Fields, H., et al. (2014). "Just plants? Impact of a vegetarian diet on mortality." J Womens Health (Larchmt) 23(11): 987-988. ->현재 번역중

               

Fraser, G., et al. (2014). "Vegetarian diets and cardiovascular risk factors in black members of the Adventist Health Study-2." Public Health Nutr: 1-9.

                OBJECTIVE: To compare cardiovascular risk factors between vegetarians and non-vegetarians in black individuals living in the USA. DESIGN: A cross-sectional analysis of a sub-set of 592 black women and men enrolled in the Adventist Health Study-2 (AHS-2) cohort of Seventh-day Adventists. SETTING: Members of the AHS-2 cohort, who lived in all states of the USA and provinces of Canada. SUBJECTS: Black/African-American members of two sub-studies of AHS-2 where blood and physiological measurements were obtained. RESULTS: Of these women and men, 25 % were either vegan or lacto-ovo-vegetarians (labelled 'vegetarian/vegans'), 13 % were pesco-vegetarian and 62 % were non-vegetarian. Compared with non-vegetarians, the vegetarian/vegans had odds ratios for hypertension, diabetes, high blood total cholesterol and high blood LDL-cholesterol of 0.56 (95 % CI 0.36, 0.87), 0.48 (95 % CI 0.24, 0.98), 0.42 (95 % CI 0.27, 0.65) and 0.54 (95 % CI 0.33, 0.89), respectively, when adjusted for age, gender, education, physical activity and sub-study. Corresponding odds ratios for obesity in vegetarian/vegans and pesco-vegetarians, compared with non-vegetarians, were 0.43 (95 % CI 0.28, 0.67) and 0.47 (95 % CI 0.27, 0.81), respectively; and for abdominal obesity 0.54 (95 % CI 0.36, 0.82) and 0.50 (95 % CI 0.29, 0.84), respectively. Results for pesco-vegetarians did not differ significantly from those of non-vegetarians for other variables. Further adjustment for BMI suggested that BMI acts as an intermediary variable between diet and both hypertension and diabetes. CONCLUSIONS: As with non-blacks, these results suggest that there are sizeable advantages to a vegetarian diet in black individuals also, although a cross-sectional analysis cannot conclusively establish cause.

 

Gadgil, M. S., et al. (2014). "Association of homocysteine with global DNA methylation in vegetarian Indian pregnant women and neonatal birth anthropometrics." J Matern Fetal Neonatal Med 27(17): 1749-1753.

                Abstract Objective: The present study was designed to evaluate if plasma maternal folate, vitamin B-12 and homocysteine levels had an effect on maternal global DNA methylation and neonatal anthropometrics in Indian pregnant women. METHODS: A total of 49 participants having completed >/=36 weeks of pregnancy were enrolled in the study. Estimation of folate was by Ion capture assay, vitamin B-12 by microparticle enzyme immunoassay, total homocysteine by fluorescence polarization immunoassay and global DNA methylation using Cayman's DNA methylation enzyme immunoassay (EIA) kit. RESULTS: Folate and vitamin B-12 were inversely correlated to homocysteine in pregnant women consuming vegetarian and non-vegetarian diet. No difference in global DNA methylation was found between the vegetarian and non-vegetarian pregnant women. Folate and vitamin B-12 did not show association with global DNA methylation, however plasma total homocysteine of the vegetarian group showed significant correlation to global DNA methylation (r(2 )= 0.49, p = 0.011). Plasma total homocysteine was inversely related to tricep skinfold (r(2 )= -0.484, p = 0.01) and chest circumference (r(2 )= -0.104, p = 0.04) of neonates in vegetarian group. CONCLUSION: Moderate vitamin B-12 deficiency in vegetarian pregnant women might be the cause of hyperhomocystinemia, hypermethylation when compared to vitamin B-12 sufficient non-vegetarian group.

 

Gibson, R. S., et al. (2014). "Is iron and zinc nutrition a concern for vegetarian infants and young children in industrialized countries?" Am J Clin Nutr 100(Supplement 1): 459S-468S.->현재 번역중

                Well-planned vegetarian diets are considered adequate for all stages of the life cycle, despite limited data on the zinc status of vegetarians during early childhood. The bioavailability of iron and zinc in vegetarian diets is poor because of their higher content of absorption inhibitors such as phytate and polyphenols and the absence of flesh foods. Consequently, children as well as adult vegetarians often have lower serum ferritin concentrations than omnivores, which is indicative of reduced iron stores, despite comparable intakes of total iron; hemoglobin differences are small and rarely associated with anemia. However, data on serum zinc concentrations, the recommended biomarker for identifying population groups at elevated risk of zinc deficiency, are sparse and difficult to interpret because recommended collection and analytic procedures have not always been followed. Existing data indicate no differences in serum zinc or growth between young vegetarian and omnivorous children, although there is some evidence of low serum zinc concentrations in vegetarian adolescents. Some vegetarian immigrants from underprivileged households may be predisposed to iron and zinc deficiency because of nondietary factors such as chronic inflammation, parasitic infections, overweight, and genetic hemoglobin disorders. To reduce the risk of deficiency, the content and bioavailability of iron and zinc should be enhanced in vegetarian diets by consumption of fortified cereals and milk, by consumption of leavened whole grains, by soaking dried legumes before cooking and discarding the soaking water, and by replacing tea and coffee at meals with vitamin C-rich drinks, fruit, or vegetables. Additional recommended practices include using fermented soy foods and sprouting at least some of the legumes consumed. Fortified foods can reduce iron deficiency, but whether they can also reduce zinc deficiency is less certain. Supplements may be necessary for vegetarian children following very restricted vegan diets.

 

Jian, Z. H., et al. (2014). "Vegetarian diet and cholesterol and TAG levels by gender." Public Health Nutr: 1-6.

                OBJECTIVE: The present study assessed the effects of vegetarian and omnivorous diets on HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), TAG and the ratio of HDL-C to total cholesterol (TC) by gender. DESIGN: HDL-C, LDL-C, TAG and HDL-C:TC were compared among three diet groups (vegan, ovo-lacto vegetarian and omnivorous). Multivariate linear regression analysis was performed to examine factors significantly and independently associated with vegetarian status and to estimate the beta value of lipid profiles for the diet groups. Settings A cross-sectional study. Data were obtained from the Taiwanese Survey on the Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension (TwSHHH). SUBJECTS: The study comprised included 3257 men and 3551 women. RESULTS: After adjusting for confounders, vegan and ovo-lacto vegetarian diets lowered LDL-C levels (beta=-10.98, P=0.005 and beta=-7.12, P=0.025, respectively) in men compared with omnivorous diet. There was a significant association between HDL-C and vegan diet (beta=-6.53, P=0.004). In females, the beta values of HDL-C, TAG and HDL-C:TC were -5.72 (P<0.0001), 16.51 (P=0.011) and -0.02 (P=0.012) for vegan diet, and -4.86 (P=0.002), 15.09 (P=0.008) and -0.01 (P=0.026) for ovo-lacto vegetarian diet, when compared with omnivorous diet. CONCLUSIONS: Vegan diet was associated with lower HDL-C concentrations in both males and females. Because the ovo-lacto vegetarian diet was effective in lowering LDL-C, it may be more appropriate for males.

 

Kahan, S. and L. J. Cheskin (2014). "ACP Journal Club. Review: vegetarian diets reduce systolic and diastolic blood pressure more than omnivorous diets." Ann Intern Med 160(12): JC3.

               

Kocaoglu, C., et al. (2014). "Cerebral atrophy in a vitamin B12-deficient infant of a vegetarian mother." J Health Popul Nutr 32(2): 367-371.

                In developed countries, vitamin B12 (cobalamin) deficiency usually occurs in children, exclusively breastfed ones whose mothers are vegetarian, causing low body stores of vitamin B12. The haematologic manifestation of vitamin B12 deficiency is pernicious anaemia. It is a megaloblastic anaemia with high mean corpuscular volume and typical morphological features, such as hyperlobulation of the nuclei of the granulocytes. In advanced cases, neutropaenia and thrombocytopaenia can occur, simulating aplastic anaemia or leukaemia. In addition to haematological symptoms, infants may experience weakness, fatigue, failure to thrive, and irritability. Other common findings include pallor, glossitis, vomiting, diarrhoea, and icterus. Neurological symptoms may affect the central nervous system and, in severe cases, rarely cause brain atrophy. Here, we report an interesting case, a 12-month old infant, who was admitted with neurological symptoms and diagnosed with vitamin B12 deficiency.

 

Kwok, C. S., et al. (2014). "Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: a systematic review and meta-analysis." Int J Cardiol 176(3): 680-686.

                BACKGROUND: Dietary interventions are an important component of cardiovascular risk factor management although their impact on cardiovascular risk and mortality remains uncertain. We have studied influence of a vegetarian diet on cardiovascular risk and mortality. METHODS: We searched MEDLINE and EMBASE for comparative studies that evaluated clinical outcomes associated with vegetarian diet as compared to non-vegetarian controls or the general population. Relevant studies were pooled using random effects meta-analysis for risk of death, ischaemic heart disease (IHD) and cerebrovascular disease. We conducted subgroup analysis according to specific type of cohort (e.g. Seventh Day Adventist [SDA]) and gender. RESULTS: Eight studies met the inclusion criteria with 183,321 participants (n=183,321). There was significant heterogeneity in all the meta-analyses, particularly evident with the studies of SDA. In all instances, we found that SDA studies showed greater effect size as compared to non-SDA studies: death (RR 0.68 95% CI 0.45-1.02 vs RR 1.04 95% CI 0.98-1.10), ischaemic heart disease (IHD) (RR 0.60 95% CI 0.43-0.80 vs RR 0.84 95% CI 0.74-0.96) and cerebrovascular disease (RR 0.71 95% CI 0.41-1.20 vs RR 1.05 95% CI 0.89-1.24). Sex specific analyses showed that IHD was significantly reduced in both genders but risk of death and cerebrovascular disease was only significantly reduced in men. CONCLUSIONS: Data from observational studies indicates that there is modest cardiovascular benefit, but no clear reduction in overall mortality associated with a vegetarian diet. This evidence of benefit is driven mainly by studies in SDA, whereas the effect of vegetarian diet in other cohorts remains unproven.

 

Lane, K., et al. (2014). "Bioavailability and potential uses of vegetarian sources of omega-3 fatty acids: a review of the literature." Crit Rev Food Sci Nutr 54(5): 572-579.

                Presently alpha-linolenic acid (ALA) is the most widely used vegetarian LC3PUFA, but only marginal amounts are converted into eicosapentaenoic (EPA) and docosahexaenoic acid (DHA); both of which are strongly related to human health. Currently, fish oils represent the most prominent dietary sources of EPA and DHA; however, these are unsuitable for vegetarians. Alternative sources include flaxseed, echium, walnut, and algal oil but their conversion to EPA and DHA must be considered. The present systematic review sets out to collate information from intervention studies examining the bioavailability of alternative vegetarian long chain omega-3 (n-3) polyunsaturated fatty acids (LC3PUFA) sources. Ten key papers published over the last 10 years were identified with seven intervention studies reporting that ALA from nut and seed oils was not converted to DHA at all. Three studies showed that ingestion of micro-algae oil led to significant increases in blood erythrocyte and plasma DHA. Further work is now needed to identify optimal doses of alternative vegetarian LC3PUFAs and how these can be integrated within daily diets. The potential role of algal oils appears to be particularly promising and an area in which further research is warranted.

 

Leitzmann, C. (2014). "Vegetarian nutrition: past, present, future." Am J Clin Nutr 100(Supplement 1): 496S-502S.->현재 번역중

                Early human food cultures were plant-based. Major religions such as Hinduism and Buddhism have recommended a vegetarian way of life since their conception. The recorded history of vegetarian nutrition started in the sixth century bc by followers of the Orphic mysteries. The Greek philosopher Pythagoras is considered the father of ethical vegetarianism. The Pythagorean way of life was followed by a number of important personalities and influenced vegetarian nutrition until the 19th century. In Europe, vegetarian nutrition more or less disappeared during the Middle Ages. In the Renaissance era and in the Age of Enlightenment, various personalities practiced vegetarianism. The first vegetarian society was started in England in 1847. The International Vegetarian Society was founded in 1908 and the first vegan society began in 1944. Prominent vegetarians during this time included Sylvester Graham, John Harvey Kellogg, and Maximilian Bircher-Benner. A paradigm shift occurred at the turn of the 21st century. The former prejudices that vegetarianism leads to malnutrition were replaced by scientific evidence showing that vegetarian nutrition reduces the risk of most contemporary diseases. Today, vegetarian nutrition has a growing international following and is increasingly accepted. The main reasons for this trend are health concerns and ethical, ecologic, and social issues. The future of vegetarian nutrition is promising because sustainable nutrition is crucial for the well-being of humankind. An increasing number of people do not want animals to suffer nor do they want climate change; they want to avoid preventable diseases and to secure a livable future for generations to come.

 

Li, D. (2014). "Effect of the vegetarian diet on non-communicable diseases." J Sci Food Agric 94(2): 169-173.->현재 번역중

                A vegetarian diet generally includes plenty of vegetables and fruits, which are rich in phytochemicals, antioxidants, fiber, magnesium, vitamins C and E, Fe(3)(+), folic acid and n-6 polyunsaturated fatty acid (PUFA), and is low in cholesterol, total fat and saturated fatty acid, sodium, Fe(2)(+), zinc, vitamin A, B(1)(2) and D, and especially n-3 PUFA. Mortality from all-cause, ischemic heart disease, and circulatory and cerebrovascular diseases was significantly lower in vegetarians than in omnivorous populations. Compared with omnivores, the incidence of cancer and type 2 diabetes was also significantly lower in vegetarians. However, vegetarians have a number of increased risk factors for non-communicable diseases such as increased plasma homocysteine, mean platelet volume and platelet aggregability compared with omnivores, which are associated with low intake of vitamin B(1)(2) and n-3 PUFA. Based on the present data, it would seem appropriate for vegetarians to carefully design their diet, specifically focusing on increasing their intake of vitamin B(1)(2) and n-3 PUFA to further reduce already low mortality and morbidity from non-communicable diseases.

 

Milankov, O. (2014). "Vegetarian diet in infants." Med Pregl 67(1-2): 5-10.

               

Neacsu, M., et al. (2014). "Appetite control and biomarkers of satiety with vegetarian (soy) and meat-based high-protein diets for weight loss in obese men: a randomized crossover trial." Am J Clin Nutr 100(2): 548-558.

                BACKGROUND: There is limited evidence with regard to the effect of different sources of protein on appetite during weight loss. Vegetarian and meat-based high-protein diets may have contrasting effects on appetite and biomarkers of protein-induced satiety.OBJECTIVE: The aim was to assess appetite response to meat or vegetarian high-protein weight-loss (HPWL) diets in obese men to monitor plasma amino acid profile and gut peptide response as potential satiety biomarkers.DESIGN: Twenty obese [body mass index (in kg/m2): 34.8] men participated in a dietary intervention study. After 3 d of a maintenance diet, they were provided in a crossover design with either a vegetarian HPWL (Soy-HPWL) or a meat-based HPWL (Meat-HPWL) diet for 2 wk. Both diets comprised 30% protein, 30% fat, and 40% carbohydrate, provided to measured resting metabolic rate. Body weight and the motivation to eat were measured daily. Plasma satiety biomarkers were collected during a test-meal challenge (5 h) at the end of each diet period.RESULTS: Over the 2 wk, subjects lost, on average, 2.41 and 2.27 kg with consumption of the Soy- and Meat-HPWL diets, respectively [P = 0.352; SE of the difference (SED): 0.1]. ANOVA confirmed that subjectively rated hunger (P = 0.569; SED: 3.8), fullness (P = 0.404; SED: 4.1), desire to eat (P = 0.356; SED: 3.7), preservation of lean body mass (P = 0.334; SED: 0.2), and loss of percentage fat mass (P = 0.179; SED: 0.2) did not differ between the 2 HPWL diets. There were differences in absolute concentrations of ghrelin and peptide YY between the 2 HPWL diets, although the response as net area under the curve was not different.Conclusions: Appetite control and weight loss were similar for both HPWL diets. Gut hormone profile was similar between the diets, which suggests that vegetarian diets can be as effective as meat-based diets for appetite control during weight loss. This trial was registered at www.clinicaltrials.gov as NCT02080325.

 

Orlich, M. J. and G. E. Fraser (2014). "Vegetarian diets in the Adventist Health Study 2: a review of initial published findings." Am J Clin Nutr 100(Supplement 1): 353S-358S.

                The Adventist Health Study 2 is a large cohort that is well suited to the study of the relation of vegetarian dietary patterns to health and disease risk. Here we review initial published findings with regard to vegetarian diets and several health outcomes. Vegetarian dietary patterns were associated with lower body mass index, lower prevalence and incidence of diabetes mellitus, lower prevalence of the metabolic syndrome and its component factors, lower prevalence of hypertension, lower all-cause mortality, and in some instances, lower risk of cancer. Findings with regard to factors related to vegetarian diets and bone health are also reviewed. These initial results show important links between vegetarian dietary patterns and improved health.

 

Pilis, W., et al. (2014). "Health benefits and risk associated with adopting a vegetarian diet." Rocz Panstw Zakl Hig 65(1): 9-14.->현재 번역중

                A vegetarian diet may be adopted for various reasons that can include ecological, economic, religious, ethical and health considerations. In the latter case they arise from the desire to lose weight, in tackling obesity, improving physical fitness and/or in reducing the risk of acquiring certain diseases. It has been shown that properly applied vegetarian diet is the most effective way of reducing body mass (expressed as BMI), improving the plasma lipid profile and in decreasing the incidence of high arterial blood pressure, cardiovascular disease, stroke, metabolic syndrome and arteriosclerosis. In addition, improved insulin sensitivity together with lower rates of diabetes and cancer has been observed. Some studies have however found that a vegetarian diet may result in changes adversely affecting the body. These could include; hyperhomocysteinaemia, protein deficiency, anaemia, decreased creatinine content in muscles and menstrual disruption in women who undertake increased physical activity. Some of these changes may decrease the ability for performing activities that require physical effort. Nevertheless, on balance it can be reasonably concluded that the beneficial effects of a vegetarian diet significantly, by far, outweigh the adverse ones. It should also be noted that the term 'vegetarian diet' is not always clearly defined in the literature and it may include many dietary variations.

 

Rothgerber, H. (2014). "Efforts to overcome vegetarian-induced dissonance among meat eaters." Appetite 79: 32-41. ->현재 번역중

                Meat eaters face dissonance whether it results from inconsistency ("I eat meat; I don't like to hurt animals"), aversive consequences ("I eat meat; eating meat harms animals"), or threats to self image ("I eat meat; compassionate people don't hurt animals"). The present work proposes that there are a number of strategies that omnivores adopt to reduce this dissonance including avoidance, dissociation, perceived behavioral change, denial of animal pain, denial of animal mind, pro-meat justifications, reducing perceived choice, and actual behavioral change. The presence of vegetarians was speculated to cause meat eating to be a scrutinized behavior, remind meat eaters of their discomfort, and undermine the effectiveness of these strategies. It was therefore hypothesized that exposure to a description of a vegetarian would lead omnivores to embrace dissonance-reducing strategies. Supporting this hypothesis, participants who read a vignette about a vegetarian denied animal mind more than participants who read about a gluten-free individual. It was also hypothesized that omnivores would be sensitive to individual differences between vegetarians and would demonstrate using dissonance-reducing strategies more when the situation failed to provide cognitions consonant with eating meat or to reduce dissonant cognitions. Four experiments supported this prediction and found that authentic vegetarians, vegetarians freely making the decision to abandon meat, consistent vegetarians, and anticipating moral reproach from vegetarians produced greater endorsement of dissonance-reducing strategies than their counterpart conditions.

 

Sharma, S., et al. (2014). "Comparison of the nutritional status and outcome in thermal burn patients receiving vegetarian and non-vegetarian diets." Indian J Plast Surg 47(2): 236-241.

                BACKGROUND: The importance of adequate nutritional support in burned patients cannot be overemphasised. For adequate long-term compliance by the patients, diet should be formulated in accordance with their pre-burn dietary habits, religious beliefs, and tastes. PATIENTS AND METHODS: A study was conducted in 42 consecutive patients suffering from 10% to 50% of 2(nd) and 3(rd) degree thermal burns with the aim to compare nutritional status, clinical outcome, and cost-effectiveness of vegetarian and non-vegetarian diets. The patients were divided into two groups depending upon their pre-injury food habits. Total calories were calculated by Curreri formula. Both groups were compared by various biochemical parameters, microbiological investigations, weight, status of wound healing, graft take, and hospital stay and they were followed for at least 60 days postburn. RESULTS: The results were comparable in both groups. Vegetarian diet was found to be more palatable and cost-effective. CONCLUSION: Vegetarian diet is a safe and viable option for the patients suffering from burn injury. The common belief that non-vegetarian diet is superior to vegetarian diet is a myth.

 

Shridhar, K., et al. (2014). "Nutritional profile of Indian vegetarian diets--the Indian Migration Study (IMS)." Nutr J 13: 55.

                BACKGROUND: The cardiovascular and other health benefits and potential harms of protein and micronutrient deficiency of vegetarian diets continue to be debated. METHODS: Study participants included urban migrants, their rural siblings and urban residents (n = 6555, mean age - 40.9 yrs) of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore. Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical activity, medical histories, as well as blood pressure, fasting blood and anthropometric measurements were collected. Nutrient databases were used to calculate nutrient content of regional recipes. Vegetarians ate no eggs, fish, poultry and meat. Using multivariate linear regression with robust standard error model, we compared the macro- and micro-nutrient profile of vegetarian and non-vegetarian diets. RESULTS: Vegetarians, (32.8% of the population), consumed greater amounts of legumes, vegetables, roots and tubers, dairy and sugar, while non-vegetarians had a greater intake of cereals, fruits, spices, salt (p < 0.01), fats and oils. Vegetarians had a higher socioeconomic status, and were less likely to smoke, drink alcohol (p < 0.0001) and engage in less physical activity (p = 0.04). On multivariate analysis, vegetarians consumed more carbohydrates (beta = 7.0 g/day (95% CI: 9.9 to 4.0), p < 0.0001), vitamin C (beta = 8.7 mg/day (95% CI: 4.3 to13.0), p < 0.0001) and folate (beta = 8.0 mcg/day (95% CI: 3.3 to 12.7), p = 0.001) and lower levels of fat (beta = -1.6 g/day (95% CI: -0.62 to -2.7), p = 0.002), protein (beta = -6.4 g/day (95% CI: -5.8 to -7.0), p < 0.0001), vitamin B12 (beta = -1.4 mcg/day (95% CI: -1.2 to -1.5), p < 0.0001) and zinc (beta = -0.6 mg/day (95% CI: -0.4 to -0.7), p < 0.0001). CONCLUSION: Overall, Indian vegetarian diets were found to be adequate to sustain nutritional demands according to recommended dietary allowances with less fat. Lower vitamin B12 bio-availability remains a concern and requires exploration of acceptable dietary sources for vegetarians.

 

Shridhar, K., et al. (2014). "The Association between a Vegetarian Diet and Cardiovascular Disease (CVD) Risk Factors in India: The Indian Migration Study." PLoS One 9(10): e110586.

                BACKGROUND: Studies in the West have shown lower cardiovascular disease (CVD) risk among people taking a vegetarian diet, but these findings may be confounded and only a minority selects these diets. We evaluated the association between vegetarian diets (chosen by 35%) and CVD risk factors across four regions of India. METHODS: Study participants included urban migrants, their rural siblings and urban residents, of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore (n = 6555, mean age-40.9 yrs). Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical history, medical history, as well as blood pressure, fasting blood and anthropometric measurements were collected. Vegetarians ate no eggs, fish, poultry or meat. Using robust standard error multivariate linear regression models, we investigated the association of vegetarian diets with blood cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, fasting blood glucose (FBG), systolic (SBP) and diastolic blood pressure (DBP). RESULTS: Vegetarians (32.8% of the study population) did not differ from non-vegetarians with respect to age, use of smokeless tobacco, body mass index, and prevalence of diabetes or hypertension. Vegetarians had a higher standard of living and were less likely to smoke, drink alcohol (p<0.0001) and were less physically active (p = 0.04). In multivariate analysis, vegetarians had lower levels of total cholesterol (beta = -0.1 mmol/L (95% CI: -0.03 to -0.2), p = 0.006), triglycerides (beta = -0.05 mmol/L (95% CI: -0.007 to -0.01), p = 0.02), LDL (beta = -0.06 mmol/L (95% CI: -0.005 to -0.1), p = 0.03) and lower DBP (beta = -0.7 mmHg (95% CI: -1.2 to -0.07), p = 0.02). Vegetarians also had decreases in SBP (beta = -0.9 mmHg (95% CI: -1.9 to 0.08), p = 0.07) and FBG level (beta = -0.07 mmol/L (95% CI: -0.2 to 0.01), p = 0.09) when compared to non-vegetarians. CONCLUSION: We found beneficial association of vegetarian diet with cardiovascular risk factors compared to non-vegetarian diet.

 

Singh, P. N., et al. (2014). "Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable disease in Asian Indians." Am J Clin Nutr 100(Supplement 1): 359S-364S.

                An increase in noncommunicable disease (NCD) in India has been attributed to an epidemiologic transition whereby, due to urbanization, there is an increase in traditional cardiovascular disease risk factors such as obesity. Accumulated biomarker data on the "Asian Indian phenotype" identify central obesity, which occurs at a lower body mass index (BMI), as a particularly potent risk factor in Asian Indians. A revised WHO case definition for obesity in India [BMI (in kg/m2) >25] has identified an obesity epidemic that exceeds 30% in some cities and rivals that in Western nations. This review summarizes 2 key lines of evidence: 1) the emergence of an obesity epidemic in urban and rural India and its contribution to the NCD burden and 2) the role of a "nutrition transition" in decreasing the whole plant food content of diets in India and increasing risk of obesity and NCDs. We then present new epidemiologic evidence from Asian Indians enrolled in the Adventist Health Study 2 that raises the possibility of how specific whole plant foods (eg, nuts) in a vegetarian dietary pattern could potentially prevent obesity and NCDs in a target population of >1 billion persons.

 

Tonstad, S., et al. (2014). "Prevalence of hyperthyroidism according to type of vegetarian diet." Public Health Nutr: 1-6.

               OBJECTIVE: Vegetarian diets may be associated with low prevalence of autoimmune disease, as observed in rural sub-Saharan Africans. Graves' disease, an autoimmune disorder, is the most common cause of hyperthyroidism. We studied prevalence of hyperthyroidism according to dietary pattern in a population with a high proportion of vegetarians. DESIGN: Cross-sectional prevalence study. The association between diet and prevalence of hyperthyroidism was examined using multivariate logistic regression analyses controlling for sociodemographic characteristics and salt use. SETTING: The Adventist Health Study-2 conducted in the USA and Canada. SUBJECTS: Church members (n 65 981) provided demographic, dietary, lifestyle and medical history data by questionnaire. RESULTS: The prevalence of self-reported hyperthyroidism was 0.9 %. Male gender (OR=0.32; 95 % CI 0.26, 0.41) and moderate or high income (OR=0.67; 95 % CI 0.52, 0.88 and OR=0.73; 95 % CI 0.58, 0.91, respectively) protected against hyperthyroidism, while obesity and prevalent CVD were associated with increased risk (OR=1.25; 95 % CI 1.02, 1.54 and OR=1.92; 95 % CI 1.53, 2.42, respectively). Vegan, lacto-ovo and pesco vegetarian diets were associated with lower risk compared with omnivorous diets (OR=0.49; 95 % CI 0.33, OR=0.72, 0.65; 95 % CI 0.53, 0.81 and OR=0.74; 95 % CI 0.56, 1.00, respectively). CONCLUSIONS: Exclusion of all animal foods was associated with half the prevalence of hyperthyroidism compared with omnivorous diets. Lacto-ovo and pesco vegetarian diets were associated with intermediate protection. Further study of potential mechanisms is warranted.

 

Tucker, K. L. (2014). "Vegetarian diets and bone status." Am J Clin Nutr 100(Supplement 1): 329S-335S.

                Osteoporosis is a common chronic condition associated with progressive loss of bone mineral density (BMD) and compromised bone strength, with increasing risk of fracture over time. Vegetarian diets have been shown to contain lower amounts of calcium, vitamin D, vitamin B-12, protein, and n-3 (omega-3) fatty acids, all of which have important roles in maintaining bone health. Although zinc intakes are not necessarily lower quantitatively, they are considerably less bioavailable in vegetarian diets, which suggests the need for even higher intakes to maintain adequate status. At the same time, healthy vegetarian diets tend to contain more of several protective nutrients, including magnesium, potassium, vitamin K, and antioxidant and anti-inflammatory phytonutrients. On balance, there is evidence that vegetarians, and particularly vegans, may be at greater risk of lower BMD and fracture. Attention to potential shortfall nutrients through the careful selection of foods or fortified foods or the use of supplements can help ensure healthy bone status to reduce fracture risk in individuals who adhere to vegetarian diets.

 

Turner-McGrievy, G. M., et al. (2014). "Transitioning to new child-care nutrition policies: nutrient content of preschool menus differs by presence of vegetarian main entree." J Acad Nutr Diet 114(1): 117-123.

                Children who attend child care outside the home may be at increased risk for developing obesity. In 2012, the South Carolina ABC Child Care program issued new standards for food and nutrition. The goal of our study (conducted June to December 2012) was to examine changes that occurred at a large, Columbia, SC, preschool during the implementation of the South Carolina ABC Child Care program standards using an observational design, including a survey of parents and nutrient analysis of menus. The nutrition content of menu items before (n=15 days; six of which were vegetarian) and after (n=15 days; six of which were vegetarian) implementation of the new standards was compared. In addition, parents (N=75) were surveyed to examine opinions and support for the changes. Independent samples t tests were used to compare nutrient values before and after menu changes and analysis of variance was used to compare pre- and post-change vegetarian menus and pre- and post-change nonvegetarian menus. There were no significant differences between before and after menus with the exception of a 0.3 cup/day increase in vegetables (P<0.05). Vegetarian menus after the revisions were significantly higher in fiber (13 +/- 3 g) than postrevision nonvegetarian menus (11 +/- 3 g; P<0.05) and lower in sodium (1,068 +/- 207 mg) than postrevision nonvegetarian menus (1,656 +/- 488 mg; P<0.05). Standards that received the most parental support were serving at least two vegetables (score of 8.7 on a scale of one to nine) and two fruits per day (score of 8.6) and implementing policies against staff using food as a reward or punishment (score of 8.6). The center-specific policy of only bringing healthy foods for celebrations received the lowest support (score of 5.8). Adding more vegetarian menu items has the potential to improve the nutrient content of menus while keeping energy intake, saturated fat, sodium, and cholesterol levels at a more optimum level.

 

Vinagre, J. C., et al. (2014). "Plasma kinetics of chylomicron-like emulsion and lipid transfers to high-density lipoprotein (HDL) in lacto-ovo vegetarian and in omnivorous subjects." Eur J Nutr 53(3): 981-987.

                PURPOSE: Previously, it was showed that vegan diet improves the metabolism of triglyceride-rich lipoproteins by increasing the plasma clearance of atherogenic remnants. The aim of the current study was to investigate this metabolism in lacto-ovo vegetarians whose diet is less strict, allowing the ingestion of eggs and milk. Transfer of lipids to HDL, an important step in HDL metabolism, was tested in vitro. METHODS: Eighteen lacto-ovo vegetarians and 29 omnivorous subjects, all eutrophic and normolipidemic, were intravenously injected with triglyceride-rich emulsions labeled with (14)C-cholesterol oleate and (3)H-triolein. Fractional clearance rates (FCR, in min(-1)) were calculated from samples collected during 60 min. Lipid transfer to HDL was assayed by incubating plasma samples with a donor nanoemulsion labeled with radioactive lipids. RESULTS: LDL cholesterol was lower in vegetarians than in omnivores (2.1 +/- 0.8 and 2.7 +/- 0.7 mmol/L, respectively, p < 0.05), but HDL cholesterol and triglycerides were equal. Cholesteryl ester FCR was greater in vegetarians than in omnivores (0.016 +/- 0.012, 0.003 +/- 0.003, p < 0.01), whereas triglyceride FCR was equal. Cholesteryl ester transfer to HDL was lower in vegetarians than in omnivores (2.7 +/- 0.6, 3.5 +/- 1.5 %, p < 0.05), but free cholesterol, triglyceride and phospholipid transfers and HDL size were equal. CONCLUSION: Similarly to vegans, lacto-ovo vegetarian diet increases remnant removal, as indicated by cholesteryl oleate FCR, which may favor atherosclerosis prevention, and has the ability to change lipid transfer to HDL.

 

West, A. A., et al. (2014). "Egg n-3 fatty acid composition modulates biomarkers of choline metabolism in free-living lacto-ovo-vegetarian women of reproductive age." J Acad Nutr Diet 114(10): 1594-1600.

                The lacto-ovo-vegetarian (LOV) dietary regimen allows eggs, which are a rich source of choline. Consumption of eggs by LOV women may be especially important during pregnancy and lactation when demand for choline is high. The aim of this single blind, randomized, crossover-feeding study was to determine how near-daily egg consumption influenced biomarkers of choline metabolism in healthy LOV women of reproductive age (n=15). Because long-chain n-3 fatty acids could influence choline metabolism, the effect of n-3-enriched vs nonenriched eggs on choline metabolites was also investigated. Three 8-week dietary treatments consisting of six n-3-enriched eggs per week, six nonenriched eggs per week, and an egg-free control phase were separated by 4-week washout periods. Choline metabolites were quantified in fasted plasma collected before and after each treatment and differences in posttreatment choline metabolite concentrations were determined with linear mixed models. The n-3-enriched and nonenriched egg treatments produced different choline metabolite profiles compared with the egg-free control; however, response to the eggs did not differ (P>0.1). Consumption of the n-3-enriched egg treatment yielded higher plasma free choline (P=0.02) and betaine (P<0.01) (vs egg-free control) concentrations, whereas consumption of the nonenriched egg treatment yielded borderline higher (P=0.06) plasma phosphatidylcholine (vs egg-free control) levels. Neither egg treatment increased levels of plasma trimethylamine oxide, a gut-flora-dependent oxidative choline metabolite implicated as a possible risk factor for cardiovascular disease. Overall these data suggest that egg fatty-acid composition modulates the metabolic use of choline.

 

Wien, M., et al. (2014). "Preface to the Sixth International Congress on Vegetarian Nutrition." Am J Clin Nutr 100(Supplement 1): 311S-312S.

               

Yokoyama, Y., et al. (2014). "Vegetarian diets and glycemic control in diabetes: a systematic review and meta-analysis." Cardiovasc Diagn Ther 4(5): 373-382.

                INTRODUCTION: Previous studies have suggested an association between vegetarian diets and improvements in glycemic control in diabetes, although this relationship is not well established. No meta-analysis of these studies has been performed. METHODS: To conduct a systematic review and meta-analysis of controlled clinical trials examining the association between vegetarian diets and glycemic control in type 2 diabetes. DATA SOURCE: The electronic databases Medline, Web of Science, Excerpta Medica Database (EMBASE), and Cochrane Central Register of Controlled Trials were searched for articles published in any language through December 9, 2013. STUDY SELECTION: The following criteria were used for study inclusion: (I) age of participants >20 years; (II) vegetarian diet as intervention; (III) mean difference in hemoglobin A1c (HbA1c) and/or fasting blood glucose levels used as outcomes; and (IV) controlled trials, duration >/=4 weeks. Exclusion criteria were: (I) not an original investigation; (II) duplicate samples; (III) diabetes other than type 2; (IV) multiple interventions; and (V) uncontrolled studies. Data extraction and synthesis: The data collected included study design, baseline population charact