Vegan Research Articles

Development and evaluation of a web-based diet quality screener for vegans (VEGANScreener): a cross-sectional, observational, multicenter, clinical study

Consumption of plant-based diets, including vegan diets, necessitates attention to the quality of the diet for the prevention and early detection of nutritional deficiencies. Within the VEGANScreener project, a unique brief screening tool for the assessment and monitoring of diet quality among vegans in Europe was developed. To provide a standardized tool for public use, a clinical study will be conducted to evaluate the VEGANScreener against a reference dietary assessment method and nutritional biomarkers. An observational study is set to include 600 participants across five European sites – Belgium, Czech Republic, Germany, Spain, and Switzerland. In total, 400 self-reported vegans (≥2 years on a vegan diet), and 170 self-reported omnivore controls will be examined, aged between 18 and 65 years, with males and females being equally represented in a 1:1 ratio for two age groups (18–35 and 36–65 years). Participants with diseases affecting metabolism and intestinal integrity will be excluded. The clinical assessment will include a structured medical history, along with taking blood pressure and anthropometric measurements. Blood and urine will be sampled and analyzed for a set of dietary biomarkers. Metabolomic analyses will be conducted to explore potential novel biomarkers of vegan diet. Moreover, saliva samples will be collected to assess the metabolome and the microbiome. Participants will receive instructions to complete a nonconsecutive 4-day diet record, along with the VEGANScreener, a socio-demographic survey, a well-being survey, and a FFQ. To evaluate reproducibility, the VEGANScreener will be administered twice over a three-weeks period. Among vegans, the construct validity and criterion validity of the VEGANScreener will be analyzed through associations of the score with nutrient and food group intakes, diet quality scores assessed from the 4-day diet records, and associations with the dietary biomarkers. Secondary outcomes will include analysis of dietary data, metabolomics, and microbiomes in all participants. Major nutrient sources and variations will be assessed in the sample. Exploratory metabolomic analysis will be performed using multivariable statistics and regression analysis to identify novel biomarkers. Standard statistical models will be implemented for cross-sectional comparisons of geographical groups and vegans versus omnivores.

Vitamin D intake and status in children and adolescents: Comparing vegetarian, vegan, and omnivorous diets.

This study aimed to evaluate papers analysing dietary intake, 25-hydroxyvitamin D (25(OH)D) concentrations and anthropometry in children on vegetarian, vegan and omnivorous diets, as research indicates all diets generally fall below recommended vitamin D intake. This mini review examined the vitamin D status of children aged 1-18 years by systematically searching PubMed, Google Scholar and Scopus databases from January 1, 2000, to December 31, 2023. The review included nine studies published between 2000 and 2023. Four studies reported lower vitamin D intake in children on vegetarian and vegan diets compared to omnivores. Three studies reported lower 25(OH)D concentrations in children on vegetarian and vegan diets. Specifically, one study found lower concentrations in vegans compared to omnivores, another found lower concentrations in vegetarians and vegans not taking supplements and a third reported lower 25(OH)D concentrations in Asian children aged 3-4.5 years compared to Caucasian children. Three studies found no significant differences in 25(OH)D between diet groups. Three studies assessing anthropometry showed that vegetarians have similar body weight and height as omnivores. Children across all dietary groups may have low vitamin D intakes; supplementation should be considered for those with inadequate sun exposure, especially those avoiding animal products.

Sustainable Dietary Patterns and Alternative Food Sources

Sustainable nutrition ensures optimal dietary intake by evaluating the life cycle of foods and their environmental impacts, aiming to meet current needs without jeopardizing the ability of future generations to do the same. It is characterized by low greenhouse gas emissions, minimal water footprint, efficient energy and land use, and reduced food waste. Sustainable dietary models, which have become increasingly important in the face of rising food demand and climate change challenges, include the Mediterranean Diet, Nordic Diet, DASH Diet, Double Pyramid Model, Flexitarian Diet, EAT-Lancet Commission Reference Diet, and Vegetarian and Vegan diets. Alternative protein sources such as algae, insects, and cultured meat are also significant. Algae offer sustainability through ocean use but have unclear metabolic impacts. Insects are efficient and environmentally friendly but require safety assessments. Cultured meat promises environmental benefits but faces cost and acceptance hurdles. Promoting sustainable eating habits requires a collective effort and is a shared responsibility towards our planet and ourselves.

A Study of Clinical, Hematological and Biochemical Profiles of Patients with Pancytopenia

This study aimed to investigate patients’ clinical, hematologic, and biochemical profiles with pancytopenia. This prospective observational study was conducted at a tertiary care hospital from January 2019 to June 2020 on 80 patients, 39 (48.7%) were males and 41 (51.2%) were females, over the age of 18 presenting with pancytopenia. All the patients were subjected to thorough clinical and physical examinations. A complete blood count (CBC), peripheral smear examination, bone marrow aspiration, and reticulocyte count were performed. The data was analyzed using the IBM SPSS 20.0 software. Most of the cases had moderate (Hb<7-9.9g/dl) anemia (63.7%, 51/80 cases), while severe anemia (<7g/dl) was seen in 31.2% (25/80) cases, and 5% (04/80) cases showed mild anemia (Hb<10-11.9g/dl). Most patients with severe anemia had vitamin B12 deficiency anemia (12/80), that is, 15%. Macrocytic anemia was noted in preponderance (50% cases, 40/80), whereas microcytic hypochromic and normocytic hypochromic anemia constituted 21.3% (17/80), and dimorphic anemia was seen in 7.5% (06/80) cases. Based on WBC counts, 56.3% of cases (45/80) showed counts between 2000 and 4000 cells/cu.mm, while counts between 1000 and 2000 cells/cu.mm were seen in 31.3% of cases (25/80), and 12.5% of cases (10/80) had counts of <1000 cells/cu.mm. The study highlighted that 28.8% (23/80) had a platelet count between 50,000 and 1 lakh/cu.mm (mild thrombocytopenia), 36.3% (29/80) cases had a platelet count between 20,000 and 50,000/cu.mm (moderate thrombocytopenia), and 35% (28/80) cases had a platelet count less than 20,000/cu.mm (severe thrombocytopenia). The most common diagnosis of bone marrow aspiration was megaloblastic anemia, seen in 50.0% (6/12) cases. Megaloblasts were seen in 50.0% (6/12) cases of megaloblast anemia. The bone marrow aspirate of a patient with dengue fever and malaria showed macrophages containing engulfed red blood cells, lymphocytes, and platelets. Myeloblasts (>20%) were seen in 1 (8.3%) case of AML, and decreased myelopoiesis was seen in 25% of cases (two cases of aplastic anemia and one case of MDS). This study concludes that vitamin B12 deficiency is the most common cause, which is more common in people who are strict vegetarians, with a predominance in the younger age group. The study also emphasized the vitality of the physical findings, detailed primary hematologic and biochemical investigations, and peripheral blood pictures, all of which provide precious information in the work-up of pancytopenia patients.

Plant-Based Beverages: Consumption Habits, Perception and Knowledge on a Sample of Portuguese Citizens.

Plant-based beverages (PBB) consumption has increased significantly worldwide due to an interest in vegetarian/vegan diets, taste preferences, health and ethical and environmental issues. Therefore, this study intends to investigate consumption habits, consumer preferences and consumers' level of knowledge about PBB. In this study, a voluntary, anonymous questionnaire survey was applied to a sample of participants from Portugal. The sample was recruited by convenience, and therefore, the distribution among the groups was not even. Data analysis involved different statistical techniques: basic statistics, chi-square tests, factor analysis, cluster analysis and tree classification analysis. The results indicated that the most consumed PBB were almond, soy and oat beverages. The majority of consumers chose these beverages for nutritional and health reasons, while a smaller number consumed them as part of a vegetarian or vegan diet. The main motivations for consuming PBB are mainly associated with sustainability and health benefits. The results regarding the respondents' knowledge about PBB revealed that a health-related profession was the most significant predictor. These results allowed us to conclude that the factors of nutrition, health, ethics and practice of a vegetarian/vegan diet influence the consumption of PBB. It was also concluded that being in a healthcare profession, along with age and professional status within this field, were significant factors influencing the level of knowledge about PBB.

The Evidence for Diet as a Treatment in Migraine-A Review.

Background/objectives: The connection between diet and migraine has gained increasing attention in migraine research due to its potential relevance as part of migraine treatment. This study reviewed the current evidence on the use of diets or specific foods in the prevention of migraine. Methods: A PubMed search was performed with the keywords "diet and migraine" OR "brain-gut-axis and migraine". One author (KVN) screened titles, abstracts, and full-text articles and excluded or included them based on eligibility criteria. Results: A ketogenic diet and a "Dietary Approaches to Stop Hypertension" diet reduced attack duration (p < 0.002), frequency (p < 0.05), and severity (p < 0.01). The ketogenic diet also reduced monthly medication intake (p ≤ 0.05). A low-fat vegan diet mixed with an elimination diet reduced the attack duration (p < 0.01), frequency (p < 0.05), severity (p < 0.0001), and percentage of medicated headaches (p < 0.001). Elimination diet reduced attack duration (p < 0.05), frequency (p < 0.02), severity (p < 0.01), and medication intake (p < 0.002). Elimination diet with IgG-positive foods reduced attack frequency (p < 0.001), and total medication intake (p < 0.01). Gluten-free diet reduced frequency (p = 0.02) and severity (p = 0.013). Conclusions: Certain diets and food items may trigger attacks in some migraine patients, though the overall evidence supporting this is limited. Modifying a diet may reduce symptoms such as attack duration, frequency, severity, and medication intake. However, the included studies' small populations and diverse study designs make the results difficult to apply in clinical practise. Further high-quality, double-blinded, randomised controlled trials are necessary to confirm the association between diet and migraine.

A systematic review and meta-analysis of functional vitamin B12 status among adult vegans.

The dietary intake of vitamin B12 among unsupplemented vegans is notably lower compared to both vegetarians and omnivores. Prolonged low intakes of vitamin B12, such as seen in those adhering to a vegan diet, lead to physiological deficiency of vitamin B12 and an elevated risk of B12-related morbidity. However, while serum B12 serves as a conventional biomarker for assessing B12 status, its utility is limited given its sensitivity and specificity in ascribing physiological deficiency of B12 and the functional vitamin B12 status of those adhering to vegan diets is unclear. We conducted a systematic review and meta-analysis using data based on the full panel of biomarkers of vitamin B12 status to test whether adherence to a vegan diet is associated with an elevated risk of functional vitamin B12 deficiency compared to vegetarian or omnivorous diets. In addition, subgroup analysis was carried out to look at the effect of vitamin B12 supplement use on B12 status among vegans. Our search identified 4002 records, of which 19 studies met the inclusion criteria for the systematic review and 17 studies were taken forward for the meta-analysis. Meta-analysis results revealed significantly lower serum B12, pmol/ (-0.72 [-1.26, -0.18]; p = 0.01) and elevated total homocysteine, μmol/L (tHcy) (0.57 [0.26, 0.89]; p < 0.001) concentrations, alongside elevated methylmalonic acid, nmol/L (MMA) (0.28 [-0.01, 0.57]; p = 0.06) and lower holotranscobalamin, pmol/ (HoloTC) (-0.42 [-0.91, 0.07]; p = 0.09) levels among vegan adults compared to omnivores, indicating increased functional B12 deficiency in addition to low vitamin B12 status in vegan adults. There were no differences between vegans and vegetarians in HoloTC (0.04 [-0.28, 0.35]; p = 0.814) or MMA (-0.05 [-0.29, 0.20]; p = 0.708), but differences were found in serum B12 (-0.25 [-0.40, -0.10]; p = 0.001) and for tHcy (0.24 [0.09, 0.39]; p = 0.002) concentrations. Subgroup analyses indicated that the use of vitamin B12 supplements among vegans contributes to significant improvements in all biomarker concentrations compared to their unsupplemented counterparts. Our findings underscore the need for improved strategies to redress poor vitamin B12 status with appropriate B12 supplementation use among those adhering to vegetarian and vegan diets.

The influence of a vegan diet on body composition, performance and the menstrual cycle in young, recreationally trained women– a 12-week controlled trial

The influence of a vegan diet on body composition, performance and the menstrual cycle in young, recreationally trained women– a 12-week controlled trial

8353 Impact of a plant-based protein diet on bone health and body composition in Sprague Dawley rats

Abstract Disclosure: M.M. Gomes: None. I.M. de Araújo: None. S.V. Rodriguez: None. F.R. Jorge: None. F.J. de Paula: None. Introduction:Vegetarian and vegan diets are associated with some health benefits; this has contributed to their growing popularity. Although studies remain limited, there is evidence that these patients may be at greater risk of reduced bone mineral density (BMD) and increased fracture risk. The general objective of this study was to analyze the impact of a high-protein, plant-based diet on bone tissue and body composition in male Sprague Dawley rats. Methodology: The study was approved by the Animal Ethics Committee. This study was done with 10 rats in the control group (CG), which received a standard AIN-93M diet; 11 in the normoprotein vegetarian group (NVG), with a normoprotein AIN-93 diet modified with pea protein and methionine; and 11 in the high-protein vegetarian group (HVG), with a modified AIN-93 diet with 40% pea protein and methionine. The dietary intervention lasted 8 weeks. The weight of the animals was measured weekly. Basal blood glucose levels were measured at baseline. At the end of the study, 6 rats from the CG, 6 rats from the NVG, and 5 rats from the HVG were subjected to a glucose tolerance test (GTT). The dual-energy X-ray absorptiometry (DXA) technique was applied in the baseline and final periods of the experiment to evaluate body composition, bone mineral content (BMC) and BMD. After sacrifice, bone strength was measured via a three-point flexion mechanical test on the tibia; brown adipose, epididymal, and retroperitoneal tissues, as well as the liver, were weighed on an analytical balance. Blood was used to measure circulatory levels of insulin, CTX, and P1NP (n=6/group). Results: Basal weight was similar between the groups, but the final weight was lower in the HVG as compared to the CG. In the DXA evaluation, the final lean mass was not different between the groups. On the other hand, total fat mass was lower in the HVG than in the CG and the NVG and the fat percentage was lower in the HVG than in the CG. The weight of epididymal adipose tissue was lower in the HVG than in the NVG, but retroperitoneal and brown adipose tissues were lower in HVG than CG. Liver weight was similar between groups. BMD was similar between groups; however, BMC was lower in the HVG than in the CG and the NVG. Bone strength was similar between groups. There was no difference in glycemia at baseline or during GTT at the eighth week. Serum levels of insulin, CTX, and P1NP were similar between groups. Discussion and Conclusion: A normoprotein vegetarian diet that includes all essential amino acids appears to have no negative impact on body composition or BMD in rats. On the other hand, a high-protein diet with plant protein appears to have a negative impact on bone mineral content, in addition to reducing the amount of body fat and weight. This finding expands on previous results by showing that high-protein diets have a negative impact on bone even when the protein is of plant origin. Presentation: 6/1/2024

Obstetric healthcare experiences and information needs of Dutch women in relation to their vegan diet during pregnancy

ObjectivesThe prevalence of a vegan (strict plant-based) diet is increasing. Adequate access to nutritional information for pregnant women on a vegan diet is vital, as optimal maternal nutrition is important in order to prevent maternal and fetal complications. This study evaluated the obstetric healthcare experiences and information needs of pregnant women following a vegan diet in the Netherlands. MethodsAn online survey examined women’s experiences with obstetric healthcare in relation to their vegan diet during pregnancy. In total, 195 women, all of whom followed a vegan diet during their pregnancy and gave birth between January 2018 and April 2020, completed an online survey about their experiences. Descriptive statistics were used to present the data. ResultsIn total, 36.5% of participants reported that an obstetric healthcare provider had inquired about their diet in general during the first prenatal consultation, and an additional 43.1% of participants proactively informed their healthcare provider about their diet. Only 19.0% of all participants received specific information about their vegan diet during pregnancy, and 25.2% reported having had extra checks, mostly blood tests, during their pregnancy. Of all participants, 35.9% would have preferred to receive additional information regarding their diet. ConclusionsOur data shows that only a minority of pregnant women following a vegan diet received information and recommendations about their diet from their healthcare providers. It is our recommendation that healthcare providers inquire about pregnant women’s diets, and refer those following a vegan diet to reliable sources of dietary information or to a specialized dietitian.

Vegan Diet: A Novel Trend in Healthy Living

Abstract: An entirely animal-free diet that prioritizes natural plant-origin foods such as vegetables, fruits, whole grains, pulses, and lentils is known as a vegan diet. Lowering persistent diseases like type-2 diabetes, cardiovascular conditions, cancer, and many others offers numerous positive health effects. Different aspects of how a vegan diet affects health are studied, and the dietary pattern is analyzed. Along with the trend of a vegan diet, many people have become aware of the importance of following a vegan diet, and many do this for health reasons or due to religious beliefs. A vegan diet has also been seen to positively affect aging. As vegan diet choices are growing, there are now more options for meat and non-dairy alternatives. Optimization for developing an alternative vegan food product is necessary to produce the most favorable product quality and achieve the best. This paper indicates the vegan diet as a whole and how the vegan diet can help treat chronic diseases. It also reviews vegan products for alternative use and their stance in the food industry.

Micronutrient intake and status in young vegans, lacto-ovo-vegetarians, pescatarians, flexitarians, and omnivores.

Whether youth who follow plant-based diets in Nordic countries meet their dietary needs for micronutrients remains unclear. This study aims to evaluate micronutrient intake and status in Norwegian youth following vegan, lacto-ovo-vegetarian, pescatarian, flexitarian and omnivore diets. Cross-sectional design, with healthy 16-to-24-year-olds (n = 165). Participants were asked to complete a questionnaire and four 24-hour dietary recalls. Dried blood spots (DBS) and spot-urine samples were collected for analysis of methyl malonic acid (MMA) (n = 65), haemoglobin (Hb) (n = 164) and urinary iodine concentration (UIC) (n = 163). Vegans reported highest habitual supplement usage of multivitamin (58%), B12 (90%) and macroalgae consumption (32%), while flexitarians reported highest habitual usage of omega-3 supplements (56%). For daily supplement usage, vegans reported highest use of multivitamins (42%), B12 (79%), iodine (37%) and iron (63%). Increased risk of inadequate intake (energy-adjusted) were found for vitamin D (60% within lacto-ovo-vegetarians), selenium (70% within lacto-ovo-vegetarians, 65% within omnivores), and iodine (63% within vegans). Median MMA levels suggest low risk of insufficient B12 status across all groups (MMA 0.04‒0.37µmol/l) and 2% had MMA levels indicating possible B12 deficiency and 8% had elevated levels. Median Hb levels indicated low risk of anemia across all groups (≥ 12.0 females, ≥ 13.0g/dl males), though 7% had Hb values indicating risk of mild anemia and 4% risk of moderate anemia. The median UIC indicates mild iodine deficiency in all groups (UIC < 100µg/l), except vegans, who were moderately iodine deficient (UIC < 50µg/l). Our study indicated that the participating youth had low risk of inadequate intake of most micronutrients, partly due to high supplement usage. However, for iodine, vitamin D, and selenium higher risk of inadequate intake was found. UIC corroborated the low iodine intake among vegans. Thus, we suggest iodine status of youth in Norway should be monitored, especially among young fertile women who omits dietary iodine sources, until a mandatory iodine fortification program is implemented. Furthermore, we suggest that food education on how to secure sufficient nutrients from food in general should be provided to the Norwegian youth population, especially how to secure adequate intake of vitamin D, selenium and iodine.

Impact of diet adherence on weight and lipids among African American participants randomized to vegan or omnivorous diets.

Prior research has found that plant-based diets (PBDs) are rated as acceptable and have similar levels of adherence as compared to other therapeutic dietary approaches; however, previous studies were mostly among white populations. Plant-based diets can produce clinically meaningful weight loss, but outcomes may vary by level of adherence. The goal of this study was to examine the differences in weight and lipids among participants in the Nutritious Eating with Soul study based on adherence to their diet assignment. African American adults (n=159; 79% female) with overweight or obesity (mean BMI 36.9±6.9kg/m2) were recruited to participate in a 24-month intervention. Participants were randomized to a plant-based vegan (n=77) or a low-fat omnivorous (n=82) diet, both emphasizing soul food cuisine. Participants attended nutrition classes and had dietary intake/adherence (three 24-h recalls; adherence score 1-5), body weight, lipids, and other secondary outcomes assessed at baseline, 6-, 12-, and 24 months. Participants who met at least half of the adherence criteria (≥2.5 out of 5) were categorized as adherents. At 24months, adherent vegans lost 5% of their body weight, non-adherent vegans lost -0.005%, adherent omnivores lost -0.03%, and non-adherent omnivores lost -0.02%. Adherent vegans lost more weight (kg) than all other participants at both 6- (-3.32±0.92 (-5.14, -1.49), p<0.001) and 24 months (-3.27±1.49 (-6.23, -0.31), p=0.03). Adherent vegans also lost more weight than less adherent vegans (-3.74±1.05 (-5.82, -1.65)), adherent omnivores (-4.00±1.27 (-6.51, -1.48)), and less adherent omnivores (-2.22±0.98 (-4.15, -0.28)) at 6months and lost more weight than less adherent vegans at 24months (-4.96±1.8 (-8.54, -1.37)) (all p<0.05). Adherent vegans had greater improvements in cholesterol-to-HDL ratio at 24months (-0.47±0.22 (-0.92, -0.03), p=0.04) and greater decreases in insulin (-4.57±2.16 (-8.85, -0.29), p=0.04) at 6months than all other participants combined. The study points to the benefit of the use of a PBD for reducing weight, lipids, and insulin in African American adults, but also highlights the importance of supporting adherence to the PBD. Nutritious Eating With Soul (The NEW Soul Study); NCT03354377.

Redox state in omnivore, vegan, vegetarian and low carbohydrate high fat diet

Redox state in omnivore, vegan, vegetarian and low carbohydrate high fat diet

A well-balanced vegan diet does not compromise daily mixed muscle protein synthesis rates when compared to an omnivorous diet in active older adults: a randomized controlled cross-over trial

A well-balanced vegan diet does not compromise daily mixed muscle protein synthesis rates when compared to an omnivorous diet in active older adults: a randomized controlled cross-over trial

Environmental sustainability and nutritional quality of different diets considering nutritional adequacy

This study examines how four diets change nutritionally and environmentally when the diets are nutritionally adjusted. Data on individual Belgian diets of omnivores (n = 131), pescovegetarians (n = 159), vegetarians (n = 494), and vegans (n = 78) were obtained, called non-adjusted diets. We assessed if diets met energy and nutrient intake requirements and calculated the Alternative Healthy Eating Index (AHEI)-2010. The environmental impact was evaluated by a cradle-to-grave life cycle assessment considering all midpoint indicators of the Environmental Footprint 3.0 and expressing the impact per “daily food and supplement intake by one Belgian adult”. The individual dietary intakes were adjusted nutritionally to meet the recommended energy and nutrition intakes using a quadratic programming algorithm. All diets had a significantly improved AHEI score but also a significantly increased water use (WU) when adjusting. The omnivore's diet demonstrated a significantly decreased carbon footprint (CF) while it significantly (except for vegans) raised for the restrictive diets due to adjustment. The omnivorous diet had the greatest improvements in AHEI (15.4), while WU increased the most among all diets (3.7 m3), primarily due to elevated fruit intake. The CF was reduced with 1.2 kg CO2 due to decreased red meat consumption. The AHEI of the vegan diet improved the second most of all diets (13.2) due to the intake of omega-3 supplements, while its WU rose the least of all diets (2.4 m3), and its CF barely increased (0.1 kg CO2-eq). The AHEI improvements of the vegetarian diet were similar to those of the vegan diet (12.5), while the one of the pescovegetarian diet was limited (3.5). The (pesco)vegetarian diet had an increase in WU (2.5 and 2.7 m3) and the highest increase in the CF (0.3 kg CO2-eq). Since nutritionally adjusted diets do not lead to similar nutritional and environmental improvements, this research highlights the need to assess both metrics.

The Association of a Vegan Diet during Pregnancy with Maternal and Child Outcomes: A Systematic Review

Background: With the increasing prevalence of pregnant women adhering to a vegan diet, gaining insight into their nutritional intake and its association with maternal and fetal outcomes is essential to providing recommendations and developing guidelines for general practice. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review of the available scientific literature in Medline, Embase, and Cochrane was conducted in January 2024. Results: The titles and abstracts of 2211 unique articles were screened. Only six studies were eligible for inclusion and assessed for methodological quality using the (National Institutes of Health Study Quality (NIHSQ) Assessment Tool. The intake of protein and various micronutrients was significantly lower among vegan pregnant women compared to omnivorous women. Vitamin B12 supplements seemed sufficient in optimizing maternal and umbilical cord vitamin B12 levels amongst vegan mothers. Further, women on a vegan diet less often showed excessive pregnancy weight gain. However, children from women on a vegan diet had a significantly lower birth weight than those from women on an omnivorous diet. Conclusion: So far, only a few studies, with a large diversity of (assessment of) outcomes and insufficient power, have been published on this topic, limiting our ability to make firm conclusions about the effects of a vegan diet during pregnancy on maternal and fetal outcomes.

Nutrition and Osteoporosis Prevention.

Osteoporosis affects 50% of women and 20% of men after the age of 50. Fractures are associated with significant morbidity, increased mortality and altered quality of life. Lifestyle measures for fragility fracture prevention include good nutrition including adequate protein and calcium intakes, vitamin D sufficiency, and regular weight bearing physical exercise. Dietary protein is one of the most important nutritional considerations as it affects bone mineral density, trabecular and cortical microstructure, and bone strength. When calcium intake is sufficient, higher dietary protein intake is associated with lower risk of fracture. Dairy products are a valuable source of calcium and high quality protein. Dairy product consumption, particularly fermented dairy products, are associated with a lower risk of hip fracture and vegan diets are associated with increased fracture risk. Other dietary factors associated with reduced fracture risk include at least 5 servings per day of fruits and vegetables, regular tea drinking, adherence to a Mediterranean diet and other dietary patterns which provide fibers, polyphenols and fermented dairy products. Such dietary patterns may confer health benefits through their effect on gut microbiota composition and/or function. A balanced diet including minerals, protein, fruits and vegetables is an important element in the prevention of osteoporosis and of fragility fracture.

Iron Deficiency Is Associated with Elevated Parathormone Levels, Low Vitamin D Status, and Risk of Bone Loss in Omnivores and Plant-Based Diet Consumers.

A cross-sectional study was performed in healthy adults (mean age 28 y, 67% women) whose habitual diet was an omnivore, lacto-ovo vegetarian, or vegan diet. The total sample (n = 297) was divided into two groups according to the parathormone (PTH) cut-off value of 65 pg/mL of either normal-PTH (n = 228) or high-PTH (n = 69). Vitamin D status (25-hydroxycholecalciferol, 25-OHD), PTH, and bone formation (bone alkaline phosphatase, BAP) and bone resorption (N-telopeptides of type I collagen, NTx) markers were determined. Hematocrit, erythrocytes, hemoglobin, platelets, serum iron, serum transferrin, transferrin saturation, and serum ferritin were also measured. In the total sample, 25-OHD and PTH were negatively correlated, and all subjects with high PTH presented vitamin D insufficiency (25-OHD < 75 nmol/L). High bone remodeling was observed in the high-PTH group, with significantly higher NTx and marginally higher BAP compared to the normal-PTH group. Hematocrit and ferritin were significantly lower in the high-PTH compared to the normal-PTH group. However, serum iron was higher in the high-PTH group, which was only observed for the lacto-ovo vegetarian and vegan subjects. It is concluded that both low vitamin D and low iron status are associated with elevated PTH and bone resorption, more in vegetarians than omnivores, which is in line with the hypothesis that chronic iron deficiency in adulthood mainly predisposes to osteoporosis in postmenopausal women and the elderly.

Importance of Supplementation in Vegan and Vegetarian Diets for Adults

Introduction and purpose Vegan and vegetarian diets are popular due to health, ethical, and ecological benefits, but they risk nutrient deficiencies. This article reviews research on supplementation to meet the nutritional needs of adults on these diets. It provides recommendations for different life stages, including pregnancy, aging, and physical activity, and highlights the risks of excessive or inadequate supplementation, stressing the need for personalized dietary approaches.. Material and method A systematic review of the past decade's literature focused on peer-reviewed articles from databases like PubMed, Google Scholar, and Scopus. It included studies on adults adhering to vegan or vegetarian diets, evaluating supplementation's effects on nutrition and health. The review encompassed observational studies, interventions, meta-analyses, and systematic reviews, using keywords such as "vegan diet," "vegetarian diet," "supplementation," "nutrient deficiencies," and "adult health." State of knowledge Research shows that well-planned vegan or vegetarian diets can be healthy for adults, but often need supplementation to prevent nutrient deficiencies. Clinical studies confirm the efficacy of supplements. Specific groups, like pregnant and lactating women and those with regular physical activity, may need extra vitamins and minerals. Excessive supplementation poses health risks, so a personalized approach considering individual needs, health status, age, and lifestyle is crucial. Conclusions A well-balanced vegan or vegetarian diet, supported by appropriate supplementation, can be beneficial for the health of adults. A personalized approach to supplementation is essential, taking into account specific nutritional needs, pregnancy, health status, age, and lifestyle. Regular monitoring of nutritional status and adjusting supplementation to the body's current needs is crucial for maintaining optimal health.