Predictors of Eating Less Meat and More Plant-Based Food in the Polish Sample.

The study aimed to identify predictors of the intention to eat less meat and more plant-based foods, including attitudes towards eating meat, habitual meat eating, subjective norms, and self-identity. A cross-sectional study using CAWI (Computer-Assisted Web Interview) was conducted in a group of 1003 Polish adults in 2023. To measure the predictor variables, the following tools were used: Beliefs and Eating Habits Questionnaire (KomPAN), Meat Attachment Questionnaire (MAQ), and scales to measure subjective norms and self-identity. Logistic regression analysis was used to verify associations between independent variables, and the intentions to eat more plant-based food and less meat next year were treated as dependent variables. More respondents were willing to increase their consumption of plant-based foods rather than reduce their meat consumption. The intention to consume less meat and more plant foods was more prevalent among women, older people (only intention to reduce meat consumption), and better-educated people (only intention to increase plant food consumption). Habitual frequency of eating plant foods, negative feelings about meat, and environmentally oriented identities had a stimulating effect on the intention to eat more plant foods and less meat, while experiencing pleasure in eating meat had a limiting effect on the intention to eat more plant foods and less meat. In addition, the habitual frequency of meat consumption and subjective norms reduced the likelihood of eating less meat, while no predictive effect was observed for the intention to eat more plant foods. In conclusion, educational and promotional activities to raise awareness of the link between food consumption and the environment can have a strong impact on eating less meat and more plant-based food, even among those strongly accustomed to meat consumption.

Depression, Anxiety, Emotional Eating, and Body Mass Index among Self-Reported Vegetarians and Non-Vegetarians: A Cross-Sectional Study in Peruvian Adults.

Background: Vegetarianism is commonly associated with various health benefits. However, the association between this dietary regimen and aspects of mental health remains ambiguous. This study compared the symptoms of depression and anxiety, emotional eating (EmE), and body mass index (BMI) in Peruvian vegetarian and non-vegetarian adults. Methods: A cross-sectional study was conducted on 768 Peruvian adults, of whom 284 (37%) were vegetarians and 484 (63%) were non-vegetarians. The Depression Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale-2 (GAD-2), and an EmE questionnaire were applied; additionally, the BMI was calculated. Simple and multiple linear regression and Poisson regression models with robust variance were used to evaluate the association between depression, anxiety, EmE, and BMI with dietary patterns. Results: The vegetarians (Adjusted Prevalence Ratio [PR] = 0.24, 95% CI 0.16-0.31; p < 0.001) reported more depressive symptoms than the non-vegetarians. This trend persisted for anxiety, with an adjusted PR of 0.17 (95% CI: 0.01-0.29; p = 0.012). However, the vegetarians (adjusted PR = -0.38, 95% CI: -0.61--0.14; p < 0.001) reported lower EmE scores compared to the non-vegetarians. Likewise, the vegetarians had a lower mean BMI than the non-vegetarians (B = -0.16, 95% CI: -0.21--0.08; p < 0.001). Conclusions: Vegetarian diets are associated with increased symptoms of depression and anxiety, as well as lower EmE and BMI scores. Further longitudinal studies are needed to elucidate these associations and determine causality and the underlying mechanisms involved.

Plant-based dietary patterns and mortality from all causes, cardiovascular disease, and cancer: The Multiethnic Cohort Study.

BACKGROUND & AIMS: Plant-based dietary patterns have been associated with lower risk of cardiovascular disease (CVD), some cancers, and related mortality in U.S. POPULATIONS: However, the quality of plant foods has rarely been considered in the association between plant-based diets and mortality, especially in a population with various racial and ethnic backgrounds. We investigated whether the adherence to plant-based dietary patterns and the healthiness of plant foods are associated with mortality from all causes, CVD, and cancer and evaluated how the association varies by race and ethnicity. METHODS: A total of 144,729 African American, Japanese American, Latino, Native Hawaiian, and White men and women who participated in the Multiethnic Cohort Study (1993-2019) were included. Cox models were used to estimate HR and 95% CI of mortality from all causes, CVD, and cancer across quintiles of three plant-based diet scores: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). RESULTS: Over an average 21 years of follow-up, we identified 65,087 deaths, including 18,663 from CVD and 16,171 from cancer. Comparing the highest versus lowest quintiles, greater scores of PDI and hPDI were associated with a lower risk of all-cause mortality in both men (HR = 0.85, 95% CI: 0.82-0.89 for PDI; HR = 0.88, 95% CI: 0.85-0.91 for hPDI; both P for trend <0.0001) and women (HR = 0.89, 95% CI: 0.86-0.93 for PDI; HR = 0.86, 95% CI: 0.83-0.89 for hPDI; both P for trend <0.0001). An increased risk of all-cause mortality with uPDI was observed only in women (HR = 1.11, 95% CI: 1.07-1.15, P for trend <0.0001; P for heterogeneity by sex = 0.019). A similar trend was shown for CVD mortality with a significant increase in risk with uPDI for both men and women. PDI was associated with a lower risk of cancer mortality in men (HR = 0.86, 95% CI: 0.80-0.92, P for trend <0.0001), while neither hPDI nor uPDI was associated in either sex. Compared with the other racial and ethnic groups within each sex, the association of uPDI with all-cause mortality was stronger in White men (P for heterogeneity by race and ethnicity = 0.009) and weaker in Latino women (P for heterogeneity = 0.002). CONCLUSION: A healthy plant-based dietary pattern emphasizing the quality of plant foods was associated with a lower risk of all-cause and CVD mortality in both men and women, although the magnitude of the associations varied across racial and ethnic groups.

Plant-Based Diets versus the Mediterranean Dietary Pattern and Their Socio-Demographic Determinants in the Spanish Population: Influence on Health and Lifestyle Habits.

BACKGROUND: Plant-based diets are becoming more and more widespread among the Spanish population, progressively replacing the Mediterranean dietary pattern. Different studies have shown the motivations for adherence to these diets, and others have highlighted some health advantages and disadvantages. PURPOSE OF THE STUDY: Further studies are needed to define the socio-demographic determinants that influence the choice of a plant-based diet and to study the relationship that the choice of dietary pattern has on the health and lifestyle habits of the population. METHODS: A descriptive, cross-sectional study was conducted on the Spanish population. The NutSo-HH questionnaire, developed and validated by the research team, was used to gather socio-demographic, nutritional, social, and lifestyle information through non-probabilistic snowball sampling. RESULTS: The questionnaire was completed by 22,181 Spanish citizens, of whom only 19,211 were of interest to the study. The socio-demographic variables gender, age, educational level, income level, and place of residence do not seem to influence the prevalence of a plant-based diet (n = 1638) compared to a Mediterranean diet (n = 17,573). People following a vegetarian or vegan diet have a lower BMI, and they consume less fried food, fast food, and ultra-processed dishes and fewer energy drinks or sugary beverages. They also do more exercise and sleep longer hours, smoke less, and consume alcohol less frequently. However, there seem to be more diagnosed eating disorders among people who follow a plant-based diet than those who follow a Mediterranean diet. CONCLUSIONS: People who adopt a plant-based diet tend to exhibit healthier lifestyle patterns and consume fewer foods that are detrimental to their health. However, it is essential for such dietary choices to be supervised by healthcare professionals to mitigate the risk of maladaptive behaviors evolving into eating disorders.

The Future of Plant-Based Diets: Aligning Healthy Marketplace Choices with Equitable, Resilient, and Sustainable Food Systems.

The future of plant-based diets is a complex public health issue inextricably linked to planetary health. Shifting the world's population to consume nutrient-rich, plant-based diets is among the most impactful strategies to transition to sustainable food systems to feed 10 billion people by 2050. This review summarizes how international expert bodies define sustainable diets and food systems and describes types of sustainable dietary patterns. It also explores how the type and proportion of plant- versus animal-source foods and alternative proteins relate to sustainable diets to reduce diet-related morbidity and mortality. Thereafter, we synthesize evidence for current challenges and actions needed to achieve plant-based sustainable dietary patterns using a conceptual framework with principles to promote human health, ecological health, social equity, and economic prosperity. We recommend strategies for governments, businesses, and civil society to encourage marketplace choices that lead to plant-rich sustainable diets within healthy, equitable, and resilient agroecological food systems.

Assessing Performance of Contemporary Plant-Based Diets against the UK Dietary Guidelines: Findings from the Feeding the Future (FEED) Study.

Uncertainty remains about the composition of contemporary plant-based diets and whether they provide recommended nutrient intakes. We established Feeding the Future (FEED), an up-to-date online cohort of UK adults following different plant-based diets and diets containing meat and fish. We recruited 6342 participants aged 18-99 [omnivores (1562), flexitarians (1349), pescatarians (568), vegetarians (1292), and vegans (1571)] between February 2022 and December 2023, and measured diet using a food frequency questionnaire and free text. We compared personal characteristics and dietary intakes between diet groups and assessed compliance with dietary guidelines. Most participants met UK dietary recommendations for fruit and vegetables, sodium, and protein, although protein intakes were lowest among vegetarians and vegans. Omnivores did not meet the fibre recommendation and only vegans met the saturated fat recommendation. All diet groups exceeded the free sugars recommendation. Higher proportions of vegetarians and vegans were below the estimated average requirements (EARs) for zinc, iodine, selenium, and, in vegans, vitamins A and B12, whereas calcium intakes were similar across the diet groups. People following plant-based diets showed good compliance with most dietary targets, and their risk for inadequate intakes of certain nutrients might be mitigated by improved dietary choices and/or food fortification.

Association between plant-based diets and the risk of coronary heart disease predicted using the Framingham Risk Score in Korean men: data from the HEXA cohort study.

OBJECTIVES: This study investigated the potential correlation between 4 plant-based diet indices and the predicted risk of coronary heart disease (CHD) in Korean men using the Framingham Risk Score. METHODS: The study included 12,356 men participants (aged ≥40 years) from the Health Examinees Study. Dietary intake was estimated using a validated food frequency questionnaire. Four plant-based diet indices were measured, including the overall plant-based diet index, the healthy plant-based diet index (hPDI), the unhealthy plant-based diet index (uPDI), and the pro-vegetarian diet index. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the predicted 10-year risk of CHD. RESULTS: The study found that individuals in the highest hPDI quintile had a 19% lower risk score for CHD based on the Framingham Risk Score (model 3: HR, 0.80; 95% CI, 0.69 to 0.93; p for trend=0.010). In stratified analyses, the highest pro-vegetarian diet index was associated with a lower risk score for CHD in physically active individuals (HR, 0.74; 95% CI, 0.59 to 0.93; p for interaction=0.020). Conversely, the highest uPDI was associated with the highest risk score for CHD in those with a body mass index of ≥25 kg/m2 and a waist circumference ≥90 cm. CONCLUSIONS: This prospective cohort study highlights the positive role of adhering to a high hPDI diet in the prevention of CHD in Korean men. Further prospective studies are needed to determine the association between various plant-based diet indices and the risk of CHD in Asian populations with different dietary habits.

Association between plant-based diet quality and chronic kidney disease in Australian adults.

OBJECTIVE: To examine associations between three different plant-based diet quality indices, chronic kidney disease (CKD) prevalence and related risk factors in a nationally representative sample of the Australian population. DESIGN: Cross-sectional analysis. Three plant-based diet scores were calculated using data from two 24-h recalls: an overall plant-based diet index (PDI), a healthy PDI (hPDI) and an unhealthy PDI (uPDI). Consumption of plant and animal ingredients from 'core' and 'discretionary' products was also differentiated. Associations between the three PDI scores and CKD prevalence, BMI, waist circumference (WC), blood pressure (BP) measures, blood cholesterol, apo B, fasting TAG, blood glucose levels (BGL) and HbA1c were examined. SETTING: Australian Health Survey 2011-2013. PARTICIPANTS: n 2060 adults aged ≥ 18 years (males: n 928; females: n 1132). RESULTS: A higher uPDI score was associated with a 3·7 % higher odds of moderate-severe CKD (OR: 1·037 (1·0057-1·0697); P = 0·021)). A higher uPDI score was also associated with increased TAG (P = 0·032) and BGL (P < 0·001), but lower total- and LDL-cholesterol (P = 0·035 and P = 0·009, respectively). In contrast, a higher overall PDI score was inversely associated with WC (P < 0·001) and systolic BP (P = 0·044), while higher scores for both the overall PDI and hPDI were inversely associated with BMI (P < 0·001 and P = 0·019, respectively). CONCLUSIONS: A higher uPDI score reflecting greater intakes of refined grains, salty plant-based foods and added sugars were associated with increased CKD prevalence, TAG and BGL. In the Australian population, attention to diet quality remains paramount, even in those with higher intakes of plant foods and who wish to reduce the risk of CKD.

Pro-vegetarian dietary patterns and mortality by all-cause and specific causes in an older Mediterranean population.

PURPOSE: Pro-vegetarian (PVG) dietary patterns have shown health benefits, although the evidence concerning their association with mortality is scarce, particularly in older populations. We investigated the effect of three defined PVG patterns on all-cause, cardiovascular disease (CVD) and cancer mortality risk in an older Mediterranean population. METHODS: We analysed baseline data from 597 adults aged 65 and older who participated in a population-based cross-sectional study, and mortality during a 12-year period. We used a validated food frequency questionnaire to estimate the adherence in tertiles to three evidence-based PVG dietary patterns: a general PVG pattern (gPVG) and two specific variations (healthful -hPVG, and unhealthful -uPVG). The gPVG pattern incorporated data from 12 food groups, consisting of 7 plant-based and 5 animal-based. The hPVG and uPVG versions included information from 18 food groups (4 food groups added and the splitting of 2 food groups). We used Cox regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for relevant covariates. RESULTS: After the 12-years follow-up period, moderate adherence to hPVG pattern was associated with lower all-cause and CVD mortality whereas greater adherence to uPVG pattern was associated with higher all-cause and CVD mortality. Compared with those in the lowest tertile, participants in the second tertile of adherence to the hPVG pattern showed a significant lower risk of all-cause mortality (HR = 0.59; 95%CI: 0.43, 0.82) and CVD mortality (HR = 0.47; 0.28, 0.78). Participants in the highest tertile of adherence to the uPVG showed an increased mortality risk of all-cause (HR = 1.53; 1.07, 2.19) and CVD (HR = 2.10; 1.19, 3.70). No significant associations were found between adherence to any of the PVG dietary patterns and cancer mortality. CONCLUSION: Moderate adherence to a healthy PVG pattern reduced the long-term mortality risk for all-cause and CVD in an older Mediterranean population, while higher adherence to an unhealthy PVG pattern increased the risk of all-cause and CVD mortality.

Impact of vegetarianism on cognition and neuropsychological status among urban community-dwelling adults in Telangana, South India: a cross-sectional study.

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

Vegetarian diets and risk of nonalcoholic fatty liver disease: An observational study of National Health and Nutrition Examination Survey 2005-2018 using propensity score methods.

BACKGROUND: Studies on the association between vegetarian diets and nonalcoholic fatty liver disease (NAFLD) are limited and have inconsistent results. This study aims to explore the association between vegetarian diets and NAFLD and compare the stage of fibrosis between vegetarians and nonvegetarians in a US representative sample. METHODS: Cross-sectional data from 23,130 participants aged ≥20 years were obtained from the National Health and Nutrition Examination Survey, 2005-2018. Vegetarian status was classified based on two 24-h dietary recalls. We examined the association between vegetarian diets and the risk of NAFLD using the propensity score weighting method. RESULTS: Vegetarian diets were significantly associated with decreases in hepatic steatosis index (HSI), US fatty liver index and nonalcoholic fatty liver disease fibrosis score with mean differences of -2.70 (95% confidence interval [CI]: -3.69, -1.70), -3.03 (95% CI: -7.15, -0.91) and -0.12 (95% CI: -0.26, -0.01), respectively. While modelling the risk of NAFLD, we estimated that vegetarians were 53% less likely to have NAFLD assessed by HSI (odds ratios [OR]: 0.47; 95% CI: 0.34, 0.65). The effect of vegetarian diets was higher among individuals with lower waist circumferences (OR: 0.20) than among those with higher waist circumferences (OR: 0.53, p interaction ${p}_{\text{interaction}}\,$ = 0.004). However, the association was largely attenuated after adjusting for body mass index and diabetes status. No significant association was identified between vegetarian diets and advanced fibrosis. CONCLUSIONS: Vegetarian diets were associated with a lower prevalence of NAFLD among US adults, and the association appeared to be stronger in people with lower waist circumferences. Further studies are warranted to replicate our findings.

Evaluación de la ingesta de calcio en mujeres pre-menopáusicas consumidoras de alimentación basada en plantas correspondiente al área metropolitana de Buenos Aires / Evaluation of calcium intake in pre-menopausal women consuming a plant-based diet in the Buenos Aires metropolitan area

El calcio es uno de los nutrientes esenciales para la salud ósea. Objetivos: evaluar la ingesta de calcio en un grupo de mujeres pre-menopáusicas consumidoras de alimentación basada en plantas (ABP). Materiales y métodos: un grupo de mujeres premenopáusicas entre 30 y 45 años consumidoras de ABP fueron invitadas a participar. Para la evaluación de ingesta se empleó un recordatorio alimentario de 24 horas. Se utilizó la Encuesta Nacional de Nutrición y Salud (ENNyS, 2007) como información relevada disponible de ingesta de calcio en nuestra población. En un subgrupo de participantes se evaluó la densidad mineral ósea (DMO) de columna lumbar (L1-L4) por el método de absorciometría de rayos X (DXA), mientras que la microarquitectura fue estudiada a través del trabecular bone score (TBS). Resultados: se incluyeron 30 mujeres con un tiempo de adherencia promedio (X±DS) a la ABP 5,6±4 años, edad de 35,6±4 años, y un índice de masa corporal (IMC) de 23.,7±3 kg/m2. Una ingesta diaria de calcio promedio (IC al 95%) de 980 mg (639 mg-1320 mg) fue observada en las mujeres vegetarianas, mientras que en las veganas fue de 772 mg (460 mg-1085 mg), lo que resulta superior a la de la población general (406 mg). Una correlación positiva fue observada entre DMO e IMC (r=0,990; p=0,01) pero no entre DMO e ingesta de calcio. Conclusiones: en esta cohorte de mujeres premenopáusicas consumidoras de ABP, las vegetarianas y el 96,5% de las veganas cubrieron el requerimiento promedio estimado. La adecuada planificación de la ABP permite evitar deficiencias nutricionales que afecten la salud ósea. (AU)

Calcium is one of the essential nutrients intervening in bone health. Objective: To assess calcium intake in a group of premenopausal women consumers of a plant-based diet (PBD). Materials and methods: Premenopausal women between 30 and 45 y/o consumers of a PBD were invited to participate. A 24-hour food reminder was provided for the intake evaluation. Argentina's National Nutrition and Health Survey (ENNyS, 2007) was used as available information on calcium intake in our population. In a participants' subset, the bone mineral density (BMD) of the lumbar spine (L1-L4) was evaluated by dual-energy X-ray absorptiometry (DXA), while the trabecular bone score (TBS) was used to study the microarchitecture. Results: The study included 30 women with an average adherence time (X±DS) to PBD of 5.6±4 years, of 35.6±4 years and a body mass index (BMI) of 23.7±3kg/m2. An average daily calcium intake (95% CI) of 980mg (639 mg-1.320mg) was observed in vegetarian women, while in vegan women it was 772 mg (460mg-1.085mg), higher than the general population (406 mg). A positive correlation was observed between BMD and BMI (r=0.990; p=0.01), though not between BMD and calcium intake. Conclusions: In this cohort of premenopausal women consuming a PBD, the vegetarians and 96.5% of vegans met the estimated average requirement. An appropriate planning of the PBD prevents nutritional deficiencies that may affect bone health. (AU)

Association of Plant-Based Diet Indices and Abdominal Obesity with Mental Disorders among Older Chinese Adults.

We aimed to explore the correlation between plant-based diet indices and abdominal obesity with depression and anxiety among older Chinese adults. This study used a cross-sectional design using data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a simplified food frequency questionnaire to evaluate the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) separately, based on the potential health effects of the foods. Waist circumference (WC) was used to define abdominal obesity. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were applied to estimate depression symptoms and anxiety symptoms, respectively. Multi-adjusted binary logistic regression models were conducted to explore the effects of the three plant-based diet indices, abdominal obesity status, and their interaction on depression and anxiety. We enrolled a total of 11,623 participants aged 83.21 ± 10.98 years, of which 3140 (27.0%) participants had depression and 1361 (11.7%) had anxiety. The trend in the prevalence of depression/anxiety across increasing quartiles of the plant-based diet indices was statistically significant after controlling for potential confounders (p-trend < 0.05). Abdominal obesity was related to a lower prevalence of depression (OR = 0.86, 95% CI: 0.77-0.95) and anxiety (OR = 0.79, 95% CI: 0.69-0.90) compared with non-abdominal obesity. The protective effects of the PDI and hPDI against depression (OR = 0.52, 95% CI: 0.41-0.64; OR = 0.59, 95% CI: 0.48-0.73, respectively) and anxiety (OR = 0.75, 95% CI: 0.57-1.00; OR = 0.52, 95% CI: 0.39-0.70, respectively) were more pronounced in non-abdominally obese participants. The harmful effects of the uPDI against depression (OR = 1.78, 95% CI: 1.42-2.23) and anxiety (OR = 1.56, 95% CI: 1.16-2.10) were more pronounced in non-abdominally obese participants. In addition, a significant interaction between the plant-based diet indices and abdominal obesity was observed in terms of causing the prevalence of depression and anxiety. Consuming more of a healthful plant-based diet and less of an animal-based diet is related to a lower prevalence of depression and anxiety. A healthful plant-based diet plays a vital role in non-abdominally obese individuals.

Changes in Plant-Based Dietary Quality and Subsequent Risk of Cognitive Impairment Among Older Chinese Adults: a National Community-Based Cohort Study.

BACKGROUND: It is unclear how changes in plant-based dietary quality are linked to the subsequent risk of cognitive impairment. OBJECTIVES: This study aims to evaluate this relationship using data from the Chinese Longitudinal Healthy Longevity Survey. METHODS: A total of 6662 participants free of cognitive impairment in 2008 were included and followed ≤2018. Plant-based dietary quality was assessed by 3 indices: overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). Changes in plant-based diet quality from 2008 to 2011 were classified into quintiles. In addition, we assessed incident cognitive impairment (from 2011 to 2018) by using the Mini-Mental State Examination. Cox proportional-hazards models were performed. RESULTS: We recorded 1571 incident cases of cognitive impairment during a median of 10 y of follow-up. Compared with participants whose plant-based diet had no change or was relatively stable over 3 y, the full-adjusted hazard ratios (HRs) with 95% confidence intervals (CI) for cognitive impairment were 0.77 (0.64, 0.93), 0.72 (0.60, 0.86), and 1.50 (1.27, 1.77) among participants with a large increase in PDI, hPDI, and uPDI, respectively. The HRs with 95% CI were 1.22 (1.02, 1.44), 1.30 (1.11, 1.54), and 0.80 (0.67, 0.96) among participants with a large decrease in PDI, hPDI, and uPDI, respectively. Every 10-point increase in PDI and hPDI was associated with a 26% and 30% lower risk of cognitive impairment, whereas every 10-point increase in uPDI was associated with a 36% higher risk. CONCLUSIONS: Older adults with increased adherence to an overall plant-based diet and a healthful plant-based diet over 3 y have a lower risk of cognitive impairment, whereas those with increased adherence to an unhealthy plant-based diet had a higher risk of cognitive impairment.

Residential Food Environment, Household Wealth and Maternal Education Association to Preschoolers' Consumption of Plant-Based Vitamin A-Rich Foods: The EAT Addis Survey in Addis Ababa.

Vitamin A deficiency is common among preschoolers in low-income settings and a serious public health concern due to its association to increased morbidity and mortality. The limited consumption of vitamin A-rich food is contributing to the problem. Many factors may influence children's diet, including residential food environment, household wealth, and maternal education. However, very few studies in low-income settings have examined the relationship of these factors to children's diet together. This study aimed to assess the importance of residential food availability of three plant-based groups of vitamin A-rich foods, household wealth, and maternal education for preschoolers' consumption of plant-based vitamin A-rich foods in Addis Ababa. A multistage sampling procedure was used to enroll 5467 households with under-five children and 233 residential food environments with 2568 vendors. Data were analyzed using a multilevel binary logistic regression model. Overall, 36% (95% CI: 34.26, 36.95) of the study children reportedly consumed at least one plant-based vitamin A-rich food group in the 24-h dietary recall period. The odds of consuming any plant-based vitamin A-rich food were significantly higher among children whose mothers had a higher education level (AOR: 2.55; 95% CI: 2.01, 3.25), those living in the highest wealth quintile households (AOR: 2.37; 95% CI: 1.92, 2.93), and in residentials where vitamin A-rich fruits were available (AOR: 1.20; 95% CI: 1.02, 1.41). Further research in residential food environment is necessary to understand the purchasing habits, affordability, and desirability of plant-based vitamin A-rich foods to widen strategic options to improve its consumption among preschoolers in low-income and low-education communities.

Plant-based diets and incident cardiovascular disease and all-cause mortality in African Americans: A cohort study.

BACKGROUND: Prior studies have documented lower cardiovascular disease (CVD) risk among people with a higher adherence to a plant-based dietary pattern. Non-Hispanic black Americans are an understudied group with high burden of CVD, yet studies of plant-based diets have been limited in this population. METHODS AND FINDINGS: We conducted an analysis of prospectively collected data from a community-based cohort of African American adults (n = 3,635) in the Jackson Heart Study (JHS) aged 21-95 years, living in the Jackson, Mississippi, metropolitan area, US, who were followed from 2000 to 2018. Using self-reported dietary data, we assigned scores to participants' adherence to 3 plant-based dietary patterns: an overall plant-based diet index (PDI), a healthy PDI (hPDI), and an unhealthy PDI (uPDI). Cox proportional hazards models were used to estimate associations between plant-based diet scores and CVD incidence and all-cause mortality. Over a median follow-up of 13 and 15 years, there were 293 incident CVD cases and 597 deaths, respectively. After adjusting for sociodemographic characteristics (age, sex, and education) and health behaviors (smoking, alcohol intake, margarine intake, physical activity, and total energy intake), no significant association was observed between plant-based diets and incident CVD for overall PDI (hazard ratio [HR] 1.06, 95% CI 0.78-1.42, p-trend = 0.72), hPDI (HR 1.07, 95% CI 0.80-1.42, p-trend = 0.67), and uPDI (HR 0.95, 95% CI 0.71-1.28, p-trend = 0.76). Corresponding HRs (95% CIs) for all-cause mortality risk with overall PDI, hPDI, and uPDI were 0.96 (0.78-1.18), 0.94 (0.76-1.16), and 1.06 (0.86-1.30), respectively. Corresponding HRs (95% CIs) for incident coronary heart disease with overall PDI, hPDI, and uPDI were 1.09 (0.74-1.61), 1.11 (0.76-1.61), and 0.79 (0.52-1.18), respectively. For incident total stroke, HRs (95% CIs) for overall PDI, hPDI, and uPDI were 1.00 (0.66-1.52), 0.91 (0.61-1.36), and 1.26 (0.84-1.89) (p-trend for all tests > 0.05). Limitations of the study include use of self-reported dietary intake, residual confounding, potential for reverse causation, and that the study did not capture those who exclusively consume plant-derived foods. CONCLUSIONS: In this study of black Americans, we observed that, unlike in prior studies, greater adherence to a plant-based diet was not associated with CVD or all-cause mortality.

Nutritional Quality of Plant-Based Meat Products Available in the UK: A Cross-Sectional Survey.

Plant-based meat (PBM) has been gaining popularity due to increasing concerns over health, animal welfare, and environmental issues linked to animal foods. This study aimed to compare the nutrient profile of PBM with equivalent meat products. We conducted a cross-sectional survey of 207 PBM and 226 meat products available from 14 retailers in the UK. We extracted data on energy density, total and saturated fat, protein, fiber, and salt per 100 g from product packaging and calculated the nutrient profile of each product. Compared to meat, PBM had significantly lower energy density, total fat, saturated fat, protein, and significantly higher fiber. Salt content was significantly higher in five out of six PBM categories. Based on the UK's Nutrient Profiling Model, 14% of PBM and 40% of meat products were classified as "less healthy" (p < 0.001). When considering the UK's front-of-pack labelling criteria 20% of the PBM and 46% of meat products were considered high in either total fat, saturated fat, or salt (p < 0.001). Nearly three quarters of PBM products did not meet the current UK salt targets. PBM products have a better nutrient profile compared to meat equivalents. However, more progress is needed to reduce salt in these products.

Nutritional Content and Health Profile of Non-Dairy Plant-Based Yogurt Alternatives.

Yogurt is considered a healthy, nutritious food in many cultures. With a significant number of people experiencing dairy intolerance, and support for a more sustainable diet, consumer demand for dairy alternatives has surged. The aim of this study was to conduct a cross-sectional survey of plant-based yogurt alternatives to assess their nutritional content and health profile. A total of 249 non-dairy yogurt alternatives were analyzed from the nutrition label listed on the commercial package. The various yogurt alternatives contained extracts of coconut (n = 79), almonds (n = 62), other nuts or seeds (n = 20), oats (n = 20), legumes (n = 16), and mixed blends (n = 52). At least one-third of the yogurt alternatives had 5 g or more of protein/serving. Only 45% of the yogurt alternatives had calcium levels fortified to at least 10% of daily value (DV), while only about one in five had adequate vitamin D and B12 fortification at the 10% DV level. One-half of the yogurt alternatives had high sugar levels, while 93% were low in sodium. Except for the coconut-based products, the yogurts were not high in fat or saturated fat. The yogurt alternatives were not fortified as frequently or to the same levels as the corresponding non-dairy, plant-based beverages.

Training and Racing Behaviors of Omnivorous, Vegetarian, and Vegan Endurance Runners-Results from the NURMI Study (Step 1).

As a key modulator of training adaptations and racing performance, nutrition plays a critical role in endurance runners' success, and the training/racing behaviors of runners are potentially affected by their diet types. The present study aimed to investigate whether distance runners with a vegan diet (i.e., devoid of foods or ingredients from animal sources), vegetarian diet (i.e., devoid of meat and flesh foods), and omnivorous diet (i.e., a mixed diet with no restriction on food sources) have different training and racing patterns in general and based on race distance subgroups. A total of 3835 recreational runners completed an online survey. Runners were assigned to dietary (omnivorous, vegetarian, and vegan) and race distance (<21 km, half-marathon, and marathon/ultra-marathon) groups. In addition to sociodemographic information, a complete profile of data sets focusing on running and racing behaviors/patterns was evaluated using a questionnaire-based epidemiological approach. There were 1272 omnivores (47% females), 598 vegetarians (64% females), and 994 vegans (65% females). Compared to vegans and vegetarians, omnivorous runners prepared for a longer time period for running events, had a higher number of half-marathons and marathons completed with a better finish time, and had more reliance on training under supervision (p < 0.05). The present findings indicate an important association of diet types with patterns of training and racing amongst endurance runners that may be related to different motives of omnivorous, vegetarian, and vegan runners for participating in events.

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.