Abstract
Health authorities increasingly recommend a more plant-based diet, rich in fruits, vegetables, pulses, whole grains and nuts, low in red meat and moderate in dairy, eggs, poultry and fish which will be beneficial for both health and the environment. A systematic review of observational and intervention studies published between 2000 and January 2020 was conducted to assess nutrient intake and status in adult populations consuming plant-based diets (mainly vegetarian and vegan) with that of meat-eaters. Mean intake of nutrients were calculated and benchmarked to dietary reference values. For micronutrient status, mean concentrations of biomarkers were calculated and compared across diet groups. A total of 141 studies were included, mostly from Europe, South/East Asia, and North America. Protein intake was lower in people following plant-based diets compared to meat-eaters, but well within recommended intake levels. While fiber, polyunsaturated fatty acids (PUFA), folate, vitamin C, E and magnesium intake was higher, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake was lower in vegetarians and vegans as compared to meat-eaters. Intake and status of vitamin B12, vitamin D, iron, zinc, iodine, calcium and bone turnover markers were generally lower in plant-based dietary patterns compared to meat-eaters. Vegans had the lowest vitamin B12, calcium and iodine intake, and also lower iodine status and lower bone mineral density. Meat-eaters were at risk of inadequate intakes of fiber, PUFA, α-linolenic acid (ALA), folate, vitamin D, E, calcium and magnesium. There were nutrient inadequacies across all dietary patterns, including vegan, vegetarian and meat-based diets. As plant-based diets are generally better for health and the environment, public health strategies should facilitate the transition to a balanced diet with more diverse nutrient-dense plant foods through consumer education, food fortification and possibly supplementation.
Highlights
Our current food system is not sustainable as global food production is threatening climate stability and ecosystem resilience
Compared to meat-eaters, average protein, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake was lower in vegetarians and vegans, yet intake of fiber, polyunsaturated fatty acids (PUFA), total n-3 fatty acids and ALA was higher in plant-based dietary patterns
In people following self-selected plant-based diets, especially vegan diets, intake, and status of certain nutrients is lower compared to meat-containing diets, with an increased risk of inadequacy for vitamin B12, vitamin D, EPA, DHA, calcium, iron, zinc and iodine
Summary
Our current food system is not sustainable as global food production is threatening climate stability and ecosystem resilience. Guiding principles for sustainable and healthy diets by the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO) were launched in the same year [5]. Both reports recommend a balanced diet rich in fruits, vegetables, pulses, whole grains and nuts, with some fish, eggs, poultry and dairy, but limited in red meat and starchy vegetables. These plant-based diets can include different forms such as semi-vegetarian, flexitarian, pesco-vegetarian, lacto-ovo-vegetarian and vegan diets
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