Differences Between Omnivores and Vegetarians in Personality Profiles, Values, and Empathy: A Systematic Review.

Numerous medical studies have documented vegetarian diets as having various health benefits. Studies have also compared vegetarians with other dietary groups from a socio-psychological perspective. The objective of this review is to investigate the differences between vegetarians and omnivores in terms of their personality profiles, values, and empathy skills. A search was conducted across three electronic databases. Non-randomized, observational, cross-sectional, and cohort studies were eligible. Outcomes provided information about the differences between the above-mentioned dietary groups regarding their personality profiles, values, and empathy skills. A shortened version of the Newcastle-Ottawa Scale was used to assess the risk of bias for the included studies. Of the 2,513 different studies found, 25 (total number of participants n = 23,589) were ultimately included. These studies indicate that vegetarians significantly differ from omnivores in their personalities, values, and ability to be empathetic. Omnivorism is associated with an increased orientation toward social dominance, greater right-wing authoritarianism, and, in line with this, a stronger tendency to be prejudiced. Vegetarianism is associated with greater openness and empathy. The values of vegetarians are based more on universalism, hedonism, stimulation, and self-direction, whereas the values of omnivores are based more on the idea of power. To answer a narrowly defined and clear question, issues such as animal ethics, animal rights, and environmental protection are not considered in this review. The findings of this review, showing marked differences in personality correlating to the choice of diet and the increasing influence of plant-based diets on a global level, indicate that further studies about vegetarianism are warranted.

Ayurvedic vs. Conventional Nutritional Therapy Including Low-FODMAP Diet for Patients With Irritable Bowel Syndrome-A Randomized Controlled Trial.

Aims: To compare the effects of Ayurvedic and conventional nutritional therapy in patients with irritable bowel syndrome (IBS). Methods: Sixty-nine patients with IBS were randomized to Ayurvedic (n = 35) or conventional nutritional therapy according to the recommendations of the German Nutrition Society including the low-FODMAP diet (n = 34). Study visits took place at baseline and after 1, 3, and 6 months. The primary outcome was IBS symptom severity (IBS-SSS) after 3 months; secondary outcomes included stress (CPSS), anxiety and depression (HADS), well-being (WHO-5) and IBS-specific quality of life (IBS-QOL). A repeated measures general linear model (GLM) for intent-to-treat-analyses was applied in this explorative study. Results: After 3 months, estimated marginal means for IBS-SSS reductions were 123.8 [95% confidence interval (95% CI) = 92.8-154.9; p < 0.001] in the Ayurvedic and 72.7 (95% CI = 38.8-106.7; p < 0.001) in the conventional group. The IBS-SSS reduction was significantly higher in the Ayurveda group compared to the conventional therapy group (estimated marginal mean = 51.1; 95% CI = 3.8-98.5; p = 0.035) and clinically meaningful. Sixty-eight percentage of the variance in IBS-SSS reduction after 3 months can be explained by treatment, 6.5% by patients' expectations for their therapies and 23.4% by IBS-SSS at pre-intervention. Both therapies are equivalent in their contribution to the outcome variance. The higher the IBS-SSS score at pre-intervention and the larger the patients' expectations, the greater the IBS-SSS reduction. There were no significant group differences in any secondary outcome measures. No serious adverse events occurred in either group. Conclusion: Patients with IBS seem to benefit significantly from Ayurvedic or conventional nutritional therapy. The results warrant further studies with longer-term follow-ups and larger sample sizes. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03019861, identifier: NCT03019861.

Efficacy of therapeutic fasting and plant-based diet in patients with rheumatoid arthritis (NutriFast): study protocol for a randomised controlled clinical trial.

BACKGROUND: Previous studies have shown beneficial effects of therapeutic fasting and plant-based dietary interventions on disease activity in patients with rheumatoid arthritis (RA) for a duration of up to 1 year. To date, the effects of such interventions on the gut microbiome and on modern diagnostic markers in patients with RA have not been studied. This trial aims to investigate the clinical effects of therapeutic fasting and a plant-based diet in patients with RA, additionally considering current immunological diagnostic tools and microbiome analyses. METHODS/DESIGN: This trial is an open-label, single-centre, randomised, controlled, parallel-group clinical trial. We will randomly assign 84 patients with RA under a stable standard therapy to either (1) therapeutic fasting followed by a plant-based dietary intervention or (2) to a conventional nutritional counselling focusing on an anti-inflammatory dietary pattern according to the recommendations of the Deutsche Gesellschaft für Ernährung (German society for nutrition). Primary outcome parameter is the group difference from baseline to 12 weeks on the Health Assessment Questionnaire (HAQ). Other secondary outcomes include established clinical criteria for disease activity and treatment response in RA (Disease Activity Score 28, Simple Disease Activity Index, ACR-Response Criteria), changes in self-reported health and physical functional ability, mood, stress, quality of life, dietary behaviour via 3-day food records and a modified Food Frequency Questionnaire, body composition, changes in the gut microbiome, metabolomics and cytometric parameters. Outcomes will be assessed at baseline and day 7, after 6 weeks, 12 weeks and after 6 months. ETHICS AND DISSEMINATION: Ethical approval to process and analyse data, and to publish the results was obtained through the institutional review board of Charité-Universitätsmedizin Berlin. Results of this trial will be disseminated through peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER: NCT03856190.

Qualitative study of yoga for Young adults in school sports.

OBJECTIVES: Distress and stress-related diseases are an increasing public health problem at schools. This qualitative study was nested in a non-randomized, controlled trial studying the effects of a 10-week yoga course as an alternative for regular school sports in two secondary schools in Germany. METHODS: We conducted a qualitative evaluation in 3 focus groups with 6 participants each. The focus groups were audio-recorded, transcribed verbatim, pseudonymised and analysed using qualitative content analysis. Furthermore open questions were asked in questionnaires. RESULTS: The analysis of the participants' interviews (mean age 19.6 ± 2.9 years, n = 10 female, n = 8 male) resulted in 4 key topics: 1. encountering yoga, 2. yoga practice, 3. effects and benefits of yoga, and 4. yoga in the school context. Yoga was very well accepted by most participants. They reported a variety of physical and psychological benefits as well as overall restorative effects. The relief of pain or other physical ailments, higher mobility and flexibility, improved posture and improved sleep were mentioned by the participants. Some participants used the new exercises and experiences (e.g. working with the breath) in their everyday life. The possibility for self-responsible action was a welcome change from the perceived pressure and heteronomy in normal (school) life. Controversial was the question of whether yoga - if it is part of school sport - should be assessed or graded, and whether it should be compulsory or voluntary. CONCLUSION: Yoga can offer both physical and psychological benefits in young adults as well as offer general regenerative effects. Yoga by sensitizing the participants to negative patterns of behaviour can encourage healthy behaviour.

Yoga in school sport - A non-randomized controlled pilot study in Germany.

OBJECTIVES: Distress is an increasing public health problem for adolescents and young adults. We aimed to evaluate potential effects of a 10-week 90-minute once-a-week yoga course. METHODS: A non-randomized controlled study with a school sport control group was implemented in two German secondary schools. Primary outcome was stress on the Perceived Stress Scale from baseline to week 10. Secondary outcomes included depression/anxiety, attention, quality of life, mood, visual analogue scales (for pain, headache, neck tension, exhaustion, sleep), and yoga-efficacy. Parameters were assessed at pre-baseline (before holidays), baseline (after 3-week holidays, before interventions started), week 10, and at a 6-months follow-up. An intention-to-treat analysis using ANCOVA was performed. RESULTS: 92 participants (67 % female; 19.6 ±â€¯2.2 years) were included into the study. No significant differences were observed between the groups with regard to PSS, at either 10 weeks (Δ=-1.4; 95 % CI: -3.6;0.8; p = 0.22) or 6 months (Δ = 2; 95 % CI: -0.2;4.2, p = 0.08). Only VAS headache in favour of yoga and HADS-D in favour of school sport showed significant group differences at the 6-months follow-up. Significant intra-group mean changes for the primary outcome and several secondary outcomes were found in the yoga group. CONCLUSIONS: Young adults in German secondary school settings might benefit from yoga, as the found effects were more prominent in the yoga group. However, the effects might be attributed to non-specific effects due to the chosen study design. Further studies are needed, which include high-quality study designs including randomization, longer-term follow-ups and larger sample sizes.

Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study.

BACKGROUND: Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system in young adults that may lead to progressive disability. Since pharmacological treatments may have substantial side effects, there is a need for complementary treatment options such as specific dietary approaches. Ketone bodies that are produced during fasting diets (FDs) and ketogenic diets (KDs) are an alternative and presumably more efficient energy source for the brain. Studies on mice with experimental autoimmune encephalomyelitis showed beneficial effects of KDs and FDs on disease progression, disability, cognition and inflammatory markers. However, clinical evidence on these diets is scarce. In the clinical study protocol presented here, we investigate whether a KD and a FD are superior to a standard diet (SD) in terms of therapeutic effects and disease progression. METHODS: This study is a single-center, randomized, controlled, parallel-group study. One hundred and eleven patients with relapsing-remitting MS with current disease activity and stable immunomodulatory therapy or no disease-modifying therapy will be randomized to one of three 18-month dietary interventions: a KD with a restricted carbohydrate intake of 20-40 g/day; a FD with a 7-day fast every 6 months and 14-h daily intermittent fasting in between; and a fat-modified SD as recommended by the German Nutrition Society. The primary outcome measure is the number of new T2-weighted MRI lesions after 18 months. Secondary endpoints are safety, changes in relapse rate, disability progression, fatigue, depression, cognition, quality of life, changes of gut microbiome as well as markers of inflammation, oxidative stress and autophagy. Safety and feasibility will also be assessed. DISCUSSION: Preclinical data suggest that a KD and a FD may modulate immunity, reduce disease severity and promote remyelination in the mouse model of MS. However, clinical evidence is lacking. This study is the first clinical study investigating the effects of a KD and a FD on disease progression of MS. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03508414. Retrospectively registered on 25 April 2018.

Adverse effects of yoga: a national cross-sectional survey.

BACKGROUND: While yoga is increasingly used for health purposes, its safety has been questioned. The aim of this cross-sectional survey was to analyze yoga-associated adverse effects and their correlates. METHODS: A cross-sectional anonymous national online survey among German yoga practitioners (n = 1702; 88.9% female; 47.2 ± 10.8 years) was conducted from January to June 2016. Participants were queried regarding their yoga practice, i.e. yoga styles used, length and intensity of yoga practice, practice patterns, and whether they had experienced acute or chronic adverse effects of their yoga practice. Independent predictors of acute or chronic adverse effects were identified using multiple logistic regression analyses. RESULTS: Ashtanga yoga (15.7%), traditional Hatha yoga (14.2%), and Sivananda yoga (22.4%) were the most commonly used yoga styles. 364 (21.4%) yoga users reported 702 acute adverse effects, occurring after a mean of 7.6 ± 8.0 years of yoga practice. The most commonly reported yoga practices that were associated with acute adverse effects were hand-, shoulder- and head stands (29.4%). Using Viniyoga was associated with a decreased risk of acute adverse effects; practicing only by self-study without supervision was associated with higher risk. One hundred seventy-three participants (10.2%) reported 239 chronic adverse effects. The risk of chronic adverse effects was higher in participants with chronic illnesses and those practicing only by self-study without supervision. Most reported adverse effects concerned the musculoskeletal system. 76.9% of acute cases, and 51.6% of chronic cases reached full recovery. On average 0.60 injuries (95% confidence interval = 0.51-0.71) per 1000 h of practice were reported, with Power yoga users reporting the highest rate (1.50 injuries per 1000 h; 95% confidence interval = 0.98-3.15). CONCLUSIONS: One in five adult yoga users reported at least one acute adverse effect in their yoga practice, and one in ten reported at least one chronic adverse effect, mainly musculoskeletal effects. Adverse effects were associated with hand-, shoulder- and head stands; and with yoga self-study without supervision. More than three quarters of of cases reached full recovery. Based on the overall injury rate per 1000 practice hours, yoga appears to be as safe or safer when compared to other exercise types.

Differences between vegetarian and omnivorous yoga practitioners-Results of a nationally representative survey of US adult yoga practitioners.

BACKGROUND: To examine the prevalence of vegetarianism among yoga practitioners, and to explore differences and similarities between yoga practitioners who also use vegetarian diet and those who do not. DESIGN AND SETTING: Using cross-sectional data from the 2012 National Health Interview Survey (NHIS) (N = 34,525), weighted frequencies for 12-month prevalence of vegetarian diet use among yoga practitioners were analyzed. Logistic regression analyses were used to analyze sociodemographic and clinical predictors of vegetarian diet use. RESULTS: A total of 1.7 million US yoga practitioners have used a vegetarian diet in the past 12 months (8.3%), compared to 2.7 million non-yoga practitioners (1.3%). Yoga practitioners who were aged between 30 and 64 years as compared to being 29 years or younger were more likely to have used a vegetarian diet in the past 12 months; while those being in a relationship (OR = 0.64), overweight (OR = 0.54), smoking (OR 0.64) or having private health insurance (OR = 0.59) were less likely. Vegetarian diet practitioners more often included meditation as part of their yoga practice and more often chose yoga because it had a holistic focus, and was perceived to treat the cause and not the symptoms of their health complaint. CONCLUSIONS: Yoga practitioners following a vegetarian diet seem to embrace yoga more as a lifestyle than as a therapy.

Yoga in Arterial Hypertension.

BACKGROUND: Yoga seems to exert its effect against arterial hypertension mainly through the associated breathing and meditation techniques, and less so through yoga postures. The goal of this trial was to compare the blood pressure-lowering effect of yoga interventions with and without yoga postures in patients with arterial hypertension. METHODS: 75 patients taking medications for arterial hypertension (72% women, mean age 58.7 ± 9.5 years) were randomized into three groups: a yoga intervention group with yoga postures (25 patients, of whom 5 dropped out of the trial before its end), a yoga intervention group without yoga postures (25 patients, 3 dropouts), and a wait list control group (25 patients, one dropout). The interventions consisted of 90 minutes of yoga practice per week for twelve weeks. The data collectors, who were blinded to the intervention received, assessed the primary outcome measures "systolic 24-hour blood pressure" and "diastolic 24-hour blood pressure" before and after the intervention. In this report, we also present the findings on secondary outcome measures, including follow-up data. RESULTS: After the intervention, the systolic 24-hour blood pressure in the yoga intervention group without yoga postures was significantly lower than in the control group (group difference [Δ]= -3.8 mmHg; [95% confidence interval (CI): (-0.3; -7.4) p = 0.035]); it was also significantly lower than in the yoga intervention group with yoga postures (Δ = -3.2 mmHg; 95% CI: [-6.3; -0.8]; p = 0.045). Diastolic blood pressures did not differ significantly across groups. No serious adverse events were encountered in the course of the trial. CONCLUSION: In accordance with the findings of earlier studies, we found that only yoga without yoga postures induced a short-term lowering of ambulatory systolic blood pressure. Yoga is safe and effective in patients taking medications for arterial hypertension and thus can be recommended as an additional treatment option for persons in this category.

Low fermentable, oligo-, di-, mono-saccharides and polyol diet in the treatment of irritable bowel syndrome: A systematic review and meta-analysis.

OBJECTIVES: The aim of this review was to systematically assess and meta-analyze the effects of a low fermentable, oligo-, di-, mono-saccharides and polyol (FODMAP) diet (LFD) on the severity of symptoms, quality of life, and safety in patients with irritable bowel syndrome (IBS). METHODS: The MEDLINE/PubMed, Scopus, and Cochrane Library databases were screened through January 19, 2016. Randomized controlled trials (RCTs) that compared LFD to other diets were included if they assessed symptoms of IBS or abdominal pain in patients with IBS. Safety, quality of life, anxiety, depression, and effect on gut microbiota were defined as secondary outcomes. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated. RESULTS: Nine RCTs with a total of 596 subjects were included. Three RCTs compared LFD with a habitual diet, two RCTs provided all meals and compared LFD with a western diet, one RCT each compared LFD with a diet high in FODMAPs or a sham diet, and two RCTs compared with other diet recommendations for IBS. A meta-analysis revealed significant group differences for LFD compared with other diets with regard to gastrointestinal symptoms (SMD = -0.62; 95% CI = -0.93 to -0.31; P = 0.0001), abdominal pain (SMD = -0.50; 95% CI = -0.77 to -0.22; P = 0.008), and health-related quality of life (SMD = 0.36; 95% CI = 0.10-0.62; P = 0.007). Three studies reported a significant reduction in luminal bifidobacteria after LFD. Adverse events were assessed in three RCTs only and no intervention-related adverse events were reported. CONCLUSIONS: This meta-analysis found evidence of the short-term efficacy and safety of LFD in patients with IBS. However, only a preliminary recommendation for LFD can be made until long-term effects are investigated.

Characteristics of Americans Choosing Vegetarian and Vegan Diets for Health Reasons.

OBJECTIVE: Examine the prevalence, patterns, and associated factors of using a vegetarian or vegan diet for health reasons in the US general population. DESIGN: Cross-sectional data from the 2012 National Health Interview Survey. PARTICIPANTS: Nationally representative sample (N = 34,525). VARIABLES MEASURED: Prevalence of ever use and 12-month use of vegetarian or vegan diet for health reasons, patterns of use, and sociodemographic and health-related factor associated with use. ANALYSIS: Multiple logistic regression analysis. RESULTS: Prevalence of ever use and 12-month use was 4.0% (n = 1,367) and 1.9% (n = 648), respectively. Health vegetarians and vegans were more likely aged 30-65 years, female, not Hispanic, from the Western US region, at least high school educated, chronically ill, and physically active. They were less likely to be in a relationship, overweight or obese, or smoking, or to have public or private health insurance. Among health vegetarians and vegans, 6.3% consulted with a practitioner for special diets; 26.1% followed the diet because of a specific health problem, mainly high cholesterol, overweight, hypertension, and diabetes; and 59.4% disclosed the diet to their health care provider. CONCLUSIONS AND IMPLICATIONS: Less than 2% of participants reported using a vegetarian or vegan diet for health reasons within the past 12 months. Despite potential benefits of plant-based nutrition, more research is warranted on the actual use and its effects and safety.

Associations between yoga practice and joint problems: a cross-sectional survey among 9151 Australian women.

Yoga exercises have been associated with joint problems recently, indicating that yoga practice might be potentially dangerous for joint health. This study aimed to analyse whether regular yoga practice is associated with the frequency of joint problems in upper middle-aged Australian women. Women aged 62-67 years from the Australian Longitudinal Study on Women's Health (ALSWH) were questioned in 2013 whether they experienced regular joint pain or problems in the past 12 months and whether they regularly practiced yoga. Associations of joint problems with yoga practice were analysed using Chi-squared tests and multiple logistic regression modelling. Of 9151 women, 29.8% reported regular problems with stiff or painful joints, and 15.2, 11.9, 18.1 and 15.9% reported regular problems with shoulders, hips, knees and feet, respectively, in the past 12 months. Yoga was practiced sometimes by 10.1% and often by 8.4% of women. Practicing yoga was not associated with upper or lower limb joint problems. No association between yoga practice and joint problems has been identified. Further studies are warranted for conclusive judgement of benefits and safety of yoga in relation to joint problems.

Herbal medicines in children with attention deficit hyperactivity disorder (ADHD): A systematic review.

OBJECTIVE: The purpose of this review is to identify evidence in herbal therapy in the treatment of ADHD concerning effectiveness and drug tolerability. METHOD: For this Medline/PubMed, Scopus and the Cochrane Central Register of Controlled Trials (Central) were searched from their inception to 15 July 2016. Only randomized controlled trails (RCT) with children (0-18years) suffering from ADHD were included in this review. RESULTS: Nine RCTs with 464 patients comparing herbal pharmaceuticals to placebo or active control were included. Seven different herbs were tested in the treatment of ADHD symptoms. Low evidence could be found for Melissa officinalis, Valeriana officinalis and Passiflora incarnata. Limited evidence could be found for pine bark extract and Gingko biloba. The other herbal preparations showed no efficacy in the treatment of ADHD symptoms. CONCLUSION: While there is still a lack of sufficient numbers of RCTs no concrete recommendations for use can be made so far.

Effect of Yoga in the Therapy of Irritable Bowel Syndrome: A Systematic Review.

BACKGROUND & AIMS: This review aims to systematically survey the effects of yoga on symptoms of irritable bowel syndrome (IBS), pain, quality of life, mood, stress, and safety in patients with IBS. METHODS: MEDLINE/Pubmed, Scopus, the Cochrane Library, CAM-QUEST, CAMbase, and IndMED were screened through November 2015. Randomized controlled trials comparing yoga with usual care, nonpharmacologic, or pharmacologic interventions were analyzed for patients with IBS. Primary outcomes included gastrointestinal symptoms, quality of life, and pain. Anxiety, mood, and safety were defined as secondary outcomes. Risk of bias was assessed according to the Cochrane Collaboration recommendations. RESULTS: Six randomized controlled trials with a total of 273 patients were included in the qualitative analysis. There was evidence for a beneficial effect of a yogic intervention over conventional treatment in IBS, with significantly decreased bowel symptoms, IBS severity, and anxiety. Furthermore, there were significant improvements in quality of life, global improvement, and physical functioning after yoga compared with no treatment. Two randomized controlled trials reported safety data stating that no adverse events occurred. Overall, risk of bias of the included studies was unclear. CONCLUSIONS: The findings of this systematic review suggest that yoga might be a feasible and safe adjunctive treatment for people with IBS. Nevertheless, no recommendation can be made regarding yoga as a routine intervention for patients with IBS because of major flaws in study methods. More research is needed with respect to a high-quality study design and consensus in clinical outcome measurements in IBS. ClinicalTrials.gov number, NCT02721836.

Structure-activity relationship in the passage of different pyrrolizidine alkaloids through the gastrointestinal barrier: ABCB1 excretes heliotrine and echimidine.

SCOPE: 1,2-Unsaturated pyrrolizidine alkaloids (PA) are found in plants such as Asteraceae and Boraginaceae families. Acute PA poisoning via contaminated food or feed causes severe damage to liver depending on species-specific oral bioavailability. For assessing PA bioavailability, their passage across the intestinal barrier was investigated using Caco-2 cells. METHODS: Differentiated Caco-2 cells were exposed in transport chambers to the PA heliotrine (Hn), echimidine (Em), senecionine (Sc), and senkirkine (Sk). Cell supernatants were analyzed by LC-MS/MS. RESULTS: PA pass Caco-2 monolayer from the apical into basolateral compartment depending on their chemical structure. Compared to the cyclic diesters Sc and Sk with a passage rate of 47% ± 4 and 40% ± 3, respectively, the transferred amount of the monoester Hn (32% ± 3) and open-chained diester Em (13% ± 2) was substantially lower. This suggested an active transport of Hn and Em. Using Madin-Darby canine kidney II/P-glycoprotein (ABCB1)-overexpressing cells, the active excretion of Hn and Em by ABCB1 from the gastrointestinal epithelium into the gut lumen was shown. CONCLUSION: PA cross the intestinal barrier structure-dependently. The passage of the noncyclic PA Hn and Em is reduced by an ABCB1-driven efflux into the gastrointestinal lumen resulting in a decreased oral bioavailability.