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Theoretical Food and Nutrient Composition of Whole-Food Plant-Based and Vegan Diets Compared to Current Dietary Recommendations.
Karlsen, MC, Rogers, G, Miki, A, Lichtenstein, AH, Folta, SC, Economos, CD, Jacques, PF, Livingston, KA, McKeown, NM
Nutrients. 2019;11(3)
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Knowledge of plant-based diets is important for clinicians to be able to engage with patients about the health benefits and potential concerns. To date, the nutrient composition and nutrient adequacy of these diets has not been thoroughly assessed. The aim of this study was to estimate theoretical food and nutrient levels of whole-food plant-based (WFPB) and vegan diets and compare these levels to the US dietary recommendations. Self-identified vegan and WFPB diet followers reported their most frequently used books and websites for nutritional information and recipes. Using these sources, 30 days of theoretical meal plans were created, and this data was compared to recommendations from a MyPlate meal plan. This data was analysed to measure adherence to the 2015 Dietary Guidelines for Americans. This analysis showed the theoretical nutrient intake from a WFPB diet deviate significantly from MyPlate recommendations. The WFPB diet offered improved quality compared to the typical US diet, providing more nutrient-dense foods with less refined grains and added sugars. While WFPB diets are of higher quality in general, they risk deficiencies of vitamins B12 and D and calcium without adequate supplementation. Based on this analysis, the authors encourage patients to consider a plant-based dietary pattern with attention given to consuming calcium-rich foods, iodised salt, and using supplements for vitamins B12 and D. The authors comment that future research should examine the actual dietary intakes of these groups, rather than the theoretical, to assess actual nutrient intake and adherence to diet.
Abstract
Public interest in popular diets is increasing, in particular whole-food plant-based (WFPB) and vegan diets. Whether these diets, as theoretically implemented, meet current food-based and nutrient-based recommendations has not been evaluated in detail. Self-identified WFPB and vegan diet followers in the Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey reported their most frequently used sources of information on nutrition and cooking. Thirty representative days of meal plans were created for each diet. Weighted mean food group and nutrient levels were calculated using the Nutrition Data System for Research (NDSR) and data were compared to DRIs and/or USDA Dietary Guidelines/MyPlate meal plan recommendations. The calculated HEI-2015 scores were 88 out of 100 for both WFPB and vegan meal plans. Because of similar nutrient composition, only WFPB results are presented. In comparison to MyPlate, WFPB meal plans provide more total vegetables (180%), green leafy vegetables (238%), legumes (460%), whole fruit (100%), whole grains (132%), and less refined grains (-74%). Fiber level exceeds the adequate intakes (AI) across all age groups. WFPB meal plans failed to meet the Recommended Dietary Allowances (RDA)s for vitamin B12 and D without supplementation, as well as the RDA for calcium for women aged 51⁻70. Individuals who adhere to WFBP meal plans would have higher overall dietary quality as defined by the HEI-2015 score as compared to typical US intakes with the exceptions of calcium for older women and vitamins B12 and D without supplementation. Future research should compare actual self-reported dietary intakes to theoretical targets.
2.
Sex and menopausal status influence human dietary requirements for the nutrient choline.
Fischer, LM, daCosta, KA, Kwock, L, Stewart, PW, Lu, TS, Stabler, SP, Allen, RH, Zeisel, SH
The American journal of clinical nutrition. 2007;85(5):1275-85
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Choline is used to form cell membranes, and it is a precursor for the neurotransmitter acetylcholine. Other than from the diet, choline can also be derived from the de novo biosynthesis of phosphatidylcholine. The current Adequate Intake for choline is considered sufficient to prevent deficiency, however an Estimated Average Requirement cannot be generated due to lack of availability of adequate human data. The aim of this study was to evaluate the dietary choline requirement in healthy men and women (pre- and postmenopausal), and to identify the clinical and metabolic sequelae of choline deficiency. Fifty-seven adult participants (26 healthy men, 16 premenopausal women and 15 postmenopausal women) were recruited for the study. A randomised double-blind protocol was followed to assign participants in one of the 2 arms; folate only (100 DFE) vs a dietary supplement of 400μg folic acid/d (768 DFE). Results show that independent of folate status, most men and postmenopausal women developed liver or muscle dysfunction when fed a low-choline diet, whereas premenopausal women were more resistant to developing such organ dysfunction. AP activity increased in all subjects in response to the low-choline diet regardless of whether they manifested organ dysfunction. Liver and muscle dysfunction occurred in response to a low-choline diet in both men and women. The current AI for choline was not be sufficient for some of the participants who became depleted despite this level of intake.
Abstract
BACKGROUND Although humans require dietary choline for methyl donation, membrane function, and neurotransmission, choline can also be derived from the de novo synthesis of phosphatidylcholine, which is up-regulated by estrogen. A recommended Adequate Intake (AI) exists for choline; however, an Estimated Average Requirement has not been set because of a lack of sufficient human data. OBJECTIVE The objective of the study was to evaluate the dietary requirements for choline in healthy men and women and to investigate the clinical sequelae of choline deficiency. DESIGN Fifty-seven adult subjects (26 men, 16 premenopausal women, 15 postmenopausal women) were fed a diet containing 550 mg choline x 70 kg(-1) x d(-1) for 10 d followed by <50 mg choline x 70 kg(-1) x d(-1) with or without a folic acid supplement (400 microg/d per randomization) for up to 42 d. Subjects who developed organ dysfunction during this diet had normal organ function restored after incremental amounts of choline were added back to the diet. Blood and urine were monitored for signs of toxicity and metabolite concentrations, and liver fat was assessed by using magnetic resonance imaging. RESULTS When deprived of dietary choline, 77% of men and 80% of postmenopausal women developed fatty liver or muscle damage, whereas only 44% of premenopausal women developed such signs of organ dysfunction. Moreover, 6 men developed these signs while consuming 550 mg choline x 70 kg(-1) x d(-1), the AI for choline. Folic acid supplementation did not alter the subjects' response. CONCLUSION Subject characteristics (eg, menopausal status) modulated the dietary requirement for choline, and a daily intake at the current AI was not sufficient to prevent organ dysfunction in 19 of the subjects.