims to elucidate the impact of three levels of soybean meal substitution combined chicken by-product minced on the growth and health of broad-snouted caiman (Caiman latirostris). The research assesses the effects of diets supplemented with soybean meal on the blood biochemical profile, intestinal histomorphometry, and hepatic parameters of C. latirostris, providing essential information for understanding on the implications of dietary changes in this species. Forty-eight 6-month-old broad-snouted caimans were assigned to three dietary groups (0%, 25%, 40% soybean meal). Over a period of 90 days, data on growth, food consumption, serum biochemical analysis, intestinal and hepatic morphometry were recorded. The results showed that diets containing higher levels of soybean meal did not significantly affect growth, feed intake or serum profiles of total protein, albumin and cholesterol. However, changes in intestinal morphology were observed, with longer and wider villi in the animals feed with diets with soybean meal, indicating a gradual adaptation to new feeding diets. The presence of soybean meal reduced serum glucose and triglyceride profiles and hepatic lipid accumulation without affecting macronutrient digestion and absorption, considered beneficial for the caiman's health. This study provides valuable insights into the inclusion of soybean meal in the diet of Caiman latirostris and its effects on the intestines, liver, and physiology. It also highlights the importance of considering nutritional management as a key tool in improving the well-being and health of crocodilians in captivity.

Effects of temperature and storage duration on quality of an insect artificial diet.

Artificial diets are widely used to produce insects for research and education programs. Completed diets, in which the diets are fully made from individual ingredients and ready to use, often have high water activity, making them vulnerable to degradation. Proper storage is critical to maintaining diet quality, yet the storage conditions are not well investigated. In this study, we characterized the effects of storage conditions (temperatures and storage duration) on the quality of a diet capable of rearing both specialist and generalist insect species. The completed diet, produced by both private industry and a USDA-Agricultural Research Service laboratory, was exposed to varying temperatures during a 24-hour transit over 1600 km. After transit, it was stored at 4°C for a total storage period of 28 days. In a separate experiment, the completed diet was stored immediately after diet production at five fixed temperatures (-20, 4, 22, 25, and 33°C) for up to 28 days. For both experiments, at 5 intervals after storage (1, 7, 14, 21, and 28 days), diet quality was accessed by life history parameters (survival, molting, and weight) of western corn rootworm (Diabrotica virgifera virgifera LeConte) larvae, the most serious maize pest in the United States. Our results showed that exposure to varying temperatures between -2°C and 27°C for 24 hours had no significant impact on diet quality. However, extended storage (beyond 24 hours) at any of the fixed temperatures negatively affected diet quality. Insects reared on diets stored for over 24 hours at fixed temperatures ranging from -20°C to 33°C had significant declines in performance. Among the tested temperatures, -20°C and 4°C were found to be the most effective for preserving diet quality. At these low temperatures, there were no significant changes in insect weight and survival for diets stored within 21 and 28 days, respectively, though molting was significantly reduced within 7 days of storage. These findings provide the base of information on the storage conditions for completed diets, supporting the production of healthy insects.

Plant-based diets-impacts of consumption of little or no animal-source foods on human health.

The world, in 2024, faces both climate and biodiversity crises, and the food system does contribute significantly to these crises. For some, the solution is simple - intakes of animal source foods (ASFs) should be considerably reduced, and consumption of plant-source foods (PSFs) should be greatly increased. Advocates for such a dietary transformation express confidence that plant-based diets will not only benefit planetary health, but will provide nutrient adequacy for all, and will also result in considerable protection from chronic non-communicable diseases (NCDs). However, as described in this perspective, the dramatic reductions in ASFs, entailed by many plant-based diets, will worsen already prevalent micronutrient and protein deficiencies. The protections provided by plant-based diets against NCDs appear to be more strongly associated with reduced intakes of calories and salt, and increased intakes of fruit, vegetables, nuts and whole grains, rather than with reduced intakes of ASFs. Any possible absolute adverse effects of red and processed meat consumption on NCDs are very small and uncertain. Other ASFs either appear to have no impact on NCDs (poultry meat and eggs), or are associated with protections against obesity, cardiovascular events, brain disorders and some cancers (seafood and dairy). Rigorous randomized controlled trials of all newly proposed environmentally-protective plant-based diets are required, so as to provide clear-cut evidence of micronutrient and protein adequacy, with or without, supplementation, fortification and/or biofortification. In the meantime, dietary guidelines should advise moderating excessive consumption, rather than substantially limiting or excluding ASFs from the human diet.

Effect of low vs high dietary-advanced glycation end products on insulin-sensitivity and inflammatory- markers among overweight/obese Asian-Indian adults-A randomised controlled trial.

The present study investigated the effect of low vs high-dietary-Advanced Glycation End products-based diets on oral disposition index-(DIo)-a marker of islet ß-cell function and cardiometabolic risks factors in 38-overweight and obese Asian Indian-adults (aged 25-45 years with body-mass-index (BMI) ≥23kg/m2) through 12-week isocaloric crossover feeding trial. Biochemical-measures included-glucose tolerance test (GTT), Insulin assay (0,30 and 120 min), lipid-profile, serum-adiponectin, serum-AGE and serum-Thiobarbituric acid reactive substances-(TBARS) assessed both at baseline and end of each intervention. Generalised linear models showed that low-dAGE diet significantly improved in oral disposition index [Least Square Mean (SE), +0.3 (0.1); p = 0.03] compared to high-dAGE diet. The low-dAGE diet also showed a significant reduction in 30-minutes plasmapost-glucose-challenge-value:(-8.1[3.8] (mg/dl) vs 3.8 [3.8] (mg/dl); p = 0.01), serum-AGEs-(-3.2 [0.2] (µg/ml) vs -0.8 [0.2] (µg/ml); p = <0.0001) compared to high-dAGE diet. In summary, low-dAGE diets exhibited improvement in the insulin-sensitivity and reduction in the inflammatory levels compared to high-dAGE diets. Hence, study first time in India revealed that low dAGE diets could be a potential strategy to reduce diabetes risk.

Meat and dairy consumption in Scottish adults: insights from a national survey.

BACKGROUND: Reducing meat and dairy consumption has been advocated for environmental benefits. This study aimed to better understand meat and dairy consumption in a population with high intakes. METHODS: Dietary data were obtained from up to two online 24-h dietary recalls of adults (≥16 years) in the 2021 Scottish Health Survey, a nationally representative, repeated cross-sectional survey. The contribution of food groups to meat and dairy intake and the nutritional contributions of meat and milk products to intake of 28 nutrients were examined. Weighted mean (95% confidence interval [CI]) daily intakes were reported per capita, overall, and by demographic subgroups (age, gender and Scottish Index of Multiple Deprivation). RESULTS: Mean daily intakes of total meat and dairy were 80.4 g (95% CI 77.1-83.7) and 238.6 g (95% CI 228.9-248.3) per capita, respectively. Chicken dishes, beef dishes and sandwiches were the primary contributors to meat intake, together accounting for 56.1% of meat consumed. Liquid milk accounted for 63.4% of the dairy consumed. Meat products were an important source of selenium and zinc (accounting for 26% and 25% of intake, respectively), whereas milk products were an important source of calcium (34%), iodine (38%) and vitamin A (25%). CONCLUSIONS: Although meat and dairy consumption in Scotland is high, a number of food groups contributed to meat intake, providing several opportunities to target for a reduction in line with climate change ambitions. However, careful attention is required for replacements to ensure Scottish diets are nutritionally adequate.

Choice architecture promotes sustainable choices in online food-delivery apps.

Greenhouse gas emissions from the food system constitute about one-third of the global total, hence mitigation in this sphere of human activity is a vital goal for research and policy. This study empirically tests the effectiveness of different interventions to reduce the carbon footprint of food choices made on food-delivery apps, using an incentive-compatible online randomized controlled trial with 4,008 participants. The experiment utilized an interactive web platform that mimics popular online food-delivery platforms (such as Just Eat) and included three treatment conditions: a sign-posted meat tax, a carbon-footprint label, and a choice-architecture intervention that changed the order of the menu so that the lowest carbon-impact restaurants and dishes were presented first. Results show that only the choice-architecture nudge significantly reduced the average meal carbon footprint-by 0.3 kg/CO2e per order (12%), driven by a 5.6 percentage point (13%) reduction in high-carbon meal choices. Moreover, we find evidence of significant health and well-being co-benefits. Menu repositioning resulted in the average meal order having greater nutritional value and fewer calories, whilst significantly increasing self-reported satisfaction with the meal choice. Simple back-of-the-envelope calculations suggest that menu repositioning would be a highly cost-effective policy instrument if implemented at scale, with the return on investment expected to be in the range of £1.28 to £3.85 per metric ton of avoided CO2 emissions, depending on implementation costs.

A systematic review and meta-analysis of functional vitamin B12 status among adult vegans.

The dietary intake of vitamin B12 among unsupplemented vegans is notably lower compared to both vegetarians and omnivores. Prolonged low intakes of vitamin B12, such as seen in those adhering to a vegan diet, lead to physiological deficiency of vitamin B12 and an elevated risk of B12-related morbidity. However, while serum B12 serves as a conventional biomarker for assessing B12 status, its utility is limited given its sensitivity and specificity in ascribing physiological deficiency of B12 and the functional vitamin B12 status of those adhering to vegan diets is unclear. We conducted a systematic review and meta-analysis using data based on the full panel of biomarkers of vitamin B12 status to test whether adherence to a vegan diet is associated with an elevated risk of functional vitamin B12 deficiency compared to vegetarian or omnivorous diets. In addition, subgroup analysis was carried out to look at the effect of vitamin B12 supplement use on B12 status among vegans. Our search identified 4002 records, of which 19 studies met the inclusion criteria for the systematic review and 17 studies were taken forward for the meta-analysis. Meta-analysis results revealed significantly lower serum B12, pmol/ (-0.72 [-1.26, -0.18]; p = 0.01) and elevated total homocysteine, µmol/L (tHcy) (0.57 [0.26, 0.89]; p < 0.001) concentrations, alongside elevated methylmalonic acid, nmol/L (MMA) (0.28 [-0.01, 0.57]; p = 0.06) and lower holotranscobalamin, pmol/ (HoloTC) (-0.42 [-0.91, 0.07]; p = 0.09) levels among vegan adults compared to omnivores, indicating increased functional B12 deficiency in addition to low vitamin B12 status in vegan adults. There were no differences between vegans and vegetarians in HoloTC (0.04 [-0.28, 0.35]; p = 0.814) or MMA (-0.05 [-0.29, 0.20]; p = 0.708), but differences were found in serum B12 (-0.25 [-0.40, -0.10]; p = 0.001) and for tHcy (0.24 [0.09, 0.39]; p = 0.002) concentrations. Subgroup analyses indicated that the use of vitamin B12 supplements among vegans contributes to significant improvements in all biomarker concentrations compared to their unsupplemented counterparts. Our findings underscore the need for improved strategies to redress poor vitamin B12 status with appropriate B12 supplementation use among those adhering to vegetarian and vegan diets.

Association between the composite dietary antioxidant index and risk of infertility: Evidence from NHANES 2013-2020 and a Mendelian randomization study.

OBJECTIVE: The Composite Dietary Antioxidant Index (CDAI) measures the antioxidant capacity of the diet, which is believed to provide protection against various diseases, including depression, osteoporosis, and papillomavirus infection, by neutralizing harmful oxidative stress. However, the relationship between CDAI and infertility is not well understood. This research aims to explore the potential correlations between CDAI and the risk of infertility. METHODS: This research harnessed data from the National Health and Nutrition Examination Survey (NHANES) to execute a cross-sectional analysis involving 8263 US women aged 20-45. Each participant was subjected to two distinct 24-h dietary recall interviews. We calculated the CDAI using average daily antioxidant intake. Infertility was assessed using a standardized questionnaire. The association between CDAI and infertility was examined using weighted multiple logistic regression models, while nonlinear correlations were explored through restricted cubic splines. To affirm the robustness of our findings, sensitivity and subgroup analyses were performed using unweighted logistic regression. Additionally, to ascertain the causal influence of circulating antioxidant levels on infertility, a two-sample univariable Mendelian randomization (MR) analysis was conducted, using the inverse variance weighted (IVW) method as the primary analytic approach. RESULTS: Participants who were infertile exhibited lower CDAI levels compared to their fertile counterparts. When confounding variables were accounted for in the multivariate weighted logistic regression model, an inverse relationship was observed between CDAI and infertility, with the odds ratio for the highest versus lowest quartile being 0.55 (0.33-0.90, P = 0.02). However, the IVW method indicated that genetically predicted elevated levels of CDAI did not significantly correlate with infertility. CONCLUSION: Cross-sectional observational studies indicate that antioxidants from diets might diminish infertility risks. However, findings from MR studies do not confirm a causal connection. Additional prospective research is required to elucidate this association further.

Identification of Chinese dietary patterns and their relationships with health outcomes: a systematic review and meta-analysis.

OBJECTIVE: China has been undergoing a rapid nutrition transition in the past few decades. This review aims to characterise commonly reported dietary patterns in Chinese populations and their associations with health outcomes. DESIGN: We searched PubMed, Embase and CNKI from inception to June 2020 to identify observational studies reporting dietary patterns or the associations between dietary patterns and health outcomes. Information regarding dietary patterns, their association with health outcomes and other related items was collected. SETTING: Chinese population and Chinese immigrants. PARTICIPANTS: Not applicable. RESULTS: Results from 130 studies with over 900 000 participants were included. Six dietary patterns were identified: traditional whole-grain diet (Traditional WG), traditional non-whole-grain diet (Traditional NWG), plant-based diet (Plant-based), animal food diet (Animal-food), Western energy-dense diet (Western) and other unclassified diets (Unclassified). The Plant-based diet was associated with a reduced risk of CVD and cancer from prospective studies, reduced risk of diabetes, hypertension, cognitive impairment and depressive symptoms from all study designs. The Traditional WG diet was associated with a reduced risk of diabetes and hypertension. Animal-food diet is associated with a range of metabolic diseases, and Western diet was associated with increased risks of obesity and depressive symptoms. CONCLUSION: Multiple dietary patterns identified reflect the diversity and transitioning of the Chinese diet. A healthy Chinese diet, comprising both the Traditional WG and Plant-based diets, was associated with reduced risks of specific undesirable health outcomes. Promoting this healthy diet will improve public health among the Chinese populations.