Vegetarian Diet Research Articles

Health benefits of fermented olives, olive pomace and their polyphenols: a focus on the role of lactic acid bacteria.

Fermented foods have regained popularity in Western diets for their health-promoting potential, mainly related to the role of lactic acid bacteria (LAB) during the fermentation process. Nowadays, there is an increasing demand for vegetable-based fermented foods, representing an environmentally sustainable options to overcome the limitations of lactose intolerance, vegetarian, or cholesterol-restricted diets. Among them, table olives and their co-products (i.e., olive pomace) represent important plant-origin matrices, whose exploitation is still limited. Olives are an important source of fiber and bioactive molecules such as phenolic compounds with recognized health-promoting effects. Based on that, this minireview offer a brief overview about the potential beneficial role of fermented table olives/olive pomace, with a particular focus on the role of LAB to obtain healthy and/or probiotic-enriched fermented foods.

Complementary Feeding in the Clinical Practice: An Exploratory Survey among Italian Primary Care Pediatricians.

Introduction: Complementary feeding (CF) is the process of introducing solid or liquid foods (complementary foods, CFs) other than human breast milk (HBM) or infant formula into infants' diet when HBM or infant formula is no longer sufficient to meet infants' nutritional needs. Primary care pediatricians (PCPs) are paramount in guiding and educating infants' families during CF. Materials and Methods: Our exploratory survey aimed to investigate PCPs' current clinical approach to managing CF. From 1 March 2024 to 30 April 2024, a digital questionnaire composed of 32 multiple-choice questions investigating PCPs' attitudes toward CF in healthy, full-term infants was proposed to 1620 PCPs contacted through scientific societies. Results: The questionnaire was completed voluntarily; 707 PCPs (79.5% female, 66.1% aged over 50 years) fully responded to the survey in the proposed timeframe (participation rate 43.6%). Among the responders, 47.5% recommended traditional CF; 42.1% declared to know the baby-led weaning (BLW) approach and on-demand CF (ODCF), but only 32.8% and 12.5% of them recommended these types of CF, respectively. The vast majority (95%) of participants recommended that CF start between 4 to 6 completed months of age. CF routinely based on vegetarian or plant-based diets was supported by 45/707 (6.1%), only if planned by a specialist by 253/707 (35.8%), and only upon request by caregivers by 257/707 (36.3%). Egg and fish introduction was mostly advised in the first year of life, although in case of a positive family history of food allergy, 13.3% of participants recommended the introduction of egg and fish after 12 months. Conclusions: In conclusion, PCPs did not display a homogenous approach to CF; further studies and educational programs are needed to achieve more flexibility and knowledge on this important nutritional issue.

Preliminary biogas production assessment on insect frass and leachates of the organic wastes fed to larvae: A Johannesburg‐based factory case study

AbstractThe biomethane potential of insect frass and leachates from waste (larvae feedstock) stockpile was evaluated. Frass was derived from a black soldier fly larvae (BSFL) operation that uses a fruit and vegetable waste diet. The two waste streams were characterized and the results of their compositional, proximate, and ultimate analysis were used in estimating methane yields from these materials. The estimated biomethane potential (BMP) of the frass ranged 149–275 L/kgVS depending on the calculation method used. This result compares well with that of empirical studies for cow manure whose BMP ranges 110–275 L/kgVS. Cow manure is the most popular biogas feedstock globally. Leachates reported an estimated BMP of 150 L/kgCOD. We conclude that it may be technically feasible to produce biogas from BSFL frass and from fruit and vegetable waste leachates. However, standard BMP experiments and semicontinuous pilot studies are still necessary before commercialization of these findings. These extra tests are executed to validate these findings and ascertain the life cycle attribute and long‐term process stability and hence determine the economics of using these potential substrates for biogas production as a strategy to implementing circularity in the fruit and vegetable industry.

The share of ultra-processed foods determines the overall nutritional quality of diet in British vegetarians.

The aim of this study was to describe the dietary intake of British vegetarians according to the Nova classification and to evaluate the association between the consumption of ultra-processed foods and the nutritional quality of the diet. We used data from the UK national survey (2008/2019). Food collected through a 4-d record were classified according to the Nova system. In all tertiles of the energy contribution of ultra-processed foods, differences in the average nutrient intake, as well as in the prevalence of inadequate intake, were analysed, considering the values recommended by international authorities. Ultra-processed foods had the highest dietary contribution (56·3 % of energy intake), followed by fresh or minimally processed foods (29·2 %), processed foods (9·4 %) and culinary ingredients (5 %). A positive linear trend was found between the contribution tertiles of ultra-processed foods and the content of free sugars (β 0·25, P < 0·001), while an inverse relationship was observed for dietary fibre (β -0·26, P = 0·002), potassium (β -0·38, P < 0·001), Mg (β -0·31, P < 0·001), Cu (β -0·22, P < 0·003), vitamin A (β -0·37, P < 0·001) and vitamin C (β -0·22, P < 0·001). As the contribution of ultra-processed foods to total energy intake increased (from the first to the last tertile of consumption), the prevalence of inadequate intake of free sugars increased (from 32·9 % to 60·7 %, respectively), as well as the prevalence of inadequate fibre intake (from 26·1 % to 47·5 %). The influence of ultra-processed foods on the vegetarian diet in the UK is of considerable magnitude, and the consumption of this food was associated with poorer diet quality.

Nutrition and fasting

Patients with rheumatic diseases often enquire about the options for nutritional therapy. Nutritional factors have been empirically described that are associated with the occurrence of inflammatory rheumatic diseases or flare-ups or improved disease states. Agrowing number of epidemiological and clinical studies deal with the evaluation of nutrition and dietary restriction in rheumatology. Narrative presentation of the evidence of nutritional interventions and fasting and its clinical implications. Only limited data from smaller clinical studies are available for evidence assessment. Abenefit in terms of symptoms and quality of life in rheumatoid arthritis was shown for the Mediterranean and plant-based diet as well as the anti-inflammatory diet. The effect sizes are small to moderate and the effectiveness in the context of complex lifestyle programs is probably sustainable. The evidence for elimination diets is weak. Initial clinical studies indicate amoderate benefit of plant-based nutrition for osteoarthritis in the context of the metabolic syndrome. There is moderate evidence for the benefit of dietary weight normalization in psoriasis. There is clear experimental evidence of asignificant anti-inflammatory effect of prolonged fasting. Several clinical studies demonstrated asymptomatic benefit of prolonged modified fasting (therapeutic fasting) in rheumatoid arthritis (RA). If fasting is followed by avegan and vegetarian diet, lasting effects of up to 1year have been documented. Cardiometabolic but not antirheumatic effects have been proven for intermittent fasting. Nutrition and fasting can be classified as apossible useful addition to conventional treatment but are currently only rarely taken into account in practice.

Determination of the Consumer Profile in Relation to New Food Products Based on Soy with Microalgae in Brazil

ABSTRACT Due to demand for functional foods and the increase of individuals adopting a vegetarian diet, the objective of this work was to investigate the preferences and consumption of soy products with microalgae among the Brazilian population. Employing an online questionnaire, participants reported consumption habits of meat and soy-based products with microalgae. The findings revealed that 74% of respondents did not have the habit of consuming soy. The majority had never consumed products with microalgae; however, those who had, reported good experiences, which indicates that the development of products with microalgae should be encouraged and explored.

Vegetarians’ and vegans’ experiences with and attitudes towards ultra-processed foods (UPF): a qualitative study

BackgroundThe consumption of ultra-processed foods (UPF) is increasing in many countries. Simultaneously, there is a growing number of consumers that follow a vegetarian or vegan diet, many due to its possible positive impact on sustainability and food waste. However, little is known about attitudes towards and experiences with UPF among vegetarians and vegans. Thus, this study investigates vegetarians’ and vegans’ experiences with and attitudes towards UPFs.MethodsWe conducted semi-structured, individual interviews with 14 participants between September and December 2021. The participants were from different areas in Norway. The data were analysed using a thematic analysis by Braun and Clarke.ResultsIn general, participants appeared to have diverse knowledge of and divergent attitudes towards UPFs. However, participants mainly associated substitute products (e.g. meat substitutes, dairy substitutes) as UPFs. They appreciated the increased availability of vegetarian and vegan UPF which made it easier for them to follow a plant-based diet. They enjoyed the taste and consistency of vegetarian and vegan UPF. However, participants expressed concerns about the effects that industrial processing has on the products’ nutritional content.ConclusionThis study indicated that there was a diverse knowledge of and various attitudes towards UPFs among the participating vegetarians and vegans. Public information and guidelines about using UPF (e.g. meat substitutes, dairy substitutes) in vegetarian and vegan diets are needed, as well as information about their possible impact on health and sustainability.

Demographic and Clinical Characteristics of Patients with Primary Hypothyroidism and Adequacy of Levothyroxine Replacement Therapy in Them: A Nationwide Study in Bangladesh

ABSTRACT Background: Despite the huge burden of primary hypothyroidism in Bangladesh, no nationwide study has been conducted describing the demographic and clinical characteristics of these patients; data on the adequacy of levothyroxine (L-T4) replacement are also lacking. This study aimed to fill the knowledge gap. Materials and Methods: This cross-sectional study was conducted among patients with primary hypothyroidism attending the endocrinology outpatient clinics of several hospitals throughout Bangladesh from July 2023 to December 2023. Adults with primary hypothyroidism who had been on L-T4 replacement for at least 1 year were included. Data on their demographic and disease-related characteristics were collected. Serum thyroid-stimulating hormone (TSH) was measured; TSH 0.4–4.0 μIU/mL was considered the therapeutic target for nonmalignant thyroid cases. Results: Two thousand six hundred and forty-one patients (median age 37 years, 86.4% female, and median disease duration 5 years) were included. Hashimoto’s thyroiditis was the most common (40.9%) cause of hypothyroidism; 1.9% had differentiated thyroid cancer (DTC), and the etiology was not established in many (40.2%). Only 26.8% of patients had high adherence to L-T4. Among the non-DTC cases (n = 2590), over half (53.9%) had TSH within the target range, whether the disease was uncontrolled in the remaining 46.1% (TSH was below the target range in 5.6% and above the target range in 40.5%). Among the DTC cases (n = 51), only a few (9.8%) had a TSH within the target range; TSH was below and above the range in 2% and 88.2% of these patients, respectively. In the nonmalignant hypothyroid cases, vegetarian diet, smokeless tobacco use, disease duration &gt;5 years, iron or calcium supplements consumption within 4 h of L-T4 intake, and low or medium adherence to L-T4 were associated with uncontrolled hypothyroidism. Conclusion: For nearly half of Bangladeshi patients with primary hypothyroidism, L-T4 replacement is not optimal. Physicians should address the barriers to reaching the therapeutic goal for these patients.

Can endurance athletes benefit from vegetarian diets?

The performance of an athlete is the result of a complex interplay of various factors, with diet representing a particularly crucial component. Nutritional profiles of vegetarian diets vary considerably from those of omnivorous diets. In our research, we propose that vegetarian diets may offer advantageous properties for endurance sportsmen. This review examines the distinctions between vegetarian and omnivorous diets and addresses these differences in the context of the nutritional requirements of athletes. The initial focus is on fundamental nutrients, including carbohydrates, proteins, and fats. Subsequently, the emphasis shifts to micronutrients. This analysis also encompasses the challenges and advantages associated with vegetarian diets. The subsequent section concerns the cardiovascular system, which is arguably the most crucial for endurance athletes. It examines the interaction between the cardiovascular system and other physiological factors, including dyslipidaemia, blood pressure and body weight. It also considers the impact of dietary modifications on these parameters and their influence on athletic performance. Finally, the recent research on the effects of a vegetarian diet on the performance of endurance athletes is presented. Despite a lack of conclusive evidence, recent research suggests that vegetarian diets may confer certain benefits, particularly in terms of endurance training. Although there is a paucity of rigorous research in this field, the existing evidence suggests that these dietary regimens may result in overall enhanced health and improved outcomes.

Systems Approach to Investigate the Role of Fruit and Vegetable Types on Vascular Function in Pre-Hypertensive Participants: Protocol and Baseline Characteristics of a Randomised Crossover Dietary Intervention.

The evidence on the impact of fruits and vegetable types on cardiovascular risk factors remains limited. Specifically, the utilisation of biomarkers to objectively measure dietary compliance and metabolic responses is emerging. This protocol and baseline characteristics of a pilot randomised controlled, crossover, dietary intervention study aimed to examine the effects of citrus fruits, cruciferous vegetables, or common fruits and vegetables on cardiovascular risk factors. A total of 39 volunteers with untreated prehypertension was recruited and consumed a standardised, provided diet with eight daily portions of citrus fruits and cruciferous vegetables, common fruits and vegetables, or a low fruit and vegetable diet (two portions/d, control diet) in a random order for 2 weeks each, separated by a wash-out week. A targeted cohort-based recruitment strategy was utilised and resulted in 74% of participants recruited by re-contacting preselected individuals from two cohort studies with a 15% average enrolment rate. Participants had an average age of 54.4 years (±6.1 years), BMI of 27.9 kg/m2, and BP of 135/81 mmHg and were mainly male (67%). The primary outcome was office blood pressure; secondary outcomes included arterial stiffness, lipid profiles, inflammation, cognitive function, and subjective mood. Biofluids, i.e., 24 h urine, stool, and blood samples, were collected for biomarker measurements with multiple metabolomic platforms and the gut microbial composition, together with traditional dietary biomarkers.

Assessment of anemia in cases of acute myocardial infarction in a tertiary care hospital in South India

Background: Anemia is a known risk factor for ischemic heart disease and heart failure. It is also associated with increased mortality in acute myocardial infarction (AMI) patients. The study aimed to determine the anemia status of AMI patients and educate them on anemia and its impact on health. Methods: This was a cross-sectional study conducted among 150 AMI patients admitted to the ICCU of Government General Hospital Srikakulam, Andhra Pradesh over 3 months. Hemoglobin levels were recorded and patients were classified as non-anemic, mildly, moderately, or severely anemic based on WHO criteria. Patients’ sociodemographic profiles and risk factors were also collected. Results: Of the 150 patients (mean age 59.6 years), 70% were males. 83% of patients had anemia- 67% mild, 12% moderate, and 4% severe. The 50-65 years age group reported the highest frequency of mild anemia cases (38 out of 54). Absence of anemia was highest among the younger 45-50 years group (3 out of 15). Anemia was higher in females, and patients with a vegetarian diet had comparatively more anemia than those consuming a mixed diet. Additionally, 24% of the cases of anemia were in the 65-75 age group. Conclusions: A high prevalence of anemia was found among AMI patients. Counselling can help improve health by increasing awareness of anemia management. Screening AMI patients for anemia and therapeutic interventions were recommended.

Dietary Interventions for Cancer Prevention: An Update to ACS International Guidelines.

Cancer, the second leading cause of death worldwide, demands the identification of modifiable risk factors to optimize its prevention. Diet has emerged as a pivotal focus in current research efforts. This literature review aims to enhance the ACS guidelines on diet and cancer by integrating the latest findings and addressing unresolved questions. The methodology involved an advanced PubMed search with specific filters relevant to the research topic. Topics covered include time-restricted diet, diet quality, acid load, counseling, exercise and diet combination, Mediterranean diet, vegetarian and pescetarian diets, weight loss, dairy consumption, coffee and tea, iron, carbohydrates, meat, fruits and vegetables, heavy metals, micronutrients, and phytoestrogens. The review highlights the benefits of the Mediterranean diet in reducing cancer risk. Adherence to overnight fasting or carbohydrate consumption may contribute to cancer prevention, but excessive fasting may harm patients' quality of life. A vegetarian/pescetarian diet is associated with lower risks of general and colorectal cancer compared to a carnivorous diet. High heme and total iron intake are linked to increased lung cancer risk, while phytoestrogen intake is associated with reduced risk. Coffee and tea have a neutral impact on cancer risk. Finally, the roles of several preventive micronutrients and carcinogenic heavy metals are discussed.

Comparison of dietary inflammatory index and inflammatory biomarkers between vegetarians and omnivores in Chinese population

Most previous studies on the association between vegetarian diet and inflammation have used only one inflammatory biomarker e.g., C-reactive protein (CRP) and the findings were generally inconsistent. Therefore, we conducted a cross-sectional study to investigate the correlation between diet and inflammation in Chinese vegetarians using dietary indices and multiple inflammatory biomarkers. 279 vegetarians and omnivores of the same sex and age recruited in Shanghai, 2016. 24-h dietary review questionnaire was collected and used to calculate Dietary inflammatory index (DII) and Energy-adjusted inflammatory index (E-DII) of both groups. In addition, energy intake matched vegetarian and omnivore recipes were designed by registed dietitions and used to calculate a theoretical DII. Five serum inflammatory biomarkers CRP, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), neutrophil–lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were measured. We found that vegetarians had significantly lower E-DII and theoretical DII than omnivores (P < 0.001). In contrast, the raw DII of vegetarians was almost the same with that of omnivores, probably due to lower energy intake in vegetarians than in omnivores (1367.97 ± 479.75 vs. 1724.78 ± 568.13, P < 0.001). Levels of TNF-α, IL-6, NLR and PLR were significantly higher in vegetarians than in omnivores while no statistical differences were found in CRP. In conclusion, a theoretical vegetarian diet with adequate energy intake as well as a balanced dietary intake showed good anti-inflammatory effects, though this was not fully reflected in vegetarian population in the real world, probably due to insufficient energy intake in the vegetarian population.

Recovery after Exercise-Induced Muscle Damage in Subjects Following a Vegetarian or Mixed Diet.

It is unclear if following a vegetarian diet affects muscle recovery after exercise-induced muscle damage (EIMD). Sixteen vegetarians (VEG) and sixteen mixed dieters (MIX) performed a vertical jump, quadriceps femoris maximal isometric, and isokinetic concentric strength tests prior to and five days following the EIMD protocol. The quadriceps muscle was injured by performing eccentric contractions. Diet: MIX consumed more g/kg of animal protein (p < 0.001) and EAA (p < 0.05) except for isoleucine. VEG consumed more plant protein (p = 0.001). Isometric strength: MIX recovered post-day 2, VEG recovered post-day 4 (group (p = 0.07), time (p < 0.001)). Concentric contractions at 60 degrees per second: Both recovered post-day 1 (group (p = 0.27), time (p = 0.05)); 180 degrees per second: MIX recovered post-day 2, VEG recovered post-day 5 (group (p = 0.10), time (p < 0.001)); and 240 degrees per second: MIX recovered post-day 1, VEG did not recover by post-day 5 (group (p = 0.01), time (p < 0.001)). Vertical jump: Both recovered post-day 3 (group (p = 0.45), time (p < 0.001)). MIX recovered isometric strength 2 days faster, concentric strength was up to 5 days faster, and soreness was 1-4 days faster when compared to VEG. Both groups had similar recovery time for power.

The potential of individuals to reduce greenhouse gas emissions through their own actions: a case of a suburb in Finland

Household consumption accounts for 65–72% of total greenhouse gas emissions globally, and therefore, a change in current consumption patterns has the potential to mitigate climate change and provide emission reductions. There is knowledge on the consumption options with a high mitigation potential, but this information has not been combined with a consumer behavior information. This study examines the emission-reduction potential of suburban residents in Finland through a survey that assesses their willingness to adopt climate actions, and by calculating the potential impact of various actions. Finnish suburban households have already implemented low-impact climate actions (recycling, reducing food waste), but the implementation of high-impact actions in households could also be increased. Transitioning to a vegetarian diet, reducing air travel and limiting consumption are identified as the most effective mitigation actions when the potential increase in the implementation rate and impact on greenhouse gas emissions are considered. However, the results suggest that voluntary individual efforts alone are not sufficient to achieve the 1.5 °C carbon budget. Thus, alongside behavioural changes, strong policy measures and technological advancements are necessary. These findings emphasise the specific individual actions that should be prioritised when formulating climate policies at the national or city levels.

Vitamin B12 Status in Vegan and Vegetarian Seventh-Day Adventists: A Systematic Review and Meta-Analysis of Serum Levels and Dietary Intake.

This systematic review and meta-analysis aimed to evaluate the vitamin B12 status and intake of Seventh-day Adventists following a plant-based diet and compare it with omnivore controls to investigate their susceptibility for vitamin B12 deficiency. Peer-reviewed articles were identified through a comprehensive search in PubMed, Scopus, and Google Scholar databases from inception up to the year 2024 using specific keywords related to vitamin B12 and Seventh-day Adventists. Observational studies published in the English language were included if they reported on vitamin B12 status or intake among plant-based Adventists and compared it with omnivore controls who may or may not have been Adventists. Studies that did not present distinguishable results for vegetarian/vegan from omnivore Adventists or only reported on food item intake without specific vitamin B12 data were excluded. Two independent reviewers extracted data on study characteristics, vitamin B12 intake, and serum levels using a customised data extraction form, resolving discrepancies through consultation with a third reviewer. A meta-analysis was conducted using random-effect models due to anticipated heterogeneity, without any subgroup analysis due to the low number of studies. Sensitivity analysis was performed using the 'leave-on-out' method to assess individual study influence on overall effect size and heterogeneity. Four studies met inclusion criteria, encompassing 1994 participants. Meta-analysis showed no significant differences in serum vitamin B12 levels (MD: -9.85pmol/L; 95% CI: -45.64 to 25.94pmol/L; P = 0.54, I2 = 50%) or daily intake (MD: 3.31mcg/d; 95% CI: -4.70 to 11.32mcg/d; P = 0.42, I2 = 90%) between plant-based Adventists and omnivore controls, although there was high heterogeneity between the studies. Adventists following a vegan or vegetarian diet did not demonstrate increased risk of vitamin B12 deficiency due to the widespread consumption of fortified foods and supplements. The findings underscore the importance of supplementation and the consumption of fortified foods for maintaining adequate B12 status among vegan or vegetarian Adventists but highlight the need for further studies to confirm these observations in diverse geographical areas.

Metabolic pathway and network analysis integration for discovering the biomarkers in pig feces after a controlled fruit-vegetable dietary intervention

This study aimed to establish a strategy for identifying dietary intake biomarkers using a non-targeted metabolomic approach, including metabolic pathway and network analysis. The strategy was successfully applied to identify dietary intake biomarkers in fecal samples from pigs fed two doses of a polyphenol-rich fruit and vegetable (FV) diet following the Dietary Guidelines for Americans (DGA) recommendations. Potential biomarkers were identified among dietary treatment groups using liquid chromatography-high resolution mass spectrometry (LC-HRMS) based on a non-targeted metabolomic approach with metabolic pathway and network analysis. Principal component analysis (PCA) results showed significant differences in fecal metabolite profiles between the control and two FV intervention groups, indicating a diet-induced differential fecal metabolite profile after FV intervention. Metabolites from common flavonoids, e.g., (epi)catechin and protocatechuic acid, or unique flavonoids, e.g., 5,3′,4′-trihydroxy-3-methoxy-6,7-methylenedioxyflavone and 3,5,3′,4′-tetrahydroxy-6,7-methylenedioxyflavone, were identified as highly discriminating factors, confirming their potential as fecal markers for the FV dietary intervention. Microbiota pathway prediction using targeted flavonoids provided valuable and reliable biomarker exploration with high confidence. A correlation network analysis between these discriminatory ion features was applied to find connections to possible dietary biomarkers, further validating these biomarkers with biochemical insights. This study demonstrates that integrating metabolic pathways and network analysis with a non-targeted metabolomic approach is highly effective for rapid and accurate identification and prediction of fecal biomarkers under controlled dietary conditions in animal studies. This approach can also be utilized to study microbial metabolisms in human clinical research.

Modeling the acceptance of vegetarian diets to promote sustainable food systems.

With increasing concerns about health, animal welfare, and the environment, changes in dietary patterns are emerging, as evidenced by the gradual shift toward plant-rich diets. To appropriately plan vegetarian meals with high consumer satisfaction that would help promote this dietary pattern and ultimately improve the sustainability of food systems, meal acceptability testing would be crucial. The present work aims to investigate the influence of individual food components' acceptability on the overall meal acceptability in vegetarian diets. Over four taste-testing periods, 94 panelists of US nationality recruited from Cornell University staff (47 males and 47 females; 30-50 years of age) were asked to rate the acceptability of 41 vegetarian meals containing various food category items, including a main dish, side dish, appetizer, salad, soup, bread, dessert, beverage, and a control food. Each meal included six menu items to ensure the tested foods resembled a typical meal. Consequently, some meals lacked one or more of the nine total food categories. Participants were asked to rate the acceptability of the six meal items and the overall meal acceptability on a 9-point hedonic scale. Multiple imputation was used to fill in any missing data, and multiple linear regression analysis was then performed. Through this study, a model that predicts the overall meal acceptability of vegetarian diets based on individual meal category components was developed with an R-squared value of .7033, suggesting that around 70.33% of the variation in overall meal acceptability could be explained by the nine food category predictors. The findings also suggested that the most influential food item on overall meal acceptability was the main dish followed by the side dish. For every unit increase in the acceptability score of the main dish on a 9-point hedonic scale, the overall meal acceptability increased by 0.324 points. The positive findings would be beneficial to food service providers in designing a vegetarian meal with high meal acceptability. By focusing on optimizing the acceptability of these two key categories, menu planners can effectively elevate customers' satisfaction of their meals.

Plant-based diets for kidney disease prevention and treatment.

Plant-based diets are associated with a lower risk of hypertension, diabetes, cardiovascular disease, and mortality. Using the most recent evidence, we critically appraised the role of plant-based diets in primary and secondary prevention of chronic kidney disease (CKD) with a focus on key nutritional factors (dietary acid load, phosphorus, potassium, sodium, and fiber). In healthy individuals, observational studies found that greater intake of plant protein and higher adherence to plant-based diets (overall, healthful, and provegetarian) was associated with a lower risk of CKD. In those with CKD, plant-based diets were associated with a lower risk of mortality, improved kidney function, and favorable metabolic profiles (fibroblast growth factor-23, uremic toxins, insulin sensitivity, inflammatory biomarkers). Only few studies reported nutrient content of plant-based diets. These studies found that plant-based diets had lower dietary acid load, lower or no significant difference in phosphorus and sodium, and higher potassium and fiber. One study reported that vegetarian diets were associated with severe vitamin D deficiency compared to nonvegetarian diets. Plant-based diets provide several benefits for prevention and management of CKD, with little risk for individuals with CKD. Incorporation of vitamin D rich foods in plant-based diets may be helpful.

Diversity and practice: local decision-making practices on multi-cultural diets for British Muslim school children (BMSC) and implications for social justice.

British Muslim School Children (BMSC) are required to follow special halal dietary requirements in accordance with their religion, which is often not accounted for in British schools. This often leaves BMSC limited to a vegetarian diet while at school, despite this not being their chosen diet or preference. This study explores the perceptions of key stakeholders regarding fairness and accessibility of school meals for BMSC, as well as discussing school food provision for those maintaining a religious diet in light of social justice. This is in the context of limited knowledge previously being explored in the North East of England regarding procurement and decision-making at a systems level to cater for BMSC. A qualitative research design was conducted. A total of 62 participants (39 BMSC, 15 parents, and 8 school and catering staff) took part in a semi-structured interview or focus group. Participants were recruited from six schools, with these schools selected based on their differing levels of BMSC in attendance. This project took place between March 2022 and October 2023. Results suggested that where schools already catered for diverse food requirements, inclusive of BMSC dietary needs, food choices were still limited in the options and amount available. School and catering staff stated that cost implications contributed to their menu development process. Despite this, there was an evident willingness to learn about the cultural food options and how these can be implemented in future school menus. Suggestions discussed included an increase in the use of halal meat in order to provide a more inclusive school food experience for BMSC.