Plant-Based Dietary Patterns for Human and Planetary Health.

The coronavirus pandemic has acted as a reset on global economies, providing us with the opportunity to build back greener and ensure global warming does not surpass 1.5 °C. It is time for developed nations to commit to red meat reduction targets and shift to plant-based dietary patterns. Transitioning to plant-based diets (PBDs) has the potential to reduce diet-related land use by 76%, diet-related greenhouse gas emissions by 49%, eutrophication by 49%, and green and blue water use by 21% and 14%, respectively, whilst garnering substantial health co-benefits. An extensive body of data from prospective cohort studies and controlled trials supports the implementation of PBDs for obesity and chronic disease prevention. The consumption of diets high in fruits, vegetables, legumes, whole grains, nuts, fish, and unsaturated vegetable oils, and low in animal products, refined grains, and added sugars are associated with a lower risk of all-cause mortality. Meat appreciation, health concerns, convenience, and expense are prominent barriers to PBDs. Strategic policy action is required to overcome these barriers and promote the implementation of healthy and sustainable PBDs.

The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials.

OBJECTIVES: The consumption of strict vegetarian diets with no animal products is associated with low blood pressure (BP). It is not clear whether less strict plant-based diets (PBDs) containing some animal products exert a similar effect. The main objective of this meta-analysis was to assess whether PBDs reduce BP in controlled clinical trials. METHODS: We searched Cumulative Index to Nursing and Allied Health Literature, Medline, Embase, and Web of Science to identify controlled clinical trials investigating the effect of PBDs on BP. Standardized mean differences in BP and 95% confidence intervals were pooled using a random effects model. Risk of bias, sensitivity, heterogeneity, and publication bias were assessed. RESULTS: Of the 790 studies identified, 41 clinical trials met the inclusion criteria (8416 participants of mean age 49.2 years). In the pooled analysis, PBDs were associated with lower SBP [Dietary Approach to Stop Hypertension -5.53 mmHg (95% confidence intervals -7.95,-3.12), Mediterranean -0.95 mmHg (-1.70,-0.20), Vegan -1.30 mmHg (-3.90,1.29), Lacto-ovo vegetarian -5.47 mmHg (-7.60,-3.34), Nordic -4.47 mmHg (-7.14,-1.81), high-fiber -0.65 mmHg (-1.83,0.53), high-fruit and vegetable -0.57 mmHg (-7.45,6.32)]. Similar effects were seen on DBP. There was no evidence of publication bias and some heterogeneity was detected. The certainty of the results is high for the lacto-ovo vegetarian and Dietary Approach to Stop Hypertension diets, moderate for the Nordic and Mediterranean diets, low for the vegan diet, and very low for the high-fruit and vegetable and high-fiber diets. CONCLUSION: PBDs with limited animal products lower both SBP and DBP, across sex and BMI.

Frequency, timing, and type of prodromal symptoms associated with hereditary angioedema attacks.

Hereditary angioedema (HAE) types I and II are autosomal dominant conditions characterized by recurrent attacks of edema formation in the subcutaneous tissue of the body or walls of the upper respiratory or gastrointestinal tract. Frequently, prodromal symptoms occur before an HAE attack. If certain prodromal symptoms were determined to be both sensitive and specific in predicting an acute HAE attack, treatment at the time of the prodrome could prevent development of an attack and decrease morbidity and mortality associated with HAE. The goal is to determine the frequency and timing of prodromal symptoms occurring before HAE attacks. After Institutional Review Board approval, a four-page survey was produced, using a focus group of patients with HAE and was assessed by HAE patients and physicians with expertise in HAE for cognitive reliability. Once devised, the questionnaire was sent to 158 HAE patients. The survey focused on questions related to prodromal symptoms that patients developed before their last HAE attack. Forty-six patients returned the survey and 40 (87.0%) reported the presence of prodromal symptoms before their last HAE attack. Forty-four of 46 (95.7%) reported having had prodromal symptoms before HAE attacks in the past. The most commonly reported prodromal symptoms included unusual fatigue, rash, and muscle aches. Prodromes occur frequently before HAE attacks. This high frequency suggests that prodromal symptoms could be a reliable indication to begin treatment to prevent an acute HAE attack, thus decreasing the anxiety associated with having an HAE attack.

Fresh frozen plasma for the treatment of hereditary angioedema.

BACKGROUND: Fresh frozen plasma (FFP) has been used as a treatment option for patients with hereditary angioedema (HAE) because it contains Cl esterase inhibitor, and alternate therapies are not yet available in the United States. However, because FFP also contains other substrates, it has been hypothesized to have the potential to worsen or precipitate an acute attack of HAE. OBJECTIVE: To research patient records and the medical literature to determine whether FFP can exacerbate symptoms or precipitate an attack of HAE. METHODS: The following keywords were searched in PubMed and OVID: hereditary angioedema, angioedema and fresh frozen plasma, angioedema and FFP, and hereditary angioneurotic edema. English-language articles were searched from 1966 to the present. Also, after institutional review board approval, the medical records of patients with HAE at our institution who have received FFP since 1990 were reviewed to determine if there was evidence that FFP exacerbated the symptoms of HAE. RESULTS: The English-language literature review and our patient medical record review failed to identify instances when FFP exacerbated symptoms of HAE or precipitated an attack. Several reports and our experience suggest that FFP is an effective prophylactic agent before surgery and for treatment of acute HAE attacks without evidence of exacerbation or initiation of symptoms. CONCLUSIONS: FFP seems to be safe and effective in preventing exacerbations of HAE before surgery and for acute exacerbations of HAE without evidence of it initiating an attack or worsening a preexisting attack.