Consumption Of Plant Foods Research Articles

TEMPORARY REMOVAL: Effect of soy isoflavones on measures of estrogenicity: A systematic review and meta-analysis of randomized controlled trials

BackgroundDespite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plant-predominant diets, controversies around the effects of soy foods and especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women. ObjectiveThis systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women. MethodsMEDLINE, Embase, and Cochrane Library were searched through August 2024 for randomized trials 3-months investigating soy isoflavones versus non-isoflavone controls in postmenopausal women. Outcomes included endometrial thickness (ET), vaginal maturation index (VMI), follicle-stimulating hormone (FSH), and estradiol. Independent authors extracted data and assessed risk of bias. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess certainty of evidence. ResultsWe included 40 trials (52 trial comparisons, n=3285) assessing the effect of a median reported dose of 75mg/day of soy isoflavones in substitution for non-isoflavone controls over a median of 24 weeks. Soy isoflavones had no statistically significant effect on any measure of estrogenicity; ET (mean difference, -0.22mm [95% confidence interval, -0.45, 0.01mm], PMD=0.059), VMI (2.31 [-2.14, 6.75], PMD=0.310), FSH (-0.02IU/L [-2.39, 2.35IU/L], PMD=0.987), and estradiol (1.61pmol/L [-1.17, 4.38pmol/L], PMD=0.256). The certainty of evidence was high-to-moderate for all outcomes. ConclusionsCurrent evidence suggests that soy isoflavones do not exhibit estrogenic effects compared to non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women. This synthesis supports that soy isoflavones likely act as selective estrogen receptor modulators, differing clinically from the hormone estrogen. Addressing public health concerns may promote soy foods as high-quality plant protein sources with low environmental impact and cost, particularly benefiting postmenopausal women, and aligning with sustainable dietary patterns and guidelines. RegistrationPROSPERO (CRD42023439239)

Adherence to a healthful plant-based diet and risk of mortality among individuals with chronic kidney disease: A prospective cohort study

BackgroundPlant-rich dietary patterns may protect against negative health outcomes among individuals with chronic kidney disease (CKD), although aspects of plant-based diet quality have not been studied. This study aimed to examine associations between healthful and unhealthful plant-based dietary patterns with risk of all-cause mortality among CKD patients for the first time. MethodsThis prospective analysis included 4,807 UK Biobank participants with CKD at baseline. We examined associations of adherence to both the healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI), calculated from repeated 24-hour dietary assessments, with risk of all-cause mortality using multivariable Cox proportional hazard regression models. ResultsOver a 10-year follow-up, 675 deaths were recorded. Participants with the highest hPDI scores showed a 34% lower risk of mortality [HRQ4vsQ1 (95% CI): 0.66 (0.52-0.83), ptrend <0.001]. Those with the highest uPDI scores had a 52% [1.52 (1.20-1.93), ptrend = 0.002] higher risk of mortality compared to participants with the lowest respective scores. In food group-specific analyses, higher wholegrain intakes were associated with a 29% lower mortality risk, while intakes of refined grains, and sugar-sweetened beverages were associated a 30% and 34% higher risk, respectively. ConclusionsIn CKD patients, a higher intake of healthy plant-based foods was associated with a lower risk of mortality, while a higher intake of less healthy plant-based foods was associated with a higher risk of mortality. These results underscore the importance of plant food quality and support the potential role of healthy plant food consumption in the treatment and management of CKD to mitigate unfavourable outcomes.

The effect of dietary changes on the water and carbon footprints in China

Dietary changes impact the production and consumption of plant and animal foods, thereby affecting water resource usage and greenhouse gas emissions. However, previous studies have ignored subnational differences in long-term dietary changes and environmental impacts. This study evaluated the environmental impacts of dietary changes in China from 1997 to 2016 by combining water and carbon footprints. Results indicated significant provincial differences in both total food consumption amounts (277.15 Mt to 445.58 Mt) and patterns. At the national level, water consumption and greenhouse gas emissions of 10 main food items rose sharply from 437.52 ± 131.26 Gm3/yr to 671.13 ± 201.34 Gm3/yr and 273.66 ± 26.43 Mt CO₂ eq. to 443.50 ± 46.96 Mt CO₂ eq. As per capita animal-based food consumption first increased and then decreased, more developed regions with balanced diets showed water-saving and carbon reduction effects. For instance, Beijing reduced its water footprint by 50.44 m3/cap/yr and reduced carbon footprint by 186.05 kg CO₂ eq./cap/yr. In contrast, in less developed regions, animal food consumption has continued to grow over the last two decades, weighing the environmental impacts. Dietary changes in more developed regions can serve as references for less developed areas. Ensuring steady growth in animal food consumption for basic health needs can also support sustainable development. Furthermore, scenario analysis indicated that replacing all meat with plant-based food could achieve maximum water saving by 13 % and maximum emission reduction by 32 % with current energy and nutritional requirements, while towards national dietary guidelines would increase water consumption by 449.43 m3/cap and emissions by 8.48 CO2 eq./cap, dominated by increasing fruits and vegetables. Policies that affect consumers' choices of food patterns could focus more on promoting adequate and appropriate animal food intake towards healthy and environmentally friendly diets, particularly in less developed regions.

Predictors of Eating Less Meat and More Plant-Based Food in the Polish Sample.

The study aimed to identify predictors of the intention to eat less meat and more plant-based foods, including attitudes towards eating meat, habitual meat eating, subjective norms, and self-identity. A cross-sectional study using CAWI (Computer-Assisted Web Interview) was conducted in a group of 1003 Polish adults in 2023. To measure the predictor variables, the following tools were used: Beliefs and Eating Habits Questionnaire (KomPAN), Meat Attachment Questionnaire (MAQ), and scales to measure subjective norms and self-identity. Logistic regression analysis was used to verify associations between independent variables, and the intentions to eat more plant-based food and less meat next year were treated as dependent variables. More respondents were willing to increase their consumption of plant-based foods rather than reduce their meat consumption. The intention to consume less meat and more plant foods was more prevalent among women, older people (only intention to reduce meat consumption), and better-educated people (only intention to increase plant food consumption). Habitual frequency of eating plant foods, negative feelings about meat, and environmentally oriented identities had a stimulating effect on the intention to eat more plant foods and less meat, while experiencing pleasure in eating meat had a limiting effect on the intention to eat more plant foods and less meat. In addition, the habitual frequency of meat consumption and subjective norms reduced the likelihood of eating less meat, while no predictive effect was observed for the intention to eat more plant foods. In conclusion, educational and promotional activities to raise awareness of the link between food consumption and the environment can have a strong impact on eating less meat and more plant-based food, even among those strongly accustomed to meat consumption.

Adherence to Healthy and Unhealthy Plant-Based Diets and the Risk of Gout

Plant-based diets are increasing in popularity due, in part, to their health benefits for selected cardiometabolic diseases as well as favorable environmental impact. Little is known about how such a diet is related to gout risk. To examine associations between adherence to a plant-based diet (including healthy and unhealthy versions of this diet), as well as its 18 individual food groups, and incident gout. This prospective cohort study used data from population-based cohorts of US men and women enrolled in the Health Professionals Follow-Up Study (1986-2012) and Nurses' Health Study (1984-2010). Participants were men and women free of gout at baseline. Statistical analyses were performed over March 2020 to August 2023. An overall plant-based diet index (PDI), as well as healthy (hPDI) and unhealthy (uPDI) versions of this index that emphasize healthy and less healthy plant-based foods, respectively. These diet indices were comprised of 18 food groups, assessed using a validated semiquantitative food frequency questionnaire. Incident cases of gout that were confirmed with a supplementary questionnaire to meet the preliminary American College of Rheumatology survey criteria for gout. Cox proportional hazards regression models were used to evaluate multivariable-adjusted associations of all 3 PDIs with incident gout using quintiles (Q) of adherence. Among a total of 122 679 participants (mean [SD] age, 53.8 [9.8] years among 43 703 men; mean [SD] age, 50.9 [7.2] years among 78 976 women) over 2 704 899 person-years of follow-up, 2709 participants experienced incident gout. The overall PDI was not significantly associated with gout in either cohort (Q5 vs Q1 pooled hazard ratio [HR], 1.02 [95% CI, 0.89-1.17]; P for trend = .63). In the pooled analysis, hPDI was significantly inversely associated with risk of gout (Q5 vs Q1 HR, 0.79 [95% CI, 0.69-0.91]; P for trend = .002), while the uPDI was positively associated with risk of gout (Q5 vs Q1 HR, 1.17 [95% CI, 1.03-1.33]; P for trend = .02), particularly in women (Q5 vs Q1 HR, 1.31 [95% CI, 1.05-1.62]; P for trend = .01). In analysis of individual food groups, higher intakes of certain healthy plant foods, such as whole grains (pooled HR per 1 serving/d, 0.93 [95% CI, 0.89-0.97]) and tea and coffee (pooled HR per 1 serving/d, 0.95 [95% CI, 0.92-0.97]), as well as dairy (pooled HR per 1 serving/d, 0.86 [95% CI, 0.82-0.90]), were independently associated with a lower risk of gout, while selected unhealthy plant foods, such as fruit juice (pooled HR per 1 serving/d, 1.06 [95% CI, 1.00-1.13]) and sugar-sweetened beverages (pooled HR per 1 serving/d, 1.16 [95% CI, 1.07-1.26]) were associated with increased risk of gout. The findings of this prospective cohort study of PDIs and gout support current dietary recommendations to increase consumption of healthy plant foods while lowering intake of unhealthy plant foods to mitigate gout risk.

Plant-Based Diets and Risk of Multimorbidity: The Health and Retirement Study

BackgroundPlant-based diets have gained attention due to their beneficial effects against major chronic diseases, although their association with multimorbidity is mostly unknown. ObjectivesWe examined the association between the healthful (hPDI) and unhealthful plant-based diet indices (uPDI) with multimorbidity among middle-aged and older adults from the United States. MethodsData on 4262 adults aged >50 y was obtained from the 2012–2020 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Food consumption was collected at baseline with a food frequency questionnaire and 2 PDIs were derived: the hPDI, with positive scores for healthy plant foods and reverse scores for less healthy plant foods and animal foods; and the uPDI, with only positive scoring for less healthy plant foods. Complex multimorbidity, defined as ≥3 coexistent conditions, was ascertained from 8 self-reported conditions: hypertension, diabetes, cancer, chronic lung disease, heart disease, stroke, arthritis, and depression. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). ResultsAfter a median follow-up of 7.8 y, we documented 1202 incident cases of multimorbidity. Compared with the lowest quartile, higher adherence to the hPDI was inversely associated with multimorbidity (HR for quartile 3: 0.77; 95% CI: 0.62, 0.96 and HR for quartile 4: 0.79; 95% CI, 0.63, 0.98; P-trend = 0.02). In addition, a 10-point increment in the hPDI was associated with a 11% lower incidence of multimorbidity (95% CI: 1, 20%). No significant associations were found for the uPDI after adjusting for sociodemographic and lifestyle factors. ConclusionsHigher adherence to the hPDI was inversely associated with multimorbidity among middle-aged and older adults. Plant-based diets that emphasize consumption of high-quality plant foods may help prevent the development of complex multimorbidity.

Quality of plant-based diets and frailty incidence: a prospective analysis of UK biobank participants.

Substantial evidence supports the inverse association between adherence to healthy dietary patterns and frailty risk. However, the role of plant-based diets, particularly their quality, is poorly known. To examine the association of two plant-based diets with incidence of physical frailty in middle-aged and older adults. Prospective cohort. United Kingdom. 24,996 individuals aged 40-70 years, followed from 2009-12 to 2019-22. Based on at least two 24-h diet assessments, we built two diet indices: (i) the healthful Plant-based Diet Index (hPDI) and (ii) the unhealthful Plant-based Diet Index (uPDI). Incident frailty was defined as developing ≥3 out of 5 of the Fried criteria. We used Cox models to estimate relative risks (RR), and their 95% confidence interval (CI), of incident frailty adjusted for the main potential confounders. After a median follow-up of 6.72 years, 428 cases of frailty were ascertained. The RR (95% CI) of frailty was 0.62 (0.48-0.80) for the highest versus lowest tertile of the hPDI and 1.61 (1.26-2.05) for the uPDI. The consumption of healthy plant foods was associated with lower frailty risk (RR per serving 0.93 (0.90-0.96)). The hPDI was directly, and the uPDI inversely, associated with higher risk of low physical activity, slow walking speed and weak hand grip, and the uPDI with higher risk of exhaustion. In British middle-age and older adults, greater adherence to the hPDI was associated with lower risk of frailty, whereas greater adherence to the uPDI was associated with higher risk.

Piloting a brief assessment to capture consumption of whole plant food and water: version 1.0 of the American College of Lifestyle Medicine Diet Screener (ACLM Diet Screener).

Despite the availability of various dietary assessment tools, there is a need for a tool aligned with the needs of lifestyle medicine (LM) physicians. Such a tool would be brief, aimed at use in a clinical setting, and focused on a "food as medicine" approach consistent with recommendations for a diet based predominately on whole plant foods. The objective of this study is to describe the development and initial pilot testing of a brief, dietary screener to assess the proportion of whole, unrefined plant foods and water relative to total food and beverage intake. A multidisciplinary study team led the screener development, providing input on the design and food/beverage items included, and existing published dietary assessment tools were reviewed for relevance. Feedback was solicited from LM practitioners in the form of a cross-sectional survey that captured information on medical practice, barriers, and needs in assessing patients' diets, in addition to an opportunity to complete the screener and provide feedback on its utility. The study team assessed feedback and revised the screener accordingly, which included seeking and incorporating feedback on additional food items to be included from subject matter experts in specific cultural and ethnic groups in the United States. The final screener was submitted for professional design, and scoring was developed. Of 539 total participants, the majority reported assessing diet either informally (62%) or formally (26%) during patient encounters, and 73% reported discussing diet with all or most of their patients. Participants also reported facing barriers (80%) to assessing diet. Eighty-eight percent believed the screener was quick enough to use in a clinical setting, and 68% reported they would use it. The ACLM Diet Screener was developed through iterative review and pilot testing. The screener is a brief, 27-item diet assessment tool that can be successfully used in clinical settings to track patient dietary intakes, guide clinical conversations, and support nutrition prescriptions. Pilot testing of the screener found strong alignment with clinician needs for assessing a patient's intake of whole plant food and water relative to the overall diet. Future research will involve pilot testing the screener in clinical interventions and conducting a validation study to establish construct validity.

The influence of plant components on microbiological and oxidative processes in dry fish and plant products during storage

A pressing issue in the food industry is providing the population with adequate nutrition. According to the concept of healthy eating, a person needs to increase the consumption of plant foods without reducing the consumption of foods containing complete protein. We have created dry fish and plant products, in the form of food concentrates, containing all the necessary macro- and micronutrients. The purpose of the research was to study the influence of plant components on the microbiological and oxidative processes of dry fish and fish-plant products during storage. To achieve the intended goal, the tasks of determining microbiological indicators and oxidation products at the beginning and end of the storage period were solved. Storage of dry fish and plant products was carried out for 12 months in polymer packaging at a temperature of plus 20±5℃. All analyses were carried out using generally accepted standard methods. As a result of the studies, it was established that the microbiological indicators of a dry fish-plant product, due to the addition of vegetables and corn flour, were higher than those of a dry fish product (0.5x104 and 0.2x104 CFU per 1 g, respectively), but during storage the bacterial contamination of dry of fish and plant products decreased from 0.5x104 to 0.1x104 CFU per 1 g of product. Also, plant components affected the oxidative processes in dry fish and vegetable products. The acid number in samples of dry fish product increased from 0.71 to 2.67 mg of KOH, and in samples of dry fish-plant product – from 0.65 to 1.87 mg of KOH after 12 months of storage. Thus, plant components inhibited the oxidation process and maintain the quality of the product during storage.

Nutritive and Phytate Contents of Raw and Fermented African Oil Bean Seeds

Studies have shown that consumption of plant foods that contain high amount of phytate (phytic acid) is associated with decrease in nutrient absorption, mineral deficiency and low sperm count. Producing natural phytase without any health or environmental challenge targeted the main focus of many researchers. This study was undertaken to evaluate the nutritive and phytate contents of raw and fermented African Oil bean seeds (Pentaclethra macrophylla). Prepared raw and fermented Oil bean seeds were randomly purchased from various markets in Awka metropolis, Anambra State, Nigeria, and their nutritive and phytic acid contents were determined using gravimetric and instrumentation techniques. The fermented PM seeds were screened for phytase-producing bacteria using standard plate technique. The data generated from the study were analyzed statistically using one way Analysis of Variance (ANOVA) and Student’s “t” test. The study revealed significant (P &lt; 0.05) reduction in carbohydrate content (23.82±0.14, 2.12±0.01) non-significant (P &gt; 0.05) reduction in ash (0.54±0.01, 0.17±0.00) and fiber contents (4.88±0.07, 1.33±0.01) increase in moisture (30.40±0.03, 42.13±0.11) and protein contents (17.84±0.21, 22.97±0.11) and significant (P &lt; 0.05) reduction in phytic acid (26.48±0.14, 0.02±0.00) during fermentation. Therefore, this study has shown that seeds of Oil bean contain vital nutrients, and phytate, which decreased during fermentation.

A Multidisciplinary Analysis of Early Modern Plant Food Consumption Based on Vegetal Ingredients in Culinary Texts and Subfossil Plant Remains from Cesspits

A Multidisciplinary Analysis of Early Modern Plant Food Consumption Based on Vegetal Ingredients in Culinary Texts and Subfossil Plant Remains from Cesspits

Plant-Based Diet Indices and Their Association with Frailty in Older Adults: A CLHLS-Based Cohort Study.

Within the realm of aging, the nexus between diet and health has garnered considerable attention. However, only select studies have amalgamated insights into the correlation between plant and animal food consumption and frailty. Our aim was to appraise the connections between the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) and frailty in the elderly, utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cohort study drew upon CLHLS data spanning from 2008 to 2018. The PDI, hPDI, and uPDI were gauged using a simplified food frequency questionnaire (FFQ). A frailty index, encompassing 35 variables across major health domains, was formulated. Cox proportional hazard models were employed to scrutinize the associations between the three plant-based dietary indices and frailty in older adults, including an exploration of gender disparities in these associations. A cohort of 2883 study participants was encompassed, with 1987 (68.9%) observed to be either frail or in the pre-frail stage. The Cox model with penalized spline exhibited linear associations of PDI, hPDI, and uPDI with the frailty index. Following covariate adjustments, it was discerned that older adults situated in the highest quartiles of PDI (HR = 0.86, 95% CI: 0.77-0.95) and hPDI (HR = 0.83, 95% CI: 0.74-0.93) experienced a 14% and 17% diminished risk of frailty compared to those in the lowest quartiles of PDI and hPDI, respectively. Conversely, when contrasted with those in the lowest quartile of uPDI, older adults adhering to the highest tertile of uPDI exhibited a 21% elevated risk of frailty (HR = 1.21, 95% CI: 1.08-1.36), with both associations achieving statistical significance (p < 0.01). Moreover, additional subgroup analyses revealed that the protective effects of PDI and hPDI against frailty and the deleterious effects of uPDI were more conspicuous in men compared to women. To forestall or decelerate the progression of frailty in the elderly, tailored dietary interventions are imperative, particularly targeting male seniors.

Late Bronze Age agriculture and the early westward transmission of rice at Luanzagangzi, Northern Xinjiang, China

The Dzungar Basin of northern Xinjiang has previously been considered a marginal environment with little evidence for the development of prehistoric agriculture. Recent archaeobotanical studies have indicated the region as being a route for the transmission of domesticated plants, technologies and ideas between East and West Eurasia during prehistory, as early as 5000 BP. These interactions are still poorly understood and most evidence for early plant food production and consumption in the region comes from limited mortuary contexts. In this study we present plant macrofossil analysis from the settlement site of Luanzagangzi on the southern side of the Dzungar Basin. From ca. 3130 BP an agricultural package of east and west Asian cereals and chaff is present, comprising wheat, barley, foxtail millet, broomcorn millet, and significantly a single grain of japonica type rice. AMS dating indicates this is the oldest directly dated rice in Xinjiang and the broader region, ranging 3069–2881 cal. BP. Cereal morphometrics and material culture from the site further indicate a connection with the Gansu region to the east. The spread of agriculture into the site environment may be linked to the onset of wetter conditions relating to strengthened westerly systems across arid Central Asia in the Late-Holocene. A declining abundance of West Asian cultivars over the period of the site’s occupation possibly reflect a shift away from intensive agriculture to low-level management of millets.

Environmental pressures and pesticide exposure associated with an increase in the share of plant-based foods in the diet

Diets rich in plant-based foods are encouraged for human health and to preserve resources and the environment but the nutritional quality and safety of such diets is debated. This study aimed to model nutritionally adequate diets with increasing plant food content and to characterise the derived diets using a multicriteria approach including, nutrients intake, environmental pressures and exposure to pesticides. Using data of the NutriNet-Santé cohort (N = 29,413), we implemented stepwise optimization models to identified maximum plant-food content under nutritional constraints. Environmental indicators at the production level were derived from the DIALECTE database, and exposure to pesticide residues from plant food consumption was estimated using a contamination database. Plant-based foods contributed to 64.3% (SD = 10.6%) of energy intake in observed diets and may reach up to 95% in modelled diets without jeopardizing nutritional status. Compared to the observed situation, an increase in plant-based foods in the diets led to increases in soy-based products (+ 480%), dried fruits (+ 370%), legumes (+ 317%), whole grains (+ 251%), oils (+ 144%) and vegetables (+ 93%). Animal products decreased progressively until total eviction, except for beef (− 98%). Dietary quality (estimated using the Diet Quality Index Based on the Probability of Adequate Nutrient Intake) was improved (up to 17%) as well as GHGe (up to − 65%), energy demand (up to − 48%), and land occupation (− 56%) for production. Exposures to pesticides from plant-based foods were increased by 100% conventional production and to a much lesser extent by 100% organic production. This study shows that shifting to nutritionally-adequate plant-based diets requires an in-depth rearrangement of food groups’ consumption but allows a drastic reduction environmental impact. Increase exposure to pesticide residues and related risks can be mitigated by consuming foods produced with low pesticide input.

Fermented vegetables and fruits as vitamin B12 sources: An overview

There is a trend towards the consumption of plant foods, especially from the public that aims to reduce meat consumption. Plant-based food diets may have low source of vitamin B12 as plants do not produce them. A possible alternative to mitigate this is the consumption of fermented vegetables and fruits. Therefore, we aimed to provide an overview of the work being done with fermented vegetables and fruits, and show evidence that it is possible to obtain the necessary daily amount of vitamin B12 for human health and maintenance. Vitamin B12, also known as cobalamin, acts as a cofactor for the enzyme methionine synthase and methylmalonylCoA mutase in eukaryotes. The dietary reference values for adult men and women range between 2 and 4 μg/day; however, the requirement may increase depending on special recommendations. The main causes for vitamin B12 deficiency are autoimmune conditions (e.g., pernicious anaemia), malabsorption, and dietary insufficiency. One of the commonly adopted measures to deal with vitamin deficiency is supplementation. It is also possible to obtain food enriched with vitamin B12 through fermentation. Different plant materials and microorganisms can be used to produce fermented products and enhance traditional products, such as tempeh, to increase vitamin B12 concentration in the final product. The bioaccessibility and bioavailability of vitamin B12 in fermented vegetables and fruits are important factors to be considered, and demand more studies. The intake of soy fermented foods, such as tempeh, tofu, and cheonggukjang was associated with cognitive enhancement and neuroprotective effects. In addition to fermented vegetables and fruits, other non-animal sources of vitamin B12 that deserve great attention are algae and mushrooms. Since fermentation can produce considerable amounts of vitamin B12, fermented vegetables and fruits are feasible alternative sources for the intake of this vitamin.

Aligning Environmental Sustainability, Health and Affordability in Diet Quality: A Systematic Review

Abstract Background Improving population health while simultaneously respecting planetary boundaries is of critical interest globally. Despite this shared motivation, research on the dietary changes required continues to operate in silos, focusing on certain pairings (diet-climate), rather than examining sustainable diets in their totality. This review aimed to summarise the literature on adherence to a priori defined dietary patterns in consideration of diet quality, environmental impacts, metabolic risk factors for non-communicable diseases (NCDs), and affordability. Methods Following the PRISMA guidelines, the review protocol was registered prospectively with PROSPERO. Seven electronic databases were searched as of October 2022. Two reviewers independently screened abstracts for inclusion, followed by full-text. One reviewer conducted data extraction and a quality assessment of eligible articles. Results Twenty-four studies were included with the majority from European countries (n = 22), and two from Australia. Thirteen distinct diet quality scores were identified, with those measuring adherence to national dietary guidelines the most reported. Thirteen distinct environmental impact indicators were identified, with greenhouse gas emissions (GHGE) (n = 23) assessed most. Indicators to assess impact on biodiversity were reported least. All studies reported on Body Mass Index (BMI) and seven on the daily cost of dietary adherence. Higher quality diets assist with maintaining a healthy weight and reducing environmental impacts, however, incongruities between population and planetary health can occur, especially between plant food consumption and water footprint. Further, sustainable diets can increase financial cost. Conclusions Higher diet quality can reduce planetary pressures, however lower impact diets are not inherently nutritionally optimal. Higher quality, low environmental impact diets may provide a protective role against risk of obesity, but have affordability implications. Key messages • Diets providing synergies between health and multiple environmental concerns requires continued research, with specific focus on the socio-cultural and economic dimensions of sustainable diets. • Public health strategies to confront the Global Syndemic should greater emphasise the win-win outcomes for population and planetary health through dietary change in higher-income countries.

Stages of Change toward Meat Reduction: Associations with Motives and Longitudinal Dietary Data on Animal-Based and Plant-Based Food Intakes in French Adults

BackgroundReducing meat consumption is advocated for healthier and more sustainable diets. However, behavioral studies are needed to better understand the mechanisms underlying meat-reducing dietary changes. ObjectivesThe main aim of this study was to compare the motives associated with stages of change toward meat reduction in French adults, using the transtheoretical model (TTM). A second aim was to investigate the associations between stages of change and adherence to dietary patterns favoring a better balance of animal and plant food consumption over time. MethodsThis longitudinal study included 25,143 non-vegetarian participants of the web-based NutriNet-Santé cohort with a mean follow-up of 6.2 (SD = 2.6) y. Dietary data were obtained from 24-h dietary records over the period 2009–2019. The contribution of meat to total energy intake and scores measuring the contribution of healthy and unhealthy plant-based foods to the diet were computed. A questionnaire completed in 2018 allowed us to identify the TTM stages of change related to meat reduction (precontemplation, contemplation, preparation, action, and maintenance), and recorded motives related to meat consumption. We used multivariate linear mixed models for repeated data to assess associations between food intake changes and stages, and logistic regression for motives, presented as adjusted frequencies. ResultsParticipants in later stages were characterized by a significantly higher decrease in meat intake over time, compared with the earliest stage (for example, βmaintenance ∗ time = −0.08, P < 0.0001), and a higher increase in the healthy plant-based food consumption score over time (for example, βmaintenance∗time = 0.11, P < 0.0001). Concerns about health, nutrition, and the environment were the most frequently cited motives for reducing meat consumption at all stages. ConclusionsIndividuals who had already initiated meat reduction adhered to healthier and more sustainable diets than meat continuers. Characterizing motives according to readiness to reduce meat consumption could support tailored public health campaigns. Trial registration numberThe study protocol is registered at clinicaltrials.gov with Clinical Trial Registry number NCT03335644 available at https://clinicaltrials.gov/ct2/show/NCT03335644.

Beyond Insoluble Dietary Fiber: Bioactive Compounds in Plant Foods.

Consumption of plant foods, including whole grains, vegetables, fruits, pulses, nuts, and seeds, is linked to improved health outcomes. Dietary fiber is a nutrient in plant foods that is associated with improved health outcomes, including a lower risk of chronic diseases such as cardiovascular disease, type 2 diabetes, and certain cancers. Different fibers deliver different health benefits based on their physiochemical properties (solubility, viscosity) and physiological effects (fermentability). Additionally, plant foods contain more than dietary fiber and are rich sources of bioactives, which also provide health benefits. The concept of the solubility of fiber was introduced in the 1970s as a method to explain physiological effects, an idea that is no longer accepted. Dividing total dietary fiber (TDF) into insoluble dietary fiber (IDF) and soluble dietary fiber (SDF) is an analytical distinction, and recent work finds that IDF intake is linked to a wide range of health benefits beyond increased stool weight. We have focused on the IDF content of plant foods and linked the concept of IDF to the bioactives in plant foods. Ancestral humans might have consumed as much as 100 g of dietary fiber daily, which also delivered bioactives that may be more important protective compounds in disease prevention. Isolating fibers to add to human diets may be of limited usefulness unless bioactives are included in the isolated fiber supplement.

The Minimum Methionine Requirement for Adults Aged ≥60 Years Is the Same in Males and Females.

The minimum methionine requirement in the presence of excess dietary cysteine has not been determined in older adults. This study aimed to determine the minimum methionine requirement in healthy older adults using the indicator amino acid oxidation (IAAO) method. Fifteen healthy adults ≥ 60 years of age received seven methionine intakes (0 to 20 mg/kg/d) plus excess dietary cysteine (40 mg/kg/d). Oxidation of the indicator, L-[1-13C]phenylalanine (F13CO2), was used to estimate the mean minimum methionine requirement using a change-point mixed-effect model. There was no statistical difference between male and female requirement estimates, so the data were pooled to generate a mean of 5.1 mg/kg/d (Rm2 = 0.46, Rc2 = 0.77; p < 0.01; 95% CI: 3.67, 6.53 mg/kg/d). This is the first study to estimate the minimum methionine requirement in healthy older adults, which is the same between the sexes and as our lab's previous estimate in young adults. The findings are relevant considering current recommendations for increased consumption of plant foods, which will help to establish the appropriate balance of methionine and cysteine intake required to satisfy the sulphur amino acid requirements of older adults.

The Role of Plant-Based Diets in Preventing and Mitigating Chronic Kidney Disease: More Light than Shadows.

Chronic kidney disease (CKD) is a non-communicable disease that affects >10% of the general population worldwide; the number of patients affected by CKD is increasing due in part to the rise in risk factors such as obesity, hypertension, and diabetes mellitus. As many studies show, diet can be an important tool for preventing and mitigating the onset of non-communicable diseases. Plant-based diets (PBDs) are those that emphasize the consumption of plant foods and may or may not include small or moderate amounts of animal foods. Recently, these diets have received increasing interest because they have been associated with favourable effects on health and also appear to protect against the development and progression of CKD. PBDs, which are associated with protein restrictions, seem to offer adjunctive advantages in patients with chronic kidney disease, as compared to conventional low-protein diets that include animal proteins. The principal aims of this review are to provide a comprehensive overview of the existing literature regarding the role of plant-based diets and low-protein, plant-based diets in the context of chronic kidney disease. Moreover, we try to clarify the definition of plant-based diets, and then we analyse possible concerns about the use of PBDs in patients with chronic kidney disease (nutritional deficiency and hyperkalaemia risk). Finally, we offer some strategies to increase the nutritional value of plant-based low-protein diets. In the Materials and Methods section, many studies about plant-based diets and low-protein plant-based diets (e.g., the very-low-protein diet and vegan low-protein diet, LPD) in chronic kidney disease were considered. In the Results and Conclusion section, current data, most from observational studies, agree upon the protective effect of plant-based diets on kidney function. Moreover, in patients with advanced CKD, low-protein plant-based options, especially a very-low-protein diet supplemented with heteroanalogues (VLPDs), compared to a conventional LPD appear to offer adjunctive advances in terms of delaying dialysis and mitigating metabolic disturbances. However, further studies are necessary to better investigate the possible metabolic and cardiovascular advantages of plant-based LPDs versus conventional LPDs.