Abstract
Obesity affects over one-third of Americans and increases the risk of cardiovascular disease and type II diabetes. Interventional trials have consistently demonstrated that consumption of plant-based diets reduces body fat in overweight and obese subjects, even when controlling for energy intake. Nonetheless, the mechanisms underlying this effect have not been well-defined. This review discusses six major dietary mechanisms that may lead to reduced body fat. These include (1) reduced caloric density, (2) improved gut microbiota symbiosis, (3) increased insulin sensitivity, (4) reduced trimethylamine-N-oxide (TMAO), (5) activation of peroxisome proliferator-activated receptors (PPARs), and (6) over-expression of mitochondrial uncoupling proteins. Collectively, these factors improve satiety and increase energy expenditure leading to reduced body weight.
Highlights
The Centers for Disease Control and Prevention estimates that 35.6% of adults age ≥20 years are obese, and more than 1.4 billion adults are overweight worldwide [1,2]
While a variety of environmental factors influence the development of obesity, diet has a significant influence on adiposity [6]
Prospective clinical trial with overweight and obese subjects diagnosed with T2DM, subjects were randomly assigned to either a low-fat vegan diet (n = 68) or a control, habitual diet (n = 45) with ad libitum intake [10]
Summary
The Centers for Disease Control and Prevention estimates that 35.6% of adults age ≥20 years are obese, and more than 1.4 billion adults are overweight worldwide [1,2]. In a comparative, randomized study, obese, middle-aged subjects (n = 62) were assigned to consume ad libitum either an omnivorous, semivegetarian, pesco-vegetarian, vegetarian, or vegan diet for six months [9]. In a 12-month randomized controlled trial, overweight and obese subjects with T2DM or CVD pathology were assigned to either consume an ad libitum whole-foods, plant-based diet (n = 33) or receive standard medical care (n = 32) [11]. Subjects consuming the plant-based diet lost 11.5 kg (p < 0.0001) compared with the control group, which did not significantly change weight (−1.6 kg, p = 0.13). The objective of this review is to discuss the potential physiological and biochemical mechanisms that contribute to the reduction in body fat in overweight or obese subjects consuming plant-based diets. Decreased TMAO increases the presentation of more metabolically active beige adipose tissue
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