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Associations between plant-based dietary patterns and risks of type 2 diabetes, cardiovascular disease, cancer, and mortality - a systematic review and meta-analysis.
Wang, Y, Liu, B, Han, H, Hu, Y, Zhu, L, Rimm, EB, Hu, FB, Sun, Q
Nutrition journal. 2023;22(1):46
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According to the World Health Organization, type 2 diabetes (T2D), cardiovascular disease (CVD), and cancer account for nearly one in every two deaths globally. These diseases have significant clinical and public health implications. This study's aim was to assess the association of adherence to plant-based dietary patterns and changes in them with risks of major chronic diseases, including T2D, CVD, and cancer, and mortality. This study was a systematic review and meta-analysis of 55 prospective studies. Results showed that greater adherence to a plant-based dietary pattern was inversely associated with risks of T2D, CVD, cancer and all-cause mortality. Associations for T2D, CVD, and cancer were strengthened when the plant-based diets further emphasised healthful plant-based foods, such as vegetables, fruits, whole grains, and legumes. Authors concluded that their findings support the current recommendations that emphasise consuming high-quality plant-based foods for achieving optimal health.
Abstract
BACKGROUND Plant-based dietary patterns are gaining more attention due to their potential in reducing the risk of developing major chronic diseases, including type 2 diabetes (T2D), cardiovascular disease (CVD), cancer, and mortality, while an up-to-date comprehensive quantitative review is lacking. This study aimed to summarize the existing prospective observational evidence on associations between adherence to plant-based dietary patterns and chronic disease outcomes. METHODS We conducted a systematic review and meta-analysis of evidence across prospective observational studies. The data sources used were PubMed and MEDLINE, Embase, Web of Science, and screening of references. We included all prospective observational studies that evaluated the association between adherence to plant-based dietary patterns and incidence of T2D, CVD, cancer, and mortality among adults (≥ 18 years). RESULTS A total of 76 publications were identified, including 2,230,443 participants with 60,718 cases of incident T2D, 157,335 CVD cases, 57,759 cancer cases, and 174,435 deaths. An inverse association was observed between higher adherence to a plant-based dietary pattern and risks of T2D (RR, 0.82 [95% CI: 0.77-0.86]), CVD (0.90 [0.85-0.94]), cancer (0.91 [0.87-0.96]), and all-cause mortality (0.84 [0.78-0.92]) with moderate to high heterogeneity across studies (I2 ranged: 47.8-95.4%). The inverse associations with T2D, CVD and cancer were strengthened when healthy plant-based foods, such as vegetables, fruits, whole grains, and legumes, were emphasized in the definition of plant-based dietary patterns (T2D: 0.79 [0.72-0.87]; CVD: 0.85 [0.80-0.92]; cancer: 0.86 [0.80-0.92]; I2 ranged: 53.1-84.1%). Association for mortality was largely similar when the analyses were restricted to healthy plant-based diets (0.86 [0.80-0.92], I2 = 91.9%). In contrast, unhealthy plant-based diets were positively associated with these disease outcomes. Among four studies that examined changes in dietary patterns, increased adherence to plant-based dietary patterns was associated with a significantly reduced risk of T2D (0.83 [0.71-0.96]; I2 = 71.5%) and a marginally lower risk of mortality (0.95 [0.91-1.00]; I2 = 0%). CONCLUSIONS Better adherence to plant-based dietary patterns, especially those emphasizing healthy plant-based foods, is beneficial for lowering the risks of major chronic conditions, including T2D, CVD, cancer, as well as premature deaths. REGISTRATION OF REVIEW PROTOCOL This review was registered at the PROSPERO International Prospective Register of Systematic Reviews ( https://www.crd.york.ac.uk/PROSPERO/ ) with the registration number CRD42022290202.
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Life expectancy can increase by up to 10 years following sustained shifts towards healthier diets in the United Kingdom.
Fadnes, LT, Celis-Morales, C, Økland, JM, Parra-Soto, S, Livingstone, KM, Ho, FK, Pell, JP, Balakrishna, R, Javadi Arjmand, E, Johansson, KA, et al
Nature food. 2023;4(11):961-965
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The mortality rate is rising in the United Kingdom (UK) due to the poor quality dietary patterns among the general population. Public Health England and the UK government recommend the population eat a healthy balanced diet based on the Eatwell Guide. Adherence to the Eatwell Guide dietary pattern could reduce the mortality rate among the general population in the UK. This research estimated the benefits of sustainably changing the unhealthy dietary pattern to the Eatwell Guide or longevity-associated dietary pattern on life expectancy in the UK. Longevity-associated dietary pattern is based on a moderate consumption of whole grains, fruit, fish and white meat; a substantial consumption of dairy, vegetables, nuts and legumes; a comparatively low consumption of eggs, red meat and sugar-sweetened beverages; and a low consumption of refined grains and processed meat. The unhealthy dietary pattern included limited amounts of whole grains, vegetables, fruits, nuts, legumes, fish, milk and dairy, and white meat and high consumption of processed meat, eggs, refined grains and sugar-sweetened beverages. This peer-reviewed review used prospective population-based cohort data from the UK Biobank. In UK adults aged 40 years, the change from an unhealthy dietary pattern to the Eatwell guide added 8.9 years in males and 8.6 years in females to their life expectancy. Furthermore, sustained adherence to the Eatwell guide increased life expectancy up to 10.8 years in males and 10.4 years in females. Further robust studies are required to evaluate the correlation between life expectancy and different food groups due to the limitations of the current research. However, healthcare professionals can use the results of this research to develop health policies and to understand the beneficial effect of following the Eatwell Guide or longevity dietary pattern in increasing life expectancy in middle-aged men and women in the UK.
Abstract
Adherence to healthy dietary patterns can prevent the development of non-communicable diseases and affect life expectancy. Here, using a prospective population-based cohort data from the UK Biobank, we show that sustained dietary change from unhealthy dietary patterns to the Eatwell Guide dietary recommendations is associated with 8.9 and 8.6 years gain in life expectancy for 40-year-old males and females, respectively. In the same population, sustained dietary change from unhealthy to longevity-associated dietary patterns is associated with 10.8 and 10.4 years gain in life expectancy in males and females, respectively. The largest gains are obtained from consuming more whole grains, nuts and fruits and less sugar-sweetened beverages and processed meats. Understanding the contribution of sustained dietary changes to life expectancy can provide guidance for the development of health policies.
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Longitudinal study of the effects of price and promotion incentives on purchases of unhealthy foods: evidence for restricting food promotions.
Kopasker, D, Ejebu, OZ, Norwood, P, Ludbrook, A
BMJ nutrition, prevention & health. 2022;5(1):62-71
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The European Commission and WHO have updated their approach to addressing obesity and promoting healthy eating among the general population. Foods that are high in calories, fat, sugar, and salt provide little nutritional value and are calorie dense. Price interventions, like the levy introduced by the UK government, have effectively reduced consumption of alcohol, tobacco, and sugary drinks. Both the UK and Scottish governments have recently proposed legislation to restrict the promotion of unhealthy foods. This longitudinal regression analysis assessed the consumer microdata over time to determine the effectiveness of price, price promotions, and volume promotions in predicting reductions in household purchases of high-fat, salt, and sugar (HFSS) foods. The results revealed that in-store promotions led to a significant increase in household purchasing. Volume promotions were more effective than price promotions, but they resulted in greater calorie intake per household. Additionally, there were significant differences in purchasing behaviour and income levels of households. Households with children tended to purchase more than those without. These findings suggest that policies aimed at limiting promotions may help reduce household purchases and consumption of HFSS foods. Healthcare professionals can utilise the outcomes of this review to comprehend the correlation between price and volume promotions on household buying and consumption of HFSS foods.
Abstract
Objectives: Taxes and restrictions on promotions have recently been proposed as policy instruments to reduce consumption of unhealthy foods. The objective of this study is to add to the limited evidence on the comparative effectiveness of price changes, price promotions and volume promotions in changing household purchasing of unhealthy foods, using biscuits, crisps and savoury snacks as examples. Design: Longitudinal regression analysis of consumer microdata. Setting: Secondary data on itemised household purchases of biscuits, crisps and savoury snacks from 2006 to 2012. Participants: Sample of 3024 households in Scotland. Main outcome measures: Changes in the number of calories (kcal) purchased in the product category by a household caused by changes in the price for the product category, any temporary in-store price promotions and any temporary in-store volume promotions. Changes are measured at the mean, median, 25th percentile and 75th percentile of the household purchasing distribution for the full sample. Subgroup analyses were conducted by household income band and for households with and without children. Results: Between product categories, the scale of purchasing response to incentives varies significantly. Within product categories, the mean calories (kcal) purchased by a household are more responsive to any volume promotion than to price or any price promotion for all product categories. As the volume of items purchased increases, households are less responsive to price, less responsive to any volume promotion and more responsive to any price promotion. Statistically significant differences are observed between household income groups in their response to price and promotion incentives within the biscuits category only. In cases where statistically significant differences are observed, households with children are more responsive to promotion and price incentives than households without children. Conclusions: For all product categories analysed (biscuits, crisps and savoury snacks), household purchasing is most responsive to any volume promotion. Therefore, assuming the response of consumers to incentives remains constant following legislation, the most effective policy instrument to reduce the calorie intake from these products may be a ban on volume promotions.
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The effect of healthy dietary patterns on male semen quality: a systematic review and meta-analysis.
Cao, LL, Chang, JJ, Wang, SJ, Li, YH, Yuan, MY, Wang, GF, Su, PY
Asian journal of andrology. 2022;24(5):549-557
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Infertility has been identified by the World Health Organization as a worldwide problem. The analysis of semen quality is key in assessing male fertility. The aim of this study was to explore the effect of healthy dietary patterns on male semen quality. This study is a systematic review and meta-analysis of six articles. The six articles were cross-sectional studies involving 1244 subjects, however, 708 subjects with the lowest and highest adherence to a healthy dietary pattern were included in the meta-analysis. Results show that the sperm concentration, progressive sperm motility, and total sperm count were significantly higher in the group with high consumption of a healthy dietary pattern than those in the group with low consumption; however, there wasn’t a clear relationship between normal sperm morphology, total sperm motility, and semen volume. Authors conclude that dietary interventions should be considered in clinical work as part of the therapies improving male semen quality.
Expert Review
Conflicts of interest:
None
Take Home Message:
- This Systematic Review and Meta Analysis showed that healthy dietary patterns had beneficial effects on sperm concentration, total sperm count, and progressive sperm motility in males, which affect male fertility.
- Authors concluded that healthy dietary patterns may promote male reproductive health and thus improve semen quality in the population.
- Healthy dietary patterns meant the Mediterranean diet for 4 out of 6 studies. All healthy diet patterns were determined by the authors to be rich in plant-based foods, where saturated fats provide only a small percentage of the total energy intake.
Evidence Category:
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A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
- This study aimed to determine the effects of healthy dietary patterns on semen quality.
Methodology
- This meta-analysis was performed following PRISMA guidelines and included 6 cross-sectional studies with 1244 participants
- The included cross-sectional studies examined the influence of the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and prudent diet patterns on semen quality parameters.
- In 4 of the studies participants were divided into groups based on their scores for the Mediterranean diet from low to high adherence.
- 2 studies examined the DASH diet and the prudent diet and used food frequency questionnaires to compare high consumption with low consumption of healthy dietary patterns.
- The PICOS (Participants, Intervention, Comparison, Outcomes, and Study design) criteria that were used to structure the research question.
- 11 Checklists were used to assess the quality of included studies.
Results:
By comparing high consumption with low consumption of healthy dietary patterns, the results of the meta-analysis showed:
- significantly higher sperm concentrations (mean difference [MD] = 6.88 × 106 ml−1, 95% confidence interval [CI]: 1.26 × 106 ml−1–12.49 × 106 ml−1; P < 0.05)
- significant increase in total sperm count (MD = 16.70 × 106, 95% CI: 2.37 × 106–31.03 × 106; P < 0.05)
- significant increase in progressive sperm motility (MD = 5.85%, 95% CI: 2.59%–9.12%; P < 0.01) but there was no significant correlation between healthy dietary patterns and total sperm motility (MD: 6.86%, 95% CI: −0.25%–13.96%; P > 0.05).
- there was no significant association between a healthy dietary pattern and normal sperm morphology (MD: 0.28%, 95% CI: −0.33%–0.90%; P > 0.05)
- there was no significant association between a healthy dietary pattern and semen volume (MD: 0.04 ml, 95% CI: −0.20 ml–0.28 ml; P > 0.05).
Limitations:
- Included studies were all cross-sectional studies, and it is impossible to determine the causal relationship between the high intake of healthy dietary patterns and semen quality.
- The number of studies included was small, and there was not enough literature to support authors in drawing reliable conclusions.
- No comparison was made between specific diets such as dash vs Mediterranean.
Clinical practice applications:
- The authors concluded that dietary interventions should be considered in clinical work as part of the therapies improving male semen quality.
- Dietary interventions for men should be included as part of preconceptional clinical management,
- Dietary interventions for men should also be considered in infertility clinical management.
Considerations for future research:
- Randomised Clinical Trials should be conducted to build on these findings.
Abstract
The incidence of infertility has recently risen. Semen quality is an important male fertility indicator, and dietary factors can affect semen quality. We conducted this systematic review and meta-analysis to determine the effects of healthy dietary patterns on semen quality. A literature search was conducted in 3 databases (Embase, Web of Science and PubMed) on August 21, 2021. The included cross-sectional studies examined the influence of the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and prudent diet patterns on semen quality parameters; six studies (1244 subjects) were included. By comparing high consumption with low consumption of healthy dietary patterns, the results of the meta-analysis showed significantly higher sperm concentrations (mean difference [MD] = 6.88 × 106 ml-1, 95% confidence interval [CI]: 1.26 × 106 ml-1-12.49 × 106 ml-1; P < 0.05), a significant increase in total sperm count (MD = 16.70 × 106, 95% CI: 2.37 × 106-31.03 × 106; P < 0.05), and a significant increase in progressive sperm motility (MD = 5.85%, 95% CI: 2.59%-9.12%; P < 0.01). The sperm concentration, progressive sperm motility, and total sperm count were significantly higher in men with higher versus lower consumption of healthy dietary patterns. However, the results must be interpreted with caution.
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Tracking of Dietary Patterns in the Secondary Prevention of Cardiovascular Disease after a Nutritional Intervention Program-A Randomized Clinical Trial.
Coura, AGL, Arruda Neta, ADCP, Lima, RLFC, Bersch-Ferreira, ÂC, Weber, B, Vianna, RPT
Nutrients. 2022;14(22)
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The likelihood of developing cardiovascular disease (CVD) is associated with eating patterns that are considered unhealthy (i.e., excessive intake of sodium and processed foods; added sugars; unhealthy fats; low intake of fruits and vegetables, whole grains, fibre, legumes, fish and nuts), along with a lack of exercise, overweight and obesity, stress, alcohol consumption and smoking. The aim of this study was to compare dietary patterns between the control group and the experimental group before and after the intervention of the BALANCE program. This is a sub-study of the multicentre randomised clinical trial Brazilian Cardioprotective Food Program, (BALANCE). The population considered for this sub-study was composed of study participants at the initial time (baseline year), after one year and after two years of the intervention of the BALANCE program. Results showed that both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective dietary patterns in the experimental group justifies the initiative of the BALANCE program. Authors conclude that knowledge of consumption patterns makes it possible to adjust the necessary interventions in the long term; however, only a longer follow-up can confirm the protective effect of these interventions.
Abstract
Individuals with a history of previous cardiovascular events have an increased risk of mortality and morbidity, so adherence to a healthy dietary pattern is essential. We aimed to evaluate and compare dietary patterns between the control and the experimental group from the BALANCE Program. A total of 2360 individuals aged 45 years or older with previous cardiovascular disease were included. The individuals were randomized into two groups: intervention (dietary prescription with nutritional recommendations, nutritional education program based on playful strategies, suggestions of typical and accessible Brazilian foods and intensive monitoring) and control (conventional nutritional counseling). The dietary patterns were identified using factor analysis with the principal component extraction method, and the t-Student tests and ANOVA test were performed to evaluate the associated factors. Four dietary patterns were identified for both groups: "Traditional", "Snack", "Western", "Cardioprotective". There was an increase in the variances of the "Cardioprotective" pattern in both groups. Regarding the "Western" pattern, there was a significant reduction in the variances of the experimental group (10.63% vs. 8.14%). Both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective pattern in the experimental group justifies the initiative of the BALANCE program.
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Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose-Response Meta-Analysis of 207,291 Participants.
Suksatan, W, Moradi, S, Naeini, F, Bagheri, R, Mohammadi, H, Talebi, S, Mehrabani, S, Hojjati Kermani, MA, Suzuki, K
Nutrients. 2021;14(1)
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Globally, consumption of ultra-processed foods (UPFs) has risen in most middle- or high-income countries and gradually displaced fresh and minimally processed foods. The aim of this study was to perform a systematic review and dose–response meta-analysis (of 7 studies) to determine if UPF intake is associated with mortality risk. Results indicate that UPF consumption was associated with an elevated risk of all-cause mortality, cardiovascular disease-cause mortality, and heart-cause mortality. However, there was no association between UPF consumption and cancer-cause mortality. Authors conclude that future studies should also investigate whether ultra-processing indices can demonstrate an association between diet and mortality compared with other nutritional quality scores/indices.
Abstract
We performed a systematic review and dose-response meta-analysis of observational studies assessing the association between UPF consumption and adult mortality risk. A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE, and Scopus electronic databases from inception to August 2021. Data were extracted from seven cohort studies (totaling 207,291 adults from four countries). Using a random-effects model, hazard ratios (HR) of pooled outcomes were estimated. Our results showed that UPF consumption was related to an enhanced risk of all-cause mortality (HR = 1.21; 95% CI: 1.13, 1.30; I2 = 21.9%; p < 0.001), cardiovascular diseases (CVDs)-cause mortality (HR = 1.50; 95% CI: 1.37, 1.63; I2 = 0.0%; p < 0.001), and heart-cause mortality (HR = 1.66; 95% CI: 1.50, 1.85; I2 = 0.0%; p = 0.022), but not cancer-cause mortality. Furthermore, our findings revealed that each 10% increase in UPF consumption in daily calorie intake was associated with a 15% higher risk of all-cause mortality (OR = 1.15; 95% CI: 1.09, 1.21; I2 = 0.0%; p < 0.001). The dose-response analysis revealed a positive linear association between UPF consumption and all-cause mortality (Pnonlinearity = 0.879, Pdose-response = p < 0.001), CVDs-cause mortality (Pnonlinearity = 0.868, Pdose-response = p < 0.001), and heart-cause mortality (Pnonlinearity = 0.774, Pdose-response = p < 0.001). It seems that higher consumption of UPF is significantly associated with an enhanced risk of adult mortality. Despite this, further experimental studies are necessary to draw a more definite conclusion.
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Plant-based dietary quality and depressive symptoms in Australian vegans and vegetarians: a cross-sectional study.
Lee, MF, Eather, R, Best, T
BMJ nutrition, prevention & health. 2021;4(2):479-486
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Poor diet and mood disorders are known leading causes of morbidity and mortality. Some studies suggest that plant-based diets are associated with improved mood and mental health. The aim of this study was to explore the association between vegan and vegetarian dietary patterns and depressive symptoms in adults by exploring the overall dietary quality of these patterns. This study is an online cross-sectional study which invited vegan and vegetarian adults aged between 18 and 44 years who live in Australia to complete an online survey through social media platforms. Results show that high plant-based diets quality was associated with decreased risk of depressive symptoms. However, this study also shows that following a plant-based diet does not necessarily mean the individual consumes a ‘healthy’ dietary pattern. Authors conclude that further studies are needed which should focus on the specific quality of vegan and vegetarian diets in relation to depression and mental well-being.
Abstract
Plant-based dietary patterns (vegan and vegetarian) are often considered 'healthy' and have been associated with broad health benefits, including decreased risk of obesity and ill health (cardiovascular disease, blood glucose and type II diabetes). However, the association between plant-based diets and mood disorders such as depression remains largely equivocal. This cross-sectional study of 219 adults aged 18-44 (M=31.22, SD=7.40) explored the associations between an estimate of overall plant-based diet quality and depression in vegans (n=165) and vegetarians (n=54). Overall plant-based diet quality was associated with depressive symptoms in vegans and vegetarians F(1, 215)=13.71, p<0.001 accounting for 6% of the variation in depressive symptoms. For those without depression, higher diet quality was protective against depressive symptoms F(1, 125)=6.49, p=0.012. Conversely, for those with depression no association with diet quality was found F(1, 89)=0.01, p=0.963. These findings suggest that a high-quality plant-based diet may be protective against depressive symptoms in vegans and vegetarians. In line with emerging research between food and mental health, higher-quality dietary patterns are associated with a reduced risk of depressive symptoms. Given the rapidly increasing rate of vegan and vegetarian food products within Australia, understanding the potential mechanisms of effects through which a plant-based diet may influence depressive symptoms is required.
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Cross-sectional associations of schoolchildren's fruit and vegetable consumption, and meal choices, with their mental well-being: a cross-sectional study.
Hayhoe, R, Rechel, B, Clark, AB, Gummerson, C, Smith, SJL, Welch, AA
BMJ nutrition, prevention & health. 2021;4(2):447-462
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There has been an increase in mental health issues among school children in recent years. The importance of good nutrition for the physical and mental well-being of school children cannot be overstated. According to previous research, a diet high in processed foods, refined carbohydrates, and saturated fat are associated with mental health issues in children, while a diet high in fruits and vegetables may protect against mental health problems. The purpose of this cross-sectional study was to evaluate the relationship between dietary choices and mental well-being among primary and secondary school children. Among secondary school children, higher consumption of fruits and vegetables was associated with a greater sense of well-being, with those who consumed five or more fruits and vegetables reporting a higher sense of well-being. The well-being scores of secondary school children who consumed no breakfast and those who consumed high-energy drinks were lower than those of secondary school children who consumed conventional breakfast. Similarly, compared to children who had packed lunches, children who had no lunch had lower well-being. Among primary school children, higher intakes of fruits and vegetables were not significantly associated with well-being, whereas the type of lunch and breakfast were significantly associated with well-being. A comprehensive investigation is required to understand how dietary strategies and their components contribute to children's well-being and their modulating effects on various mechanisms. This research can be used by healthcare professionals to gain a better understanding of how a child's mental and physical health is impacted by their nutrition.
Abstract
BACKGROUND Poor mental well-being is a major issue for young people and is likely to have long-term negative consequences. The contribution of nutrition is underexplored. We, therefore, investigated the association between dietary choices and mental well-being among schoolchildren. METHODS Data from 7570 secondary school and 1253 primary school children in the Norfolk Children and Young People Health and Well-being Survey, open to all Norfolk schools during October 2017, were analysed. Multivariable linear regression was used to measure the association between nutritional factors and mental well-being assessed by the Warwick-Edinburgh Mental Well-being Scale for secondary school pupils, or the Stirling Children's Well-being Scale for primary school pupils. We adjusted all analyses for important covariates including demographic, health variables, living/home situation and adverse experience variables. RESULTS In secondary school analyses, a strong association between nutritional variables and well-being scores was apparent. Higher combined fruit and vegetable consumption was significantly associated with higher well-being: well-being scores were 3.73 (95% CI 2.94 to 4.53) units higher in those consuming five or more fruits and vegetables (p<0.001; n=1905) compared with none (n=739). The type of breakfast or lunch consumed was also associated with significant differences in well-being score. Compared with children consuming a conventional type of breakfast (n=5288), those not eating any breakfast had mean well-being scores 2.73 (95% CI 2.11 to 3.35) units lower (p<0.001; n=1129) and those consuming only an energy drink had well-being scores 3.14 (95% CI 1.20 to 5.09) units lower (p=0.002; n=91). Likewise, children not eating any lunch had well-being scores 2.95 (95% CI 2.22 to 3.68) units lower (p<0.001; 860) than those consuming a packed lunch (n=3744). In primary school analyses, the type of breakfast or lunch was associated with significant differences in well-being scores in a similar way to those seen in secondary school data, although no significant association with fruit and vegetable intake was evident. CONCLUSION These findings suggest that public health strategies to optimise the mental well-being of children should include promotion of good nutrition.
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Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis.
Lee, KW, Loh, HC, Ching, SM, Devaraj, NK, Hoo, FK
Nutrients. 2020;12(6)
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High blood pressure or hypertension is defined as systolic blood pressure of 140 mmHg or higher, and diastolic blood pressure of 90 mmHg or higher. It is an independent and major risk factor for cardiovascular disease and chronic kidney failure. The aim of this study was to determine the effect of a vegetarian diet on the reduction of blood pressure. This study is a systematic review together with trial sequential analysis. A total of 15 studies involving 856 individuals met the eligibility criteria and were included in the final analyses. Results show that a vegetarian dietary pattern significantly reduced systolic and diastolic blood pressure. Furthermore, dietary patterns based solely on plant sources are more effective in reducing blood pressure than other types of vegetarian diet which still include animal products or by-products, such as eggs and dairy products. Authors conclude that vegetarian diets, especially vegan diets, reduce blood pressure when compared with omnivorous diets. Thus, suggesting that they may be crucial in the primary prevention and overall management of hypertension.
Abstract
The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative effectiveness is not well established. Here, we performed a systematic review together with trial sequential analysis to determine the effect of a vegetarian diet on the reduction of blood pressure. We searched the randomized controlled trial (RCT) through Medline, PubMed and Cochrane Central Register. Fifteen eligible RCTs with 856 subjects were entered into the analysis. The pooled results demonstrated that vegetarian diet consumption significantly lowered the systolic blood pressure (weighted mean difference (WMD), -2.66 mmHg (95% confidence interval (CI) = -3.76, -1.55, p < 0.001) and diastolic BP was WMD, -1.69 95% CI = -2.97, -0.41, p < 0.001) as compared to an omnivorous diet. In subgroup analysis, a vegan diet demonstrated a greater reduction in systolic BP (WMD, -3.12 mm Hg; 95% CI = -4.54, -1.70, p < 0.001) as compared with a lacto-ovo-vegetarian diet (WMD, -1.75 mm Hg, 95% CI -5.38, 1.88, p = 0.05). The vegan diet has showed a similar trend in terms of diastolic blood pressure reduction (WMD, -1.92 mm Hg (95% CI = -3.18, -0.66, p < 0.001) but those with a lacto-ovo-vegetarian diet showed no changes in diastolic BP reduction (WMD, 0.00, 95% CI = 0.00, 0.00), p =0.432). In conclusion, vegetarian diets are associated with significant reductions in BP compared with omnivorous diets, suggesting that they may play a key role in the primary prevention and overall management of hypertension.
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Non-Systematic Review of Diet and Nutritional Risk Factors of Cardiovascular Disease in Obesity.
Rychter, AM, Ratajczak, AE, Zawada, A, Dobrowolska, A, Krela-Kaźmierczak, I
Nutrients. 2020;12(3)
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Nutrition is a major factor influencing obesity associated heart disease risk, however many people with this disease do not follow nutritional recommendations. This review of 155 studies aimed to summarise dietary aspects of heart disease prevention. The paper began by outlining the role of obesity through the development of other disorders that contribute to heart disease, such as type 2 diabetes, high blood pressure and blood sugar imbalance. The quantity and distribution of fat tissue also can contribute to heart disease risk, especially if it is located within the heart or around the major organs of the body. Dietary factors which can increase heart disease risk were described as an increased intake of processed foods, sugar, salt and certain fats and low intakes of fruit, vegetables, fibre, whole grains, beans and nuts. The Mediterranean diet, the dietary approaches to stop hypertension (DASH) diet, plant-based diets, the portfolio dietary pattern and low carbohydrate diets were all reviewed and although mixed results were stated for low carbohydrate diets, most of the diets reviewed reported improved heart disease outcomes. The role of intestinal microbiota in heart disease were also reviewed and the influence of a poor diet was implicated in imbalanced gut microbiota and the development of heart disease. It was concluded that an unhealthy diet can contribute to heart disease and that dietary patterns such as the Mediterranean diet and plant-based diets may be favourable for its management. This study could be used by healthcare professionals to individualise dietary recommendations for patients with heart disease or who are at risk of it.
Abstract
Although cardiovascular disease and its risk factors have been widely studied and new methods of diagnosis and treatment have been developed and implemented, the morbidity and mortality levels are still rising-cardiovascular disease is responsible for more than four million deaths each year in Europe alone. Even though nutrition is classified as one of the main and changeable risk factors, the quality of the diet in the majority of people does not follow the recommendations essential for prevention of obesity and cardiovascular disease. It demonstrates the need for better nutritional education in cardiovascular disease prevention and treatment, and the need to emphasize dietary components most relevant in cardiovascular disease. In our non-systematic review, we summarize the most recent knowledge about nutritional risk and prevention in cardiovascular disease and obesity.