Plant-based Research Articles

Gout and Nutrition

Gout, the most common arthritis worldwide, is closely linked to cardiovascular disease and metabolic syndrome. The most impor-tant risk factor for developing gout is hyperuricemia. Serum uric acid is the end product of purine metabolism and can be partially influenced by dietary changes. Since a quarter of serum uric acid is excreted via the intestine, there is also a connection with diet here - keyword microbiome. Recently, genetic predispositions and drug therapy for gout have come to the fore. However, since cardiovascular comorbidities exist in high frequency, a dietary adjustment also makes sense to improve the comorbidities. Recently, the focus has shifted away from simply reducing purine intake in favor of introducing a largely plant-based diet. Reducing alcohol consumption makes sense for many reasons but does not lead to a significant reduction in serum uric acid. In addition to drug therapy, however, all possibilities should be exploited to enable a rapid reduction in serum uric acid to the target range; a change in diet can contribute to this. A change in diet can also have a positive effect on the frequency of gout flares. Targeted, structured information for patients promotes their knowledge of the disease and motivation to achieve their serum uric acid (SUA) goal. The right diet may be the personal contribution to quickly reaching the SUA target level and freedom from gout flares.

Carbon and Climate: Is There a Serious Link?

Climate change is a topic that becomes increasingly relevant with each passing day. I've encountered buzzwords like carbon emissions resulting from industries, greenhouse gases, climate change, global warming, carbon offsetting, carbon neutrality, and more. Recently, at the G20 summit in New Delhi, it was a matter of serious concern among global leaders. Carbon dioxide (CO2) plays a vital role in our atmosphere by helping to regulate Earth's temperature. Each individual actively contributes to the carbon footprint, whether directly or indirectly. Major contributors to our carbon footprint include transportation, electricity, home heating, and increased affluence, which leads to greater production. Around the world, various efforts are underway to combat the ongoing harm to our planet caused by this man-made issue. Whether these attempts are genuine or merely superficial is a different discussion, but various technologies, methods, and government policies aim to control the magnitude of this threat. Reducing waste production, reusing materials, and enhancing recycling are all helpful strategies. Adopting a plant-based diet goes a long way in supporting the planet. Every individual bears responsibility for their own consumption and should be willing to change their lifestyle. The goal should be achieving zero emissions rather than settling for net-zero carbon emissions.

Plant-Based Diet and Survival Among Patients with Metastatic Colorectal Cancer.

Plant-based diet is associated with better survival among patients with non-metastatic colorectal cancer (CRC), but its association in metastatic CRC is unknown. Using an NCI-sponsored trial (CALGB/SWOG 80405), we included 1,284 patients who completed validated food frequency questionnaires at the initiation of metastatic CRC treatment. We calculated three indices: overall plant-based diet index (PDI), which emphasized consumption of all plant foods while reducing animal food intake; healthful plant-based diet index (hPDI), which emphasized consumption of healthful plant foods such as whole grains, fruits, and vegetables; and unhealthful plant-based diet index (uPDI), which emphasized consumption of less healthful plant foods such as fruit juices, refined grains, and sugar-sweetened beverages. We estimated the associations of three indices (quintiles) with overall survival (OS) and progression-free survival (PFS) using multivariable Cox proportional hazards regression. We observed 1,100 deaths and 1,204 progression events (median follow-up: 6.1 years). Compared to the lowest quintile, patients in the highest quintile of PDI had significantly better survival (HR for OS: 0.76 [0.62-0.94], P trend=0.004; PFS: 0.81 [0.66-0.99], P trend=0.09). Similar findings were observed for hPDI (HR for OS: 0.81 [0.65-1.01], P trend=0.053; PFS: 0.80 [0.65-0.98], P trend=0.04), whereas uPDI was not associated with worse survival (HR for OS: 1.16 [0.94-1.43], P trend=0.21; PFS: 1.12 [0.92-1.36], P trend=0.42). Our study suggests that plant-based diet, especially when rich in healthful plant foods, is associated with better survival among patients with metastatic CRC. The cause of survival benefits warrants further investigation.

A Comprehensive Review of the Triangular Relationship among Diet-Gut Microbiota-Inflammation.

The human gastrointestinal tract hosts a complex and dynamic community of microorganisms known as the gut microbiota, which play a pivotal role in numerous physiological processes, including digestion, metabolism, and immune function. Recent research has highlighted the significant impact of diet on the gut microbiota composition and functionality, and the consequential effects on host health. Concurrently, there is growing evidence linking the gut microbiota to inflammation, a key factor in many chronic diseases such as inflammatory bowel disease (IBD), obesity, diabetes, and cardiovascular diseases (CVDs). This review explores how dietary components influence the gut microbiota composition, how these microbial changes affect inflammatory pathways, and the therapeutic implications of modulating this axis for chronic inflammatory disease prevention and management. Beneficial dietary patterns, such as the Mediterranean diet (MD) and plant-based diets, promote a diverse and balanced gut microbiota composition, supporting anti-inflammatory pathways. Conversely, the Western diet (WD), high in saturated fats and refined sugars, is associated with dysbiosis and increased inflammation. With all the links between the three variables considered, this review attempts to offer a thorough examination of the triangle formed by inflammation, the gut microbiota, and food.

Maternal dietary patterns during pregnancy and birth weight: a prospective cohort study

BackgroundExisting data on maternal dietary patterns and birth weight remains limited and inconsistent, especially in non-Western populations. We aimed to examine the relationship between maternal dietary patterns and birth weight among a cohort of Chinese.MethodsIn this study, 4,184 mother-child pairs were included from the Iodine Status in Pregnancy and Offspring Health Cohort. Maternal diet during pregnancy was evaluated using a self-administered food frequency questionnaire with 69 food items. Principal component analysis was used to identify dietary patterns. Information on birth weight and gestational age was obtained through medical records. Adverse outcomes of birth weight were defined according to standard clinical cutoffs, including low birth weight, macrosomia, small for gestational age, and large for gestational age.ResultsThree maternal dietary patterns were identified: plant-based, animal-based, and processed food and beverage dietary patterns, which explained 23.7% variance in the diet. In the multivariate-adjusted model, women with higher adherence to the plant-based dietary patten had a significantly higher risk of macrosomia (middle tertile vs. low tertile: odds ratio (OR) 1.45, 95% CI 1.00-2.10; high tertile vs. low tertile: OR 1.55, 95% CI 1.03–2.34; P-trend = 0.039). For individual food groups, potato intake showed positive association with macrosomia (high tertile vs. low tertile: OR 1.72, 95% CI 1.20–2.47; P-trend = 0.002). Excluding potatoes from the plant-based dietary pattern attenuated its association with macrosomia risk. No significant associations was observed for the animal-based or processed food and beverage dietary pattern with birth weight outcomes.ConclusionsAdherence to a plant-based diet high in carbohydrate intake was associated with higher macrosomia risk among Chinese women. Future studies are required to replicate these findings and explore the potential mechanisms involved.

Relationship of vegetarianism with body weight loss and ASCVD.

The association between a plant-based diet and weight loss and atherosclerotic cardiovascular disease (ASCVD) has not been fully elucidated. We performed a pooled analysis and Mendelian randomization (MR) analysis to investigate this question. We searched for randomized controlled trials on the effects of a plant-based diet on weight loss compared with a non-plant-based diet. In addition, a two-sample MR study was conducted. IVs were obtained from the genome-wide association studies (GWAS) on the exposures, and we obtained summary statistics on the outcomes. The inverse-variance weighted (IVW) method was used as the main analysis and other MR methods were performed as supplementary analyses. Individuals on the plant-based diet lost more weight than the non-plant-based diet group (WMD -0.96 kg; 95% CI: -1.32 to -0.60). Population conditions and energy restriction were identified as the study-level factors that influenced the pooling results in the subgroup analyses. Increased consumption of raw vegetables was significantly associated with lower BMI (IVW, β -0.35, 95% CI: -0.62 to -0.08, p = 0.012) and lower risk of obesity (IVW, OR 0.11, 95% CI: 0.01 to 0.99, p = 0.048), coronary heart disease (IVW, OR 0.44, 95% CI: 0.21 to 0.92, p = 0.029) and myocardial infarction (IVW, OR 0.39,95% CI: 0.15 to 0.98, p = 0.045) and a higher HDL-C (IVW, β 0.47, 95% CI: 0.24 to 0.70, p = 4×10-5). The present findings suggest that raw vegetable intake is beneficial for weight loss and prevention of ASCVD.

Leisure activity engagement attenuates the risks of cognitive impairment induced by unhealthy plant-based diets: a nationwide cohort study.

We intended to reveal the joint effects between LAE and uPDI on cognition in Chinese older adults. Data were collected from the Chinese Longitudinal Healthy Longevity Survey. In total, 10,617 individuals aged 65 years and above without cognitive impairment or dementia at baseline were enrolled in 2008 and followed up in 2011, 2014, and 2018. The uPDI and the scores of LAE were derived from survey responses, and both were categorized into three groups (low, intermediate, and high). Individuals with a Mini-Mental State Examination (MMSE) score lower than 18 were considered to have cognitive impairment. Cox proportional hazards models were employed to explore the joint association of uPDI and LAE on cognitive impairment, followed by restricted cubic spline (RCS) to observe the effects of the continuous-type variable of uPDI and the scores of LAE on the risk of cognitive impairment. Stratified analysis was applied to examine the association of LAE with cognitive impairment in uPDI groups (high uPDI vs. low uPDI). Compared to participants maintained low scores of LAE and high uPDI, those who maintained high scores of LAE and low uPDI had a decreased risk of cognitive impairment (HR = 0.52, 95% CI, 0.43-0.62). The findings of the stratified analysis demonstrated that the protective effects of high scores of LAE on cognition was pronounced in individuals with low uPDI (HR = 0.61, 95% CI: 0.47-0.79) and those with high uPDI (HR = 0.63, 95% CI: 0.51-0.78). In this cohort study, a higher score of uPDI, which indicated higher intake of salt-preserved vegetables, sugars, and refined grains, was associated with an increased risk of cognitive impairment, whereas this association may be mitigated by regular engagement in leisure activities.

Diet and gut microbiome: Impact of each factor and mutual interactions on prevention and treatment of type 1, type 2, and gestational diabetes mellitus

The gut microbiota (GM) plays a key role in health by influencing several physiological functions, including the digestive process, the immune system, vitamin production, and mental health. Dysbiosis in gut microbial composition and function has been linked to systemic inflammatory response and the development of metabolic diseases, including diabetes mellitus (DM). "Leaky gut" resulting from dysbiosis causes endotoxemia, leading to systemic inflammation and insulin resistance, which are pathogenetic agents of type 2 and gestational DM. Moreover, in children, gut dysbiosis has been associated with the immunitary dysregulation with increased risk of autoimmunity and development of type 1 DM. However, dietary changes in the GM and their role in DM are poorly understood. Plant-based diets that are low in fat and high in fiber have been associated with beneficial effects on the GM. Clinical trials of prebiotics and probiotics have shown promising, albeit mixed, results. This narrative review summarizes recent findings on the relationship between the GM, diet, and DM, focusing on the systems in which the microbiota is involved in the pathogenesis of this disease and its potential use as a therapy. In addition, we discuss immune dysfunction associated with gut dysbiosis and its role in type 1, type 2, and gestational DM. Further research is needed to evaluate the GM as a potential therapeutic target for the prevention and treatment of DM.

Food is Medicine Interventions and Climate Change

Food is Medicine (FiM), also known as Food as Medicine, integrates food and nutrition interventions into health care delivery with the primary goal to improve population health and address diet-related health conditions. To date, there has been little focus on the relation between FiM and climate change despite FiM’s involvement with 2 key drivers of climate change: health care delivery and food systems. FiM may be able to advance lifestyle medicine and population health objectives, as well as mitigate some of the health care and food-related drivers of climate change, by focusing on 4 key areas: (1) Increasing the absolute number and proportion of patients who follow plant-based diets; (2) reducing food waste; (3) reducing unnecessary health care utilization; and (4) lowering transportation-related greenhouse gas emissions related to food procurement. Measuring the ecological impact of FiM alongside clinical, utilization, and financial measures will require a different analytical approach than that used traditionally in health care. Ultimately, thoughtful, data-driven, and urgent interventions that span the food and health care sectors are needed to sustainably support not only FiM, but human, environmental, and planetary health as well.

The role of ultra-processed foods in plant-based diets: associations with human health and environmental sustainability.

Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC). Analyses were based on 35,030 participants (20-70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. Plant-based diet indices (hPDI and uPDI) and UPF consumption were calculated from a validated FFQ, assessed at baseline. Cox proportional hazard and multiple linear regression models were used to estimate associations between combined quartiles of the PDI indices and UPF consumption. With lower hPDI and higher UPF diets as the reference, we observed the following. Risk estimates of all-cause mortality were 0.98 (95% CI: 0.83, 1.16) for lower UPF consumption, 0.86 (95% CI: 0.68, 1.08) for higher hPDI, and 0.78 (95% CI: 0.66, 0.89) for combined higher hPDI and lower UPF consumption. Results with the uPDI were inconclusive. Mean differences in GHGE and BWC were 1.4% (95% CI: 0.3, 2.4) and 1.6% (95% CI: -0.5, 3.7) for lower UPF consumption, -7.4% (95% CI: -8.6, -6.4) and 9.6% (95% CI: 7.2, 12.0) for higher hPDI, and - 6.8% (95% CI: -7.4, -6.1) and 13.1% (95% CI: 11.6, 14.8) for combined higher hPDI and lower UPF consumption. No apparent conflict between environmental impacts was observed for the uPDI; GHGE and BWC were lower for higher uPDI scores. Mortality risk and environmental impacts were mostly associated with the amount of plant-based foods and to a lesser extent UPF in the diet. Shifting to a more healthful plant-based diet could improve human health and reduce most aspects of environmental impact (GHGE, but not BWC) irrespective of UPF consumption.

Association between different diet quality scores and depression risk: the REGICOR population-based cohort study

BackgroundOur aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain.MethodsProspective observational study using participants’ baseline (2003–2006), follow-up (2007–2013) and clinical records data. Five diet quality scores were derived from a food frequency questionnaire (FFQ) at baseline: the relative Mediterranean Diet Score (rMED), the Modified Mediterranean Diet Score (ModMDS), a Dietary Approaches to Stop Hypertension (DASH) score, a Healthful Plant-based Diet Index (HPDI) and the World Health Organization Healthy Diet Indicator (WHO-HDI). Participants using pharmacological antidepressant treatment were excluded as a proxy for presence of depression at baseline. At follow-up, the Patient Health Questionnaire (PHQ-9) was applied to assess depressive symptoms (≥ 10 defining depressive disorder). A secondary outcome was depression diagnosis assessed through clinical records. Logistic regression and Cox proportional hazards models were used.ResultsMain analysis included 3046 adults (50.3% women) with a mean age of 54.7 (SD = 11.6) years. After 6-years follow-up, 184 (6.04%) cases of depressive disorder were identified. There was 16% lower odds of depressive disorder per 1SD increase of rMED (OR = 0.84; 95%CI = 0.71–0.98). Secondary outcome analysis (n = 4789) identified 261 (5.45%) incident cases of clinical depression diagnosis over 12 years follow-up, and 19% lower risk of clinical depression was observed with the WHO-HDI (HR = 0.81; 95%CI = 0.70–0.93). Adjusting for BMI did not attenuate the findings.ConclusionsA significant inverse association between diet quality and depression incidence was found in this population-based cohort study, independent of sociodemographic, health and lifestyle. Adherence to a healthy diet could be a complementary intervention for the prevention of depression.

To imitate or not to imitate? How consumers perceive animal origin products and plant-based alternatives imitating minimally processed vs ultra-processed food

Changing dietary habits towards a reduction of animal origin proteins, such as meat and fish, in favor of plant-based alternatives can positively contribute to sustainability, health and animal suffering related issues. Despite this awareness and the large variety of plant-based alternatives available on the market, willingness to reduce or substitute animal origin proteins is still very low. This research investigates the role of a so far overlooked factor in the study of consumer adoption of plant-based diets, namely the role of food processing, adding to the understanding of how consumers perceive animal origin products and their plant-based alternatives imitating a minimally processed vs ultra-processed food. Through a Swiss online study with 607 consumers, our results showed that the resemblance to a minimally processed (e.g., chicken filet, tuna) or ultra-processed product (e.g., meatball, fish stick) differently affect animal origin products and plant-based imitations. Specifically, while consumers perceived more positively the minimally processed meat/fish than the ultra-processed one in the animal origin category, in terms of perceived environmental friendliness, perceived health and purchase intention, the reverse was observed for the plant-based imitations. Thus, contributing to theory and practice, the results of this research suggest that the like-to-like imitation of an animal origin product is not only ineffective but can also be counterproductive for perceptions-of sustainability and health- and purchase intentions of plant-based alternatives.

Tolerance and toxicity assessment of a novel methionine source, dipeptide Met-Met on common carp Cyprinus carpio

Methionine is the first-limiting essential amino acid in plant-based diet, and also is the most toxic amino acid. The study aimed to evaluate the tolerance and toxicity of a dipeptide DL-methionyl-DL-methionine (Met-Met) in the diet of common carp Cyprinus carpio. Five iso‑nitrogenous (∼ 380 g kg−1) and isoenergetic (∼185 MJ kg−1) diets were formulated including a positive control diet (100 g kg−1 fish meal, FM) supplemented with 3 g kg−1DL-Met and four low fish meal diets (40 g kg−1 fish meal), with 0 (M0), 3 (M3), 6 (M6), and 15 (M15) g kg−1 Met-Met being supplemented. The Met-Met supplementation levels of 6 and 15 g kg−1 were designed as the 2- and 5-fold of the optimal level (3 g kg−1) for the tolerance and toxicity assessment, respectively. After 10 weeks of feeding, the lowest growth performance was observed in the M0 group, as evidenced by the lowest weight gain rate and specific growth rate. Contents of protein and amino acid in whole-body, and retentions of nitrogen and amino acid were highest in the M6 group, while these values decreased in M15 group. Fish fed diet M15 showed lower levels of albumin, high density lipoprotein cholesterol (HDL), total cholesterol, alkaline phosphatase, and higher alanine aminotransferase, total bile acid, total antioxidant capacity (T-AOC) compared with M3. Fish fed diet M15 had lower levels of glucose, HDL, and higher T-AOC and malonaldehyde compared to M6. Genes related to bile acid metabolism (cyp8b1, rxrα, fxr), anti-inflammatory (tgfβ1, tgfβ2, il10), proinflammatory (tnfα, il1β, il17) were significantly down-regulated in the M15 group compared to M3. However, caspase-3 expression significantly up-regulated in the M15 group compared with M6. Increased signals of hepatic vacuolation and fibrosis were observed in the M0 and M15 groups. Besides M15 group showed higher expression of apoptosis signal marker, cleaved caspase-3 in hepatopancreas. This study clarified the safety margin of Met-Met was 2× dosage as 6 g kg−1, while 15 g kg−1 Met-Met caused deleterious consequences, manifested as the highly occurred of cholestatic liver disease.

A systematic review and meta-analysis of randomized trials of substituting soymilk for cow’s milk and intermediate cardiometabolic outcomes: understanding the impact of dairy alternatives in the transition to plant-based diets on cardiometabolic health

BackgroundDietary guidelines recommend a shift to plant-based diets. Fortified soymilk, a prototypical plant protein food used in the transition to plant-based diets, usually contains added sugars to match the sweetness of cow’s milk and is classified as an ultra-processed food. Whether soymilk can replace minimally processed cow’s milk without the adverse cardiometabolic effects attributed to added sugars and ultra-processed foods remains unclear. We conducted a systematic review and meta-analysis of randomized controlled trials, to assess the effect of substituting soymilk for cow’s milk and its modification by added sugars (sweetened versus unsweetened) on intermediate cardiometabolic outcomes.MethodsMEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched (through June 2024) for randomized controlled trials of ≥ 3 weeks in adults. Outcomes included established markers of blood lipids, glycemic control, blood pressure, inflammation, adiposity, renal disease, uric acid, and non-alcoholic fatty liver disease. Two independent reviewers extracted data and assessed risk of bias. The certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). A sub-study of lactose versus sucrose outside of a dairy-like matrix was conducted to explore the role of sweetened soymilk which followed the same methodology.ResultsEligibility criteria were met by 17 trials (n = 504 adults with a range of health statuses), assessing the effect of a median daily dose of 500 mL of soymilk (22 g soy protein and 17.2 g or 6.9 g/250 mL added sugars) in substitution for 500 mL of cow’s milk (24 g milk protein and 24 g or 12 g/250 mL total sugars as lactose) on 19 intermediate outcomes. The substitution of soymilk for cow’s milk resulted in moderate reductions in non-HDL-C (mean difference, − 0.26 mmol/L [95% confidence interval, − 0.43 to − 0.10]), systolic blood pressure (− 8.00 mmHg [− 14.89 to − 1.11]), and diastolic blood pressure (− 4.74 mmHg [− 9.17 to − 0.31]); small important reductions in LDL-C (− 0.19 mmol/L [− 0.29 to − 0.09]) and c-reactive protein (CRP) (− 0.82 mg/L [− 1.26 to − 0.37]); and trivial increases in HDL-C (0.05 mmol/L [0.00 to 0.09]). No other outcomes showed differences. There was no meaningful effect modification by added sugars across outcomes. The certainty of evidence was high for LDL-C and non-HDL-C; moderate for systolic blood pressure, diastolic blood pressure, CRP, and HDL-C; and generally moderate-to-low for all other outcomes. We could not conduct the sub-study of the effect of lactose versus added sugars, as no eligible trials could be identified.ConclusionsCurrent evidence provides a good indication that replacing cow’s milk with soymilk (including sweetened soymilk) does not adversely affect established cardiometabolic risk factors and may result in advantages for blood lipids, blood pressure, and inflammation in adults with a mix of health statuses. The classification of plant-based dairy alternatives such as soymilk as ultra-processed may be misleading as it relates to their cardiometabolic effects and may need to be reconsidered in the transition to plant-based diets.Trial registrationClinicalTrials.gov identifier, NCT05637866.

A multiproxy approach for the feeding ecology of Late Miocene ground sloths from the southwestern Amazonia, Upper Solimões Formation, Brazil

A rich assemblage of fossil sloths is recognized in the southwestern Brazilian Amazon, Upper Solimões Formation (Acre Basin), and represents some of the most diverse Folivora fauna from the Late Miocene of tropical South America. Here, we have used a multiproxy approach using carbon (δ13Csc) and oxygen (δ18Osc) isotope compositions of bioapatite structural carbonate, stereomicrowear, ecomorphological indices (relative muzzle width, RMW and occlusal surface area, OSA), and body mass estimates in order to suggest the habitats and diet of the mylodontids (Octodontobradys puruensis, Urumacotherium campbelli, Pseudoprepotherium venezuelanum and Mylodontinae gen. et. sp. nov.) and the nothrotheriid (cf. Mionothropus) ground sloths from localities along the banks at the Purus and Acre rivers in Amazonas and Acre states. The isotopic results (δ13Csc = −13.2 ± 1.2 ‰; δ18Osc = +24.7 ± 0.8 ‰) indicated a consistently C3 plant diet in open-canopy woodland and closed-canopy forest habitats during warm conditions across the Tortonian ages (∼10 and 8.5 Myr). U. campbelli (Urumacotherium sp., bm: 605 kg; Niterói Site) and cf. Mionothropus (bm: 163 kg; Acre 5 Site) possibly had specialized browsing habits (folivorous/frugivorous), due to the few coarse scars in relatively polished tooth surfaces and elongate skull with narrow muzzle, respectively. Both taxa, as also P. venezuelanum (bm: 733 kg; Niterói Site), showed a low OSA values suggesting limited oral food processing offset by higher fermentation capacity and/or lower metabolic requirements. Efficient capacity for oral food processing and a generalized browsing habit with consumption of high intrinsic toughness and abrasiveness items were inferred for O. puruensis (bm: 526 kg; Talismã Site), resembling the pattern observed for the Pleistocene megathere Eremotherium laurillardi from the southwestern Amazon (Acre State). A non-selective browser diet was also supported for the Mylodontinae gen. et. sp. nov. specimen from Cavalcante Site; its similar dentary morphology to the bulk-feeder taxa implies that this individual could occasionally eat C3 herbaceous/grasses.

Dietary Strategies in the Prevention and Treatment of Hypertension in Children and Adolescents: A Narrative Review.

This study aims to gather information on effective dietary strategies for the prevention and treatment of hypertension (HTN) in children and adolescents. It discusses specific nutritional models such as the Diet Approaches to Stop Hypertension (DASH diet), traditional Asian diets, plant-based diets, the Southern European traditional Atlantic diet, and the Mediterranean diet, highlighting the benefits of these approaches. The manuscript also addresses dehydration resulting from insufficient fluid intake among children, as well as the consumption of inappropriate beverages, like soft drinks and energy drinks, which contributes to the development of HTN. Additionally, it examines the role of oxidative stress in the pathomechanism of HTN in children, particularly in relation to the antioxidant potential of food components such as selenium, magnesium, and selected vitamins. The relationship between sodium and potassium intake from food and the development of HTN in children is also explored. Finally, this study discusses public health strategies for the prevention of HTN in children. A comprehensive search was performed across multiple databases, such as PubMed/MEDLINE, the Cochrane Library, Science Direct, and EBSCO. This search focused on locating English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from around the globe.

Is Nutrient Quality of the Locally-Existing, EAT-Lancet-like Plant-Based Diet Better or Worse than the Average Diet in Taiwan? An Example of Local Translation.

The EAT-Lancet commission advocated a planetary health diet in 2019. Some have raised concerns about its nutrient adequacy. This study used data from recent Nutrition and Health Surveys in Taiwan-from 2017 to 2020 (n = 6538)-to assess food intake and nutrient adequacy among three red meat consumption levels (low/medium/high). The low red meat group, whose diet was similar to the EAT-Lancet reference, showed significantly higher/better levels of vitamins C and E, calcium, magnesium, sodium, dietary fiber, and the polyunsaturated to saturated fatty acids ratio. However, protein, B vitamins, phosphorus for females, and zinc were slightly compromised, but they were still near or above 100% of the Daily Reference Intakes (DRIs), except for zinc (74~75%). The intake levels of vitamin D, calcium, and dietary fiber in all three groups at times did not reach 70% of the DRIs, but this was more pronounced in the high red meat group compared to the low red meat group. Replacing ultra-processed foods (UPFs) with whole/healthy foods improved levels of zinc, calcium, and dietary fiber, but not vitamin D. Finally, a proposed local planetary health dietary construct was provided, suggesting maintaining the original distribution of the food groups recommended by the Taiwan Food Guide while specifying amounts of protein sources in line with the EAT-Lancet principles. The proposed diet, according to our estimation and comparison with Taiwanese DRIs, was nearly perfect in its nutrient composition.

Dietary starch, non-starch polysaccharides and their interactions affect nutrient digestibility, faecal waste production and characteristics differentially in three salmonids: Rainbow trout, Atlantic salmon and Arctic charr

Waste management has emerged as a critical issue in aquaculture. In this study, we examined the impact of dietary starch and non-starch polysaccharides (NSP) content on nutrient digestibility, faecal waste production, faecal removal efficiency and the faecal characteristics in three salmonid species, namely rainbow trout (Oncorhynchus mykiss), Atlantic salmon (Salmo salar) and Arctic charr (Salvelinus alpinus). Four diets were formulated according to a 2 × 2 factorial design. The first factor, starch, was tested by including 0% gelatinised wheat flour (low starch) or 20% gelatinised wheat flour (high starch) in a plant-based basal diet. The second factor, NSP, was tested by adding 0% NSP source (low NSP) or 10% NSP source (high NSP). High NSP level was achieved by adding an equal mixture of soya hull (5%) and wheat bran (5%). Diets were tested in triplicates for each species and feeding was done restrictively. Experimental duration was 42 days for rainbow trout and Atlantic salmon and 49 days for Arctic charr. Among the three species investigated, Arctic charr had the lowest digestibility values for most nutrients, whereas rainbow trout and Atlantic salmon values were comparable. High starch level in the diet reduced the macronutrient (protein, fat and ash) digestibility in all three species. High starch and high NSP levels in the diet increased faecal waste production, with the effect being more pronounced for the NSP content of the diet. High dietary starch levels increased the proportion of smaller-sized particles, while high NSP content increased the ability of faecal particles to withstand mechanical stress. The high starch level in the diet lowered faecal removal efficiency but increased by high NSP content. The highest and lowest faecal removal efficiency was recorded for Atlantic salmon and Arctic charr, respectively. The amount of non-removed faeces accumulating in the system was increased by the high starch levels in rainbow trout and Atlantic salmon but remained unaffected by the NSP content of the diet across the species. No interaction effect between starch and NSP content of diets was observed for faecal removal efficiency and non-removed faeces. Among the three species investigated, Arctic charr had the maximum amount of non-removed faeces per kilogram of dry matter feed.

Interventions to improve glycaemic control in people living with, and at risk of developing type 2 diabetes.

Type 2 diabetes mellitus is one of the most prevalent health conditions worldwide, affecting millions of individuals and posing significant public health challenges. Understanding the nature of type 2 diabetes, its causes, symptoms and treatments is crucial for managing and preventing its complications. Many different dietary strategies are used by individuals to treat and manage diabetes. This review provides an overview of popular dietary strategies that have evidence for improving long-term glycaemic control or achieving diabetes remission, as well as strategies that may be useful to reduce postprandial hyperglycaemia, which may be of use in the prevention of diabetes, but also as strategies for those already diagnosed but trying to manage their condition better. Recent clinical trials have provided evidence that in people living with type 2 diabetes who also live with overweight or obesity, using a total diet replacement weight loss programme results in significant and substantial weight loss, and as a result, many people can achieve remission from their diabetes. There has been considerable interest in whether similar effects can be achieved without reliance on formula foods, using real diet approaches. Reduced or low-carbohydrate diet approaches hold some promise, with observational or preliminary findings suggesting beneficial effects, but evidence from robust trials or systematic reviews of randomized controlled trials is still lacking. The Mediterranean dietary pattern, low in saturated fat and high in monounsaturated fat, also has some potential, with evidence to suggest some people can lose weight and achieve remission using this approach, which may be easier to adhere to longer term than more intensive total diet replacement and low-carbohydrate strategies. Plant-based diets that advocate for the elimination of animal-based and/or animal-derived foods have increased in popularity. There is evidence from epidemiological studies that people who follow these diets have a lower risk of developing type 2 diabetes, and evidence from trials and systematic reviews of trials that changing to a dietary pattern lower in animal-based and animal-derived foods has benefits on glycaemic control and other markers of cardiovascular disease. While these approaches all provide food or nutrient prescriptions, approaches that incorporate periods of fasting do not provide rules on the types of foods that can or cannot be consumed, but rather provide time windows of when to eat. Evidence suggests that these approaches can be as effective in achieving energy restriction and weight loss as approaches that advocate continuous energy restriction, and there is evidence for benefits on glycaemic control independent of weight loss. Finally, popular dietary strategies that may be useful to use or combine to help prevent postprandial hyperglycaemia include reducing the glycaemic index or glycaemic load of the diet, high-fibre diets, eating foods in a meal in the order vegetables > protein > carbohydrates, preloading or combining acids such as vinegar or lemon juice with meals and engaging in low-intensity aerobic exercise immediately after meals.

Compliance with a Healthful Plant-Based Diet Is Associated with Kidney Function in Patients with Autosomal Dominant Polycystic Kidney Disease.

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic kidney disorder with multiple cyst formation that progresses to chronic kidney disease (CKD) and end-stage kidney disease. Plant-based diets have attracted considerable attention because they may prevent CKD development. This study investigated whether adherence to a plant-based diet is associated with kidney function in patients with ADPKD. The overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) were calculated using dietary intake data. Among 106 ADPKD patients, 37 (34.91%) were classified as having advanced CKD (eGFR < 60 mL/min/1.73 m2). The overall PDI and hPDI were lower, but the uPDI was higher in patients with advanced CKD than in those with early CKD. The hPDI was negatively correlated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Moreover, the hPDI was inversely associated with advanced CKD [odds ratio (OR): 0.117 (95% confidence interval (CI): 0.039-0.351), p < 0.001], and the uPDI was positively associated with advanced CKD [OR: 8.450 (95% CI: 2.810-25.409), p < 0.001]. The findings of the current study demonstrate that greater adherence to a healthful plant-based diet is associated with improved kidney function in ADPKD patients.