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Vegetarian and Plant-Based Diets in Health and Disease Prevention

Vegetarian and Plant-Based Diets in Health and Disease Prevention

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Contents

List of Contributors

Foreword

Preface

1 - Setting the Scene – General Features Associated With Vegetarian Diets

1 - Vegetarian Diets: Definitions and Pitfalls in Interpreting Literature on Health Effects of Vegetarianism

1. Introduction

2. Underlying Motivation of Plant-Based and Vegetarian Diets

3. Definitions

4. Methodological Pitfalls in Interpreting the Literature on Health Effects of Vegetarian Diets

4.1 Heterogeneity in Dietary Composition

4.2 Self-Defined Vegetarianism Versus “Measured” Degree of Avoidance of Specific Animal Foods

4.3 Confounding

4.4 Is the Study Sample Representative for the Concerned Base Population?

5. Conclusion

References

2 - Attitudes Toward Meat and Plants in Vegetarians

1. Introduction

2. Studies Comparing Attitudes Among “Vegetarians” to Meat Eaters

2.1 Limitations to Studies Comparing Attitudes Among “Vegetarians” to Meat Eaters

2.2 Summary

3. Differences in Attitudes Toward Meat Between Varying Types of Vegetarians

3.1 Semivegetarians Versus True Vegetarians

3.2 Vegans Versus Other Vegetarians

3.3 Health Versus Ethical Vegetarians

4. The Role of Values

5. The Role of Attitudes Toward Meat in Becoming a Vegetarian and in Maintaining a Vegetarian Diet

5.1 Vegetarian Diet and Dissonance Theory

5.2 Vegetarian Diet and Moralization

5.3 Vegetarian Diet and Social Identity

6. Conclusion

References

3 - Nutrition Knowledge of Vegetarians

1. Introduction

1.1 Vegetarians as Unwitting Nutrition Educators

2. Defining Nutrition Knowledge

3. Transcultural Considerations

4. Measuring Nutrition Knowledge in Vegetarians

5. Nutrition Knowledge of Vegans as Compared to Ovolactovegetarians

6. Nutrition Knowledge of Vegetarians as Compared to Nonvegetarians

7. Nutrition Knowledge of Ethically Oriented as Compared to Health-Oriented Vegetarians

8. Nutrition Knowledge and Dietary Behavior Among Vegetarians

9. Nutrition Knowledge and the Process of Becoming a Vegetarian

10. Discussion

10.1 Does Nutrition Knowledge Precede or Result From Vegetarianism or Both?

10.2 Synthesis

References

4 - Vegetarianism and Eating Disorders

1. Defining Terminology

1.1 Defining Meat Avoidance

1.2 The Motive for Meat Avoidance

2. Vegetarianism and Restrained Eating

2.1 Defining Restrained Eating

2.2 Specific Findings

2.3 Summary

3. Vegetarianism and Disordered Eating

3.1 Defining Disordered Eating

3.2 Specific Findings

3.3 Summary

4. Vegetarianism and Clinical Eating Disorders

4.1 Defining Clinical Eating Disorders

4.2 Anorexia Nervosa and Vegetarianism

4.3 Bulimia Nervosa and Vegetarianism

4.4 Summary

5. Is Vegetarianism a (Causal) Risk Factor for Eating Pathology?

5.1 Clinical Implications

5.2 Areas of Future Study

5.2.1 Cultural Variation

5.2.2 Gender

6. Final Summary

References

5 - Cognitive Processes Underlying Vegetarianism as Assessed by Brain Imaging

1. Introduction

2. Quantitative Methods in Neuroscience

3. Vegetarianism and Social Cognitive Neuroscience

3.1 Vegetarianism and Motivation

3.2 Vegetarianism and Empathy

3.3 Vegetarianism, Affect System, and Cognition

4. Conclusions

References

6 - Geographic Aspects of Vegetarianism: Vegetarians in India

1. Introduction

1.1 Vegetarianism and Nutrition Transition in India

1.2 Types of Vegetarian Diet Consumption in India and States

1.3 Nutritional Profile of Vegetarian Diets in India

2. Health Implications of Vegetarianism in India

2.1 Prevalence of Diabetes and Obesity According to Types of Vegetarian Diet Consumption

3. Conclusions

References

Further Reading

7 - Religious Variations in Vegetarian Diets and Impact on Health Status of Children: Perspectives From Traditional Vegetarian Societies

1. Religion and Diet

2. The Relationship Between Religion and Diet

3. Vegetarian Diet and Health: Evidence From Religion-Based Studies

4. Vegetarianism and Child Health: Impact of Fetal Nutritional Environment

5. Vegetarian Diet During Childhood

6. Conclusion

References

Further Reading

8 - Dietary Transition: Longterm Trends, Animal Versus Plant Energy Intake, and Sustainability Issues

1. Introduction

2. Food Systems

2.1 Production

2.2 Consumption

2.3 The Composition of Food Commodities

2.4 The Food System and Natural Resources

2.5 Efficiency of Meat Production: the Example of Water Footprints of Meat

2.6 Food Supply and Income

2.7 Trends

2.8 Future Changes

2.9 The Impact on Natural Resources

3. Conclusions

Abbreviations

References

9 - Plant-Based Diets for Mitigating Climate Change

1. What Is the Diet–Climate Connection?

2. How Can Diets Be Measured to Assess Their Climate Impact?

3. How Can Climate Impact Be Measured and Attributed to Diet?

3.1 How Can We Measure the Climate Impact of GHGs from Diets?

3.2 Why is Methane So Important for Understanding the Climate Impact of Diets?

3.3 Is CO2 from Respiration a Greenhouse Gas?

3.4 How Does Diet Contribute to Nitrous Oxide Emissions?

4. What Do We Know About the Relative Climate Impact of Different PBDs?

4.1 What Functional Unit Can Be Used to Compare GHGE of Different Diets?

4.2 How Do the GHGE of Existing Diets Compare?

4.3 What Can Model Diets Tell Us?

4.4 What Are the GHGE of Different Foods?

4.5 What Are the Climate Impacts of the Effect of PBDs via the Healthcare System?

5. Conclusion

Acknowledgments

References

10 - Barriers to Increasing Plant Protein Consumption in Western Populations

1. Introduction

2. The Consumption and Cultural Place of Plant Proteins in Western Food Cultures

3. Are Consumers Trying to Change Their Use of Meat and Pulses?

4. Barriers to Increasing Plant-Based Protein Consumption

5. Solutions: How Could Plant Protein Consumption Increase?

References

2 - Setting the Scene – Specific Dietary Characteristics of Vegetarian Diet and Their Relation to Health

11 - Dietary Patterns in Plant-Based, Vegetarian, and Omnivorous Diets

1. Introduction

2. Defining and Typical Differences Between Plant-Based, Vegetarian, and Omnivorous Diets

2.1 Selection of a Representative Set of Vegetarians

2.2 Reference Groups

2.3 Composition of the Restricted Diets

3. Dietary Quality Models

3.1 Mediterranean Diet Score

3.2 The Healthy Eating Index

3.3 Diet in Relation to Disability Adjusted Lost Years (DALYs): Adjustment of the Weight of the Components

3.4 Comparison of Importance of the Components Over the Three Models

3.5 Diet Quality and Relative Risks

4. Diet Quality Measures and Vegetarian Diets

5. Death Rates and Vegetarian Diets

6. Recommendations for Dietary Quality Indices for Vegan and Other Vegetarian Diets

7. Conclusions

Conflicts of Interest

References

12 - Meat Consumption and Health Outcomes

1. Introduction

2. Meat Consumption and Obesity

3. Red and Processed Meat Consumptions and Cancer Risk

3.1 Epidemiological Evidence

3.2 Meat and Cancer-Specific Mortality

3.3 Red and Processed Meat Consumptions and Cancer Risk: Mechanistic Hypotheses

4. Meat Consumption and Risk of Type 2 Diabetes

4.1 Epidemiological Evidence

4.2 Meat and Type 2 Diabetes Risk: Mechanistic Hypotheses

5. Meat Consumption and Cardiovascular Risk and Mortality

5.1 Meat Consumption and the Risk of Coronary Heart Disease (CHD)

5.2 Meat Consumption and the Risk of Stroke

5.3 Meat Consumption and Cardiovascular Mortality

5.4 Meat and CVD Risk/Mortality: Mechanistic Hypotheses

6. Meat Consumption and All-Cause Mortality

7. Meat Consumption and Bone Health

7.1 Protein Intake and Risk of Bone Mineral Density (BMD) or Bone Mineral Content (BMC)

7.2 Protein Intake, Including Meat, and Risk of Fracture

7.3 Protein Intake and Bone Health: Mechanistic Hypotheses

8. Conclusion and Future Trends

References

13 - Fruits, Vegetables, and Health: Evidence From Meta-analyses of Prospective Epidemiological Studies

1. Introduction

2. Search Strategy

3. Results

3.1 Mortality

3.2 Cardiovascular Disease

3.2.1 Coronary Heart Disease

3.2.2 Stroke

3.3 Obesity

3.4 Diabetes

3.5 Other Diseases

3.5.1 Asthma

3.5.2 Dementia

3.5.3 Depression

3.6 Cancer

3.6.1 Bladder Cancer

3.6.2 Breast Cancer

3.6.3 Lung Cancer

3.6.4 Colorectal Cancer

3.6.5 Colorectal Adenoma

3.6.6 Prostate Cancer

3.6.7 Gastric Cancer

3.6.8 Esophageal Cancer

3.6.9 Hepatocellular Carcinoma

3.6.10 Non-Hodgkin Lymphoma

3.6.11 Pancreatic Cancer

4. Discussion

4.1 Confounding Factors

4.2 Interaction With Smoking

4.3 Subtypes of Fruits and Vegetables

4.4 Limitations

4.5 Causality

5. Conclusion

References

14 - Whole Grains and Disease Risk

1. Introduction

2. Whole Grain Definition and Types

2.1 Definition

2.2 Structure and Composition of a Grain

2.3 Whole Grain in Human Diet

2.4 Effect of Refining on Chemical Composition

3. Whole Grain and Cardiovascular Disease

3.1 Cardiovascular Disease

3.2 Epidemiological Evidence

3.2.1 Coronary Heart Disease/Stroke

3.2.2 Diabetes/Insulin Resistance

3.3 Intervention Trials

3.3.1 Whole Grain and Lipid Profile

3.3.2 Whole Grain, Blood Glucose, and Insulin Sensitivity

3.3.3 Whole Grain, Inflammatory Markers, and Blood Pressure

3.3.4 Whole Grain and Body Weight Regulation

3.4 Mechanisms of Action

3.4.1 Compounds With Antioxidant-Related Properties

3.4.2 Cereal Fibers

4. Whole Grain and Cancer

5. Conclusion

References

15 - Nut Intake and Health

1. Introduction

2. Coronary Heart Disease

2.1 Epidemiological Studies

2.2 Nut Intervention Trials

2.2.1 Nut Intake and Blood Lipids

2.3 Other Coronary Heart Disease Risk Factors

3. Diabetes Mellitus

3.1 Epidemiological Studies

3.2 Nut Intervention Trials

3.3 Polycystic Ovary Syndrome

4. Weight Management

4.1 Epidemiological Studies

4.2 Nut Intervention Trials

5. Metabolic Syndrome

5.1 Epidemiological Studies

5.2 Nut Intervention Trials

6. Cognition

6.1 Epidemiological Studies

6.2 Nut Intervention Trials

7. Conclusion and Future Trends

References

16 - New Concepts and Paradigms for the Protective Effects of Plant-Based Food Components in Relation to Food Complexity

1. Introduction

2. Plant-Based Food Groups and Their Bioactive Compounds: An Emphasis on Food Structure

2.1 Carbohydrates, Proteins, and Lipids

2.1.1 The Carbohydrate Fraction

2.1.2 The Lipid Fraction

2.1.3 The Protein Fraction

2.2 Vitamins, Minerals, and Trace Elements

2.2.1 Vitamins

2.2.2 Minerals and Trace Elements

2.3 Fiber- and Phenolic-Type Compounds, Carotenoids, and Other Bioactive Phytochemicals

2.3.1 Fiber-Type Components

2.3.1.1 SOLUBLE VERSUS INSOLUBLE FIBER

2.3.1.2 THE FIBER COPASSENGERS

2.3.2 Polyphenol-Type Components

2.3.3 Other Bioactive Phytochemicals

3. Compound Packages and Synergistic Effects: A Holistic Picture of Plant-Based Foods

3.1 The Concept of Compound Packages

3.2 Synergy, Complementarity, and Multifunctionality

3.3 From a Reductionist to a Holistic Picture of Plant-Based Bioactive Compounds

4. Processing, Bioactive Compounds, and Plant Health Potential

4.1 Thermal Treatments and Bioactive Compounds

4.2 Refining and Bioactive Compounds

4.3 Fermentation, Germination and Soaking, and Bioactive Compounds

5. Conclusions

References

3 - The Relations Between Vegetarian Diets and Health and Disease

17 - Bone Health and Vegan Diets

1. Introduction

2. Bone Status in Individuals With Vegan Diets

3. Vegan Diets and Bone Health

4. Dairy Substitutes and Their Bone Benefiting Nutrients

4.1 Calcium

4.2 Vitamin D

5. Dietary Protein: Are Plant Sources Beneficial to Bone?

6. Vitamin B12 Is Important for Bone Health

7. Zinc

8. n-3 Fatty Acids

9. Protective Nutrients in Vegan Diets

10. Conclusions

References

18 - Weight Maintenance and Weight Loss: The Adoption of Diets Based on Predominantly Plants

1. Introduction

2. Population Studies

3. Clinical Trials

4. Mechanisms

4.1 Energy Density

4.2 Macronutrients: Protein, Fat, and Carbohydrate

4.3 Gut Microbiota, Inflammation, and Obesity

5. Conclusion

References

19 - Cancer Risk and Vegetarian Diets

1. Introduction

2. How Can Diet Affect Cancer?

3. Established Associations of Diet With Cancer Risk

4. The Evidence Available on Cancer Risk and Vegetarian Diets

4.1 The Role of Body Mass Index and Obesity

5. Cancers of the Upper Gastrointestinal Tract and Stomach

6. Colorectal Cancer

7. Cancer of the Pancreas

8. Lung Cancer

9. Breast Cancer

10. Cancer of the Endometrium

11. Cancer of the Cervix

12. Cancer of the Ovary

13. Prostate Cancer

14. Cancers of the Lymphatic and Hematopoietic Tissue

15. Other Types of Cancer

16. All Cancers Combined

17. Conclusions

References

Further Reading

20 - Vegetarian Diets and the Risk of Type 2 Diabetes

1. Introduction

2. Diabetes Prevalence in Vegetarians

2.1 Seventh-Day Adventist Populations

2.2 Other Western Populations

2.3 Asian Populations

3. Diabetes Incidence in Vegetarians

4. Meat Intake and Risk of Diabetes

5. Metabolic Syndrome and Components

5.1 Vegetarian Diets and Metabolic Syndrome

5.1.1 Lipids, Body Weight, and Glucose

5.1.2 Blood Pressure

5.1.3 Metabolic Syndrome

5.2 Meat Consumption and Metabolic Syndrome

6. Insulin Resistance and Sensitivity

6.1 Vegetarian Diets and Insulin Resistance and Sensitivity

6.1.1 Observational Studies

6.1.2 Intervention Studies

6.2 Meat Consumption and Insulin Resistance

7. Discussion

8. Conclusions

References

21 - Vegetarian Diets in People With Type 2 Diabetes

1. Introduction

2. Vegetarian Diets in the Treatment of Type 2 Diabetes

2.1 Cardiovascular Risk Factors

2.1.1 Glycemic Control and Insulin Sensitivity

2.1.2 Body Weight and Metabolic Syndrome

2.1.3 Blood Pressure

2.1.4 Blood Lipids

2.1.5 Platelet Aggregation

2.1.6 Atherosclerosis

2.1.7 Oxidative Stress

2.2 Microvascular Complications

2.2.1 Diabetic Nephropathy

2.2.2 Diabetic Neuropathy

2.2.3 Diabetic Retinopathy and Macular Degeneration

2.3 Quality of Life, Mood, and Eating Behavior

3. Healthy Components of a Vegetarian Diet Related to Diabetes

3.1 Possible Mechanisms of Positive Effects of Vegetarian Diets on Diabetes

3.1.1 Energy Restriction

3.1.2 Reduced Intake of Saturated Fatty Acids

3.1.3 High Intake of Polyunsaturated Fatty Acids

3.1.4 High Intake of Monounsaturated Fatty Acids

3.1.5 Low Glycemic Index

3.1.6 High Intake of Fiber

3.1.7 High Intake of Antioxidants, Vitamins, and Micronutrients

3.1.8 Reductions in Heme-Iron Intake

3.1.9 High Intake of Vegetable Proteins Instead of Animal Proteins

3.1.10 High Intake of Plant Sterols

3.2 Meal Suggestions

3.3 Seven Most Common Mistakes When Starting a Vegetarian Diet in Diabetes

3.4 Practical Aspects of Changing a Diet in Patients With Diabetes

4. Official Position Statements on Vegetarian Diets

5. Conclusions

References

Further Reading

22 - Blood Pressure and Vegetarian Diets

1. Epidemiology of Blood Pressure

2. Vegetarian Diets and Blood Pressure

2.1 Cross-Sectional Studies With High Percentages of Vegetarian Participants

2.2 Meta-analysis of Observational Studies

2.3 Meta-analysis of Clinical Trials

2.4 Update Search After Meta-analysis

3. Possible Mechanisms

3.1 Nutrition-Related Factors Affecting Vegetarians

3.2 Key Foods and Nutrients for Vegetarians

3.3 Key Foods and Nutrients Effective in Lowering Blood Pressure

3.3.1 Fruits and Vegetables

3.3.2 Legumes

3.3.3 Nuts

3.3.4 Minerals

3.3.5 Protein Source

3.3.6 Specific Amino Acids

3.3.7 Vitamin C

3.3.8 Vitamin B12

3.3.9 Antioxidants

3.3.10 Fiber

3.3.11 Microbiome

4. Conclusion

References

23 - Ischemic Heart Disease in Vegetarians and Those Consuming a Predominantly Plant-Based Diet

1. Introduction

1.1 Epidemiological Evidence

2. Effects of Vegetarianism and Plant-Based Diets on Major Cardiovascular Risk Factors

2.1 Body Fatness

2.2 Blood Pressure

2.3 Lipids and Lipoproteins

2.4 Diabetes and Insulin Sensitivity

2.5 Other Risk Determinants

3. Effects of Individual Plant-Based Foods and Dietary Patterns on Cardiovascular Risk

3.1 Nuts

3.2 Whole Grains

3.3 Fruit and Vegetables

3.4 Dietary Patterns

4. Conclusion

References

24 - Vegetarian Diets and the Microbiome

1. Introduction

2. Background

2.1 Microbiome Methodologies

2.2 The Human Microbiome

3. The Microbiome in Health and Disease

3.1 Infectious Diseases

3.2 Inflammation and Inflammatory Diseases

3.3 Obesity

3.4 Diabetes Mellitus

3.5 Cardiovascular Disease

3.6 Cancer

4. Diet and the Microbiome

4.1 Probiotics and Fermented Foods

4.2 Carbohydrates and Prebiotics

4.3 Fats

4.4 Proteins

4.5 Phytochemicals

4.6 Artificial Compounds and Food Additives

4.7 Dietary Patterns

5. Vegetarian Diets and the Microbiome

5.1 International Comparisons

5.2 Feeding Studies

5.3 Early Studies of Vegetarians

5.4 Recent Studies of Vegetarians

5.5 Summary

6. Conclusions and Future Directions

References

25 - Vegetarianism and the Risk of Gastroesophageal Reflux Disease

1. Introduction

2. Obesity and GERD Development

3. Vegetarian Diet and GERD Prevention

4. Conclusion

References

26 - Defecation and Stools in Vegetarians: Implications in Health and Disease

1. Introduction

2. Frequency of Bowel Movements

3. Form and Consistency of Stool

4. Vegetarian Diet and Constipation

4.1 Fecal Microbiota Composition in Vegetarians

5. Vegetarian Diet and Gastrointestinal Diseases

5.1 Effect of Vegetarian Diet on Irritable Bowel Syndrome

6. Impact of Vegetarian Diet in Inflammatory Bowel Disease

7. Vegetarian Diet and Diverticular Diseases

8. Impact of Vegetarian Diet on Colorectal Carcinoma

9. Conclusions

References

27 - Plant-Based Diets and Asthma

1. Introduction

2. Asthma Prevalence and Diet

3. Asthma Control and Diet

4. Asthma Lung Function and Diet

5. Asthma Exacerbation and Diet

6. Relationship Between Plant-Based Diets and Asthma

7. Conclusion

References

Further Reading

28 - Vegetarian Diet and Possible Mechanisms for Impact on Mood

1. Overview

2. Evidences That Vegetarian Diets May Favorably Impact Mood

3. Antiinflammatory Properties of Vegetarian Diets

3.1 The Proinflammatory Cytokines

3.2 The Proinflammatory Prostaglandin PGE2

4. Neurotransmitter Action and Vegetarian Diets

4.1 Serotonin

4.1.1 Dietary Tryptophan

4.1.2 Vitamin B6

4.2 Norepinephrine

5. Conclusion

References

4 - Life Events

29 - Vegetarian Infants and Complementary Feeding

1. Introduction

2. Vegetarian Complementary Solid Food, Macronutrients, and Micronutrients Requirements

2.1 Energy in Infants (7–12Months)

2.2 Protein in Infants (7–12Months)

2.3 Lipids in Infants (7–12Months)

2.4 Carbohydrates in Infants (7–12Months)

2.5 Iron in Infants (7–12Months)

2.6 Zinc in Infants (7–12Months)

2.7 Calcium in Infants (7–12Months)

2.8 Sodium in Infants (7–12Months)

2.9 Vitamin B12 in Infants (7–12Months)

3. Conclusion

4. Nutritional Advices in Vegetarian Infants (0–12Months)

References

30 - Nutritional Status of Vegetarian Children

1. Energy

2. Proteins

3. Fats

4. Carbohydrates and Dietary Fiber

5. Sodium and Potassium

6. Calcium

7. Phosphorus

8. Magnesium

9. Iron

10. Zinc

11. Selenium

12. Iodine

13. Vitamin A

14. Vitamin B1

15. Vitamin B2

16. Vitamin B6

17. Vitamin B12

18. Vitamin C

19. Vitamin D

20. Vitamin E

21. Vitamin K

22. Conclusion

References

Further Reading

31 - Food and Meals in Vegetarian Children and Adolescents

1. Introduction

2. Food-Based Dietary Guidelines for Vegetarian Children and Adolescents

2.1 Principles

2.2 Sample Menus for Vegetarian Diets

2.3 Analysis of Nutrient Intake

3. Food Groups in Detail

3.1 Beverages

3.2 Vegetables and Fruit

3.3 Nuts and Seeds

3.4 Legumes

3.5 Whole Grains

3.6 Special Vegetarian Food Products

3.6.1 Dairy and Vegan Dairy Substitutes

3.7 Meat Substitutes

4. Eggs

5. Sweets and Snacks

6. Supplements and Fortification

7. Conclusion and Perspective

Acknowledgment

References

32 - Vegetarian and Plant-Based Diets in Pregnancy

1. Background

2. Vegetarian Diets in Pregnancy: The Reviews

3. Vegetarian Diets in Pregnancy: Four Major Categories, According to the Reasons of Choice

4. What Is a “Well-Balanced” Vegetarian Diet in Pregnancy?

5. The “Healthy and Wealthy”: The Benefits of the Vegetarian Diet in Preventing Diseases

6. The “Poor and Obliged”: The Main Side Effects of Low Quality in Vegetarian Diets

7. The “Nutritionally Disturbed”: The Main Side Effects of Low Quantity in Vegetarian Diets

8. The “Sick and Controlled”: The Benefits of the Vegetarian Diets in Counteracting Kidney Diseases

9. Conclusions

References

33 - Vegetarian Diet and Menopausal Women

1. Introduction

2. Bone Health

3. Breast Cancer

4. Cardiovascular Disease, Diabetes

4.1 Cardiovascular Disease

4.2 Diabetes

5. Conclusion

References

34 - Nutritional Profiles of Elderly Vegetarians

1. Introduction

2. Overview of Studies on Elderly Vegetarians

2.1 North America

2.2 Western Europe

2.3 Chinese Vegetarians

3. Nutritional Profiles of Elderly Vegetarians

3.1 Diet and Death

3.2 BMI and Energy Intake

3.3 Blood Cholesterol and Related Nutrients (Fats, Cholesterol, Fiber)

3.4 Blood Pressure and Related Nutrients

3.5 Bone Mineral Density and Related Nutrients

4. Energy Macronutrients

4.1 Protein Intake

4.2 Total Fat

4.3 Carbohydrate

4.4 Sugar (Mono- and Di-Saccharides)

4.5 Omega-3 Fatty Acids

5. Minerals

5.1 Iron

5.2 Zinc

5.3 Selenium

5.4 Iodine

6. Vitamins

6.1 Folate

6.2 Vitamin B12

6.3 Vitamin C

6.4 Vitamin D

7. Conclusion

7.1 Nutritional Status

7.2 Research Approach

Conflicts of interest

References

5 - Nutrients and Other Substances Intakeand Status

35 - Plant Protein, Animal Protein, and Protein Quality

1. Introduction

2. Initial Evaluations of Plant and Animal Protein Quality

3. Protein Quality Based on the Nitrogen Balance in Humans

4. Digestibility

5. Amino Acid Profiles and Requirements

6. Amino Acid Scores and Protein Digestibility Corrected Amino Acid Score (PDCAAS) of Plant Proteins

7. PDCAAS as a Proxy for the Protein Quality of Single Protein Sources

8. PDCAAS of Mixed Protein Diets and Protein Intake in Plant-Based Diets

9. Limitations of the AAS, PDCAAS, and DIAAS Approaches

10. Uncertainties Affecting Protein Quality Evaluation

11. When Might Protein Quantity and Quality Be Limiting With Respect to Protein Requirements?

12. Refining With Metabolic Aspects: the Timing of Protein and Amino Acid Intake and Protein Metabolism, Especially Among Older ...

13. Beyond Protein Metabolism? Functional Impacts

14. Conclusion

Acknowledgments

References

36 - Plant Protein, Animal Protein, and Cardiometabolic Health

1. Introduction

2. Plant Protein, Amino Acids, and Underlying Metabolism

2.1 Overall Changes to Background Amino Acid Metabolism

2.2 Could Some Amino Acids in Plant Versus Animal Protein Procure Specific Benefits?

3. Clinical Trials and Interventional Studies With Plant Protein

3.1 Plant Protein and Plasma Cholesterol

3.2 Plant Protein and Other Cardiometabolic Factors

3.3 Interventional Studies With Whole Diets

4. Observational Studies

5. Plant Protein, Nutrient Profile, and Overall Diet Quality

6. Conclusion

Acknowledgments

References

37 - Polyunsaturated Fatty Acid Status in Vegetarians

1. Introduction

2. Dietary Sources of Polyunsaturated Fatty Acids

3. Biomarkers of PUFA Intake

3.1 Influence of Omega-3 Supplementation on Biomarkers

4. Differences Between ALA and Long-Chain n-3 PUFA on Cardiovascular Risk

4.1 Serum Lipids and Lipoproteins

4.2 Blood Pressure, Hemostatic, and Inflammatory Risk Markers

4.3 Effects on Arterial Aging

4.4 Results From Prospective Cohort Studies With Clinical Endpoints

4.5 Intervention Trials With Clinical Endpoints

5. Conclusion

References

38 - Implications of a Plant-Based Diet on Zinc Requirements and Nutritional Status

1. Introduction

2. Plant-Based Diets

3. Food Sources and Bioavailability of Zinc

3.1 Zinc in Foods

3.1.1 Zinc Fortification

3.2 Zinc Bioavailability

3.2.1 Phytate

3.2.2 Phytate:Zinc Molar Ratio

4. Dietary Zinc Recommendations

5. Whole-Body Zinc Homeostasis

6. Zinc Status Throughout the Life Cycle

6.1 Zinc Status in Healthy Vegetarian Adults

6.1.1 High-Income Countries

6.1.2 Low- and Middle-Income Countries

6.2 Zinc Status in Pregnancy and Lactation

6.2.1 Pregnancy

6.2.2 Lactation

6.3 Zinc Status in Infants, Young Children, and Adolescents

6.3.1 High-Income Countries

6.3.2 Low- and Middle-Income Countries

6.4 Summary

7. Translating Research Into Practice

7.1 Meeting Zinc Recommendations in Individuals

7.2 Research in Populations: Translational Implications

7.3 Strategies for Improving the Zinc Bioavailability of Plant-Based Diets

8. Conclusions

References

39 - Plant-Based Diets and Iron Status

1. Introduction

2. Iron Sources in the Diet, Iron Metabolism, and Assessment of Iron Status

2.1 Iron Metabolism

2.2 Assessment of Iron Status

3. Iron Bioavailability in Different Dietary Components and Composite Diets

3.1 Enhancers of Iron Absorption

3.1.1 Ascorbic Acid

3.1.2 Muscle Protein

3.2 Inhibitors of Iron Absorption

3.2.1 Phytic Acid

3.2.2 Polyphenols and Tannins

3.2.3 Calcium

3.3 Complete Diets and Iron Bioavailability

3.4 Iron Fortification and Biofortification

4. Iron Status and Plant-Based Diets

4.1 Predictors of Iron Status in Epidemiological Studies

4.2 Iron Status in Vegetarians

4.2.1 Pregnancy

4.2.2 Children

5. Conclusions

References

40 - Plant-Based Diets and Selenium Intake and Status

1. Introduction

2. Importance of Selenoproteins for Human Health

3. Selenium Metabolism and Selenium Transport in Humans

4. Biomarkers of Selenium Status

5. Selenium Content in Food Items

6. Selenium Status of Ovolactovegetarians and Vegans

7. Health Risks of Insufficient Se Intake

8. Conclusions

References

41 - B Vitamins Intake and Plasma Homocysteine in Vegetarians

1. Introduction

2. Vegetarianism

2.1 Classification of Vegetarians

2.2 Homocysteine Status of Vegetarians Compared to Omnivores

3. What Is Homocysteine?

3.1 The Metabolism of Homocysteine

3.1.1 Methionine Cycle in Its Role in Homocysteine Formation

3.1.2 Folate Cycle

3.1.3 Transsulfuration Pathway

3.1.4 The Trimethylglycine Reaction

3.1.5 Impact of Methionine on Status of Plasma tHcy of Vegetarians

4. Homocysteine-Related Nutrients

4.1 Recommended Dietary Allowances and Adequate Intakes

4.2 Supporting Evidence for Nutritional Causes of Elevated Homocysteine

5. Cobalamin

5.1 Origins

5.1.1 Summary of Types of Cobalamin (Vitamin B12)

5.1.1.1 CYANOCOBALAMIN

5.1.1.2 METHYLCOBALAMIN

5.1.1.3 HYDROXOCOBALAMIN

5.1.1.4 ADENOSYLCOBALAMIN

5.1.1.5 PSEUDOVITAMIN B12

6. Impact of Elevated Plasma tHcy

7. Main Conclusions

References

Further Reading

42 - Iodine Status, Thyroid Function, and Vegetarianism

1. The Thyroid and Iodine

2. Thyroid Health and Nutrition in Pregnancy

3. Nutrients and Dietary Compounds Affecting Thyroid Function

4. Iodine Nutrition, Food Sources

4.1 Dairy, Fish

4.2 Salt

4.3 Seaweed

4.4 Supplements

5. Assessing Iodine Sufficiency and Iodine Intake

6. Iodine Intake and Status in Ovolactovegetarians and Vegans

7. Iodine Status

8. Supplement Usage

9. Selenium and Iron Intake and Status

10. Iodine Toxicity: Prevalence in General and Links to Thyroid Health

11. Thyroid Diseases and Vegetarianism

12. Goitrogens and Thyroid Function

13. Final Considerations: Nutritional Knowledge of Ovolactovegetarians and Vegans

References

Further Reading

43 - Vitamin B12 Deficiency in Vegetarians

1. Vitamin B12 and Its Metabolism

2. Vitamin B12 Sources and Hemostasis

3. Vitamin B12 Deficiency

3.1 Vitamin B12 Status and Vegetarian Diet

3.2 Vitamin B12 Deficiency in Early Life

3.3 Diagnosis of Vitamin B12 Deficiency

3.4 Modern and Traditional Biomarkers for Metabolic Vitamin B12 Deficiency

4. Clinical Manifestations of Vitamin B12 Deficiency

4.1 Hematological Symptoms

4.2 Neurological Complications

4.3 Vitamin B12 Deficiency and Osteoporosis

5. Conclusion

References

Further Reading

44 - Probiotics in Nondairy Products

1. Introduction

2. The Gut Microbiota–Probiotic Axis

3. Probiotic Bacteria in Fermented Dairy Products: What Was Lost After the Industrial Revolution Is Being Recovered Today

4. Health Benefits of Probiotic Bacteria

5. Functionality of Probiotic Bacteria: The Food Matrix Matters

6. Opportunities and Challenges for Probiotic Bacteria in Nondairy Foods

7. Plant Material and Technological Strategies for the Development of Nondairy Probiotic Products

7.1 Nondairy Plant-Based Probiotic Beverages Derived From Uncontrolled Fermentations

7.2 Nondairy Plant-Based Probiotic Beverages Derived From Controlled Fermentation

7.3 Nondairy Plant-Based Beverages Added With Probiotic Cultures

8. Human Clinical Trials Supporting the Health Benefits of Probiotics in Nondairy Plant-Based Foods

9. Concluding Remarks

References

45 - Exposure to Pesticide Residues and Contaminants of the Vegetarian Population—French data

1. Introduction

2. Dietary Exposure to Pesticide Residues

3. Dietary Exposure to Environmental Contaminants

3.1 Trace Elements

3.1.1 Summary for Trace Elements

3.2 Persistent Organic Pollutants

3.2.1 Exposure to PCB, Dioxins, and Furans

3.2.1.1 EXPOSURES OF THE VEGETARIAN POPULATION

3.2.1.2 EXPOSURES OF THE VEGAN POPULATION

3.2.1.3 EXPOSURES OF THE NONVEGAN POPULATION

3.2.2 Perfluoalkyl Acids

3.2.3 Brominated Flame Retardants (BFR)

3.2.4 Summary for Persistent Organic Pollutants

3.3 Mycotoxins

3.3.1 Summary for Mycotoxins

3.4 Phytoestrogens

4. Conclusion

References

Index

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

X

Y

Z

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