Breast cancer (BC) is one of the leading causes of death and morbidity among women worldwide. Epidemiologic evidence shows that the risk of BC and other chronic diseases decreases as the proportion of whole plant foods increases, while the proportion of animal foods (fish, meat, poultry, eggs, seafood, and dairy products) and non-whole plant foods (e.g., refined grains, added sugars, French fries) in the diet decreases. Whole plant foods include fruits, vegetables, roots, tubers, whole grains, legumes, nuts, and seeds from which no edible part has been removed and to which no non-whole food been added. A whole plant foods diet lowers insulin resistance, inflammation, excess body fat, cholesterol, and insulin-like growth factor 1 and sex hormone bioavailability; it also increases estrogen excretion, induces favorable changes in the gut microbiota, and may also favorably affect mammary microbiota composition and decrease the risk of early menarche, all contributing to reduced BC incidence, recurrence, and mortality. This review explores the connection between a whole plant foods diet and BC risk and mortality as well as the potential mechanisms involved. Additionally, this diet is compared with other dietary approaches recommended for BC. A whole plant foods diet seems the optimal dietary pattern for BC and overall disease prevention as it exclusively consists of whole plant foods which, based on existing evidence, lead to the best health outcomes.

It is the position of the Academy of Nutrition and Dietetics that, in adults, appropriately planned vegetarian and vegan dietary patterns can be nutritionally adequate and can offer long-term health benefits such as improving several health outcomes associated with cardiometabolic diseases. Vegetarian dietary patterns exclude meat, poultry, and seafood, and vegan dietary patterns exclude all foods of animal origin. Registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs) play a pivotal role in providing meal-planning strategies and evidence-based nutrition information to clients currently following vegetarian or vegan dietary patterns or who may benefit from and express interest in following vegetarian or vegan dietary patterns. RDNs and NDTRs can work with their clients to create tailored, lifestyle-oriented, nutritionally balanced, and culturally suitable vegetarian and vegan dietary patterns that optimize health benefits while reducing concerns about nutrient inadequacies. Adults follow vegetarian and vegan dietary patterns for various reasons. The aim of this position paper is to inform health care practitioners, including RDNs and NDTRs, about the evidence-based benefits and potential concerns of following vegetarian and vegan dietary patterns for different populations of nonpregnant, nonlactating adults. This position paper is supported by current evidence, including several systematic reviews. As leaders in evidence-based nutrition care, RDNs and NDTRs should aim to support the development and facilitation of vegetarian and vegan dietary patterns and access to nutrient-dense plant-based meals. Promoting a nutrient-balanced vegetarian dietary pattern on both individual and community scales may be an effective tool for preventing and managing many diet-related conditions. This position was approved in January 2025 and will remain in effect until December 31, 2032.

Plant-based diets are associated with favourable cardiovascular health markers. Although increasingly consumed among younger demographics, it is unclear how plant-based diet quality tracks from adolescence to young adulthood, and how this impacts cardiovascular health later in life. Thus, this study aimed to explore trajectories of plant-based dietary patterns from adolescence to young adulthood and investigate associations with cardiometabolic health markers in young Australian adults.

Longitudinal data from 417 participants from the Raine Study were included. Semi-quantitative food frequency questionnaires conducted at 14, 20, and 27 years of were used to derive three plant-based diet quality index scores: an overall plant-based diet (PDI), a healthy plant-based diet (hPDI), and a less healthy plant-based diet (uPDI). Markers of cardiometabolic health included waist circumference, blood lipids, and blood pressure obtained at 14 and 28 years of age. Group-based trajectory modelling was used to describe plant-based diet quality trajectory groups from adolescence to young adulthood. Multivariate linear regression models were used to investigate associations with cardiovascular health markers.

Plant-based diet quality trajectory groups were different by sex, but remained relatively stable over the life stages, with participants remaining either above or below average diet quality at all time points. Associations with cardiovascular health outcomes differed between the sexes, with the hPDI having the greatest number of associations for females, and the uPDI for males. Being female with a higher hPDI score was associated with lower insulin (β = -1.11 (95% CI -2.12, -0.09)), HOMA-IR (β = -0.25 (95% CI -0.48, -0.01)), systolic blood pressure (β = -2.75 (95% CI -5.31, -0.19)), and hs-CRP (β = -1.53 (95% CI -2.82, -0.23)), and higher HDL-cholesterol (β = 0.13 (95% CI -0.03, 0.23)) compared to females with lower hPDI scores. Being male in the higher scoring uPDI group was associated with higher waist circumference (β = 3.12 (95% CI 0.61, 5.63)), waist-to-height ratio (β = 0.02 (95% CI 0.01, 0.03)), insulin (β = 1.54 (95% CI 0.33, 2.76)), HOMA-IR (β = 0.35 (95% CI 0.07, 0.63)), and hypertension status (β = 6.60 (95% CI 1.04, 42.00)) when compared to the lower scoring uPDI group.

This study provides new insights into how plant-based diets track across adolescence into adulthood, impacting on cardiometabolic risk factors differently for males and females. Findings highlight the importance of early sex-specific interventions in adolescence to reduce future risk of cardiovascular-disease.

Evidence shows that the consumption of plant foods, particularly those in their whole form (fruits, vegetables, whole grains, nuts, seeds, and legumes from which no edible part has been removed), improves cardiometabolic risk factors and is associated with reduced risk of cardiovascular diseases (CVDs), diabetes, cancer, chronic kidney disease and mortality compared with animal (meat, fish, eggs and dairy) and nonwhole plant foods (sugar-sweetened beverages, refined grains, etc.). Erectile dysfunction (ED) is considered a strong predictor of CVD. The underlying defect in arteriogenic ED is endothelial dysfunction. A plant-based diet focused on whole plant foods could enhance penile erection as it improves endothelial function through various mechanisms. First, it provides nitrates, L-arginine, and L-citrulline, substrates for nitric oxide production. In addition, this diet lowers low-density lipoprotein cholesterol, trimethylamine N-oxide, postprandial triglycerides, advanced glycation end product, inflammation, and vasoconstrictors levels, contributing to higher nitric oxide concentrations, increased endothelial progenitor cells preservation and decreased arterial stiffness. This review explores the epidemiological evidence of a plant-based diet emphasizing whole plant foods on ED and the potential biological pathways involved.

Background: Environmental and cardiometabolic impacts of adherence to plant-based dietary patterns with different quality are unclear. Objectives: To investigate the associations between adherence to the overall, healthy, and unhealthy plant-based dietary patterns, as assessed by the plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI), respectively, and risk of myocardial infarction (MI), type 2 diabetes (T2D), stroke, and all-cause mortality and greenhouse gas (GHG) emissions. Methods: Data from adults (N = 14,652 for cardiometabolic diseases and 15,318 for all-cause mortality) in the China Health and Nutrition Survey (1997-2015 wave) were analyzed. PDI, hPDI, and uPDI scores were calculated with dietary intake data. The total GHG emissions were calculated by summing the amount of emissions from all food groups included in the index. Cox proportional hazard regression models and linear regression models were used for statistical analysis. Results: Greater adherence to an unhealthy plant-based dietary pattern, as reflected by higher uPDI scores, was positively associated with risk of MI (Q5 vs. Q1: HR = 5.90; 95% CI: 2.59-13.48), T2D (Q5 vs. Q1: HR = 2.18; 95% CI: 1.75-2.73), stroke (Q5 vs. Q1: HR = 5.96; 95% CI: 2.86-12.42) and all-cause mortality (Q5 vs. Q1: HR = 6.87; 95% CI: 4.70-10.03). PDI scores were inversely associated with the risk of MI, T2D, and all-cause mortality, and hPDI scores were inversely and positively associated with the risk of T2D and stroke, respectively. All scores were inversely associated with GHG emissions (all p-trends < 0.001). Conclusions: Long-term adherence to unhealthy plant-based dietary patterns guided by higher uPDI scores may be a risk factor for new-onset cardiometabolic diseases and all-cause death in Chinese adults. Food-based dietary guidelines, clinicians, and dietitians should consider the quality of plant-based dietary patterns prior to making recommendations for both healthy individuals and those with elevated cardiometabolic disease risk.

Chronic kidney disease (CKD) is highly prevalent among people with diabetes. While identifying modifiable risk factors to prevent a decline in kidney function among those living with diabetes is pivotal, there is limited evidence on dietary risk factors for CKD. In this study, we examined the associations between healthy and less healthy plant-based diets (PBDs) and the risk of CKD among those with diabetes, and to identify potential underlying mechanisms.

We conducted a prospective analysis among 7,747 UK Biobank participants with prevalent diabetes. Multivariable Cox proportional hazard regression models were used to examine the associations between healthful and unhealthful PBDs and the risk of CKD. Causal mediation analyses were further employed to explore the underlying mechanisms of the observed associations.

Among 7,747 study participants with diabetes, 1,030 developed incident CKD over 10.2 years of follow-up. Higher adherence to a healthy PBD was associated with a 24% lower CKD risk (HRQ4 versus Q1: 0.76 [95%CI: 0.63-0.92], ptrend = 0.002), while higher adherence to an unhealthy PBD was associated with a 35% higher risk (HRQ4 versus Q1: 1.35 [95%CI: 1.11-1.65], ptrend = 0.006). The observed associations were predominantly mediated by markers of body fatness (proportion mediated: 11-25%) and kidney function (23-89%).

In this prospective cohort study of middle-aged adults with diabetes, adherence to a healthy PBD was associated with lower CKD risk, whereas adherence to an unhealthy PBD was associated with a higher CKD risk. Associations were primarily mediated by markers of lower body fatness and improved kidney function.

The risk factors for type 2 diabetes mellitus (T2DM) have been increasingly researched, but the lack of systematic identification and categorization makes it difficult for clinicians to quickly and accurately access and understand all the risk factors, which are categorized in this paper into five categories: Social determinants, lifestyle, checkable/testable risk factors, history of illness and medication, and other factors, which are discussed in a narrative review. Meanwhile, this paper points out the problems of the current research, helps to improve the systematic categorisation and practicality of T2DM risk factors, and provides a professional research basis for clinical practice and industry decision-making.

Excess body adiposity, referred to as overweight and obesity, represents a major health concern given that it increases the risk of various diseases, including cardiovascular diseases, type 2 diabetes, and cancer. Body weight reduction can be achieved via a wide variety of dietary strategies as long as an energy deficit is achieved. However, the effect of such diets on disease risk and mortality will depend on the foods included. Increasing evidence shows that consumption of whole plant foods (e.g., fruits, vegetables, whole grains, nuts, seeds, legumes) in place of animal foods (e.g., meat, poultry, dairy, fish, eggs, and seafood and their derivatives) and non-whole plant foods (e.g., refined grains, French fries, sugar-sweetened beverages) is associated with improvements in cardiometabolic risk factors and lower risk of chronic diseases and mortality. This review focuses on the effect of a whole plant-foods diet on overweight and obesity from observational to clinical studies and discusses the potential mechanisms involved. According to existing evidence, a whole plant foods diet seems to be more advantageous than other dietary approaches for the prevention and treatment of excess adiposity given that it is composed of the foods that lead to the best health outcomes.

The global incidence of prediabetes and type 2 diabetes mellitus (T2DM) has increased substantially in recent years. Among the established, modifiable lifestyle factors associated with favorable prediabetes and T2DM risk, healthy dietary patterns have attracted considerable attention.

The association between adherence to plant-based dietary pattern indices (PDIs), including the overall PDI (O-PDI), healthy PDI (H-PDI), and unhealthy PDI (U-PDI), and the risk of prediabetes and T2DM was investigated in this study.

A literature search was conducted of the PubMed/Medline, Scopus, and Web of Sciences databases from their inception to February 2024. A systematic review and meta-analysis were conducted using random effects models and dose-response analyses. The Cochran Q test and the I2 statistic were used to evaluate heterogeneity between studies.

A total of 16 publications, with data on a total of 721 012 participants, were identified for the meta-analysis.

According to a pooled analysis, compared with the lowest category of O-PDI and H-PDI adherence, the highest category was associated with a 14% and 19% reduction in T2DM risk, respectively, for O-PDI (effect size [ES] = 0.86; 95%CI, 0.82-0.90; I2 = 57.7) and H-PDI (ES = 0.81; 95%CI, 0.75-0.88; I2 = 82.6). Greater adherence to U-PDI was significantly associated with an 10% increase in the risk of T2DM (ES = 1.10; 95%CI, 1.04-1.16). Consistent associations were found within the predetermined subgroups. As well, there was a nonlinear inverse association between O-PDI, H-PDI, and T2DM risk. No significant association was found between adherence to O-PDI (ES = 0.87; 95%CI, 0.75-1.01; I2 = 68%), H-PDI (ES = 0.99; 95%CI, 0.87-1.13; I2 = 0.0%), and U-PDI (ES = 1.09; 95%CI, 0.94-1.21; I2 = 22.9%) and risk of prediabetes.

These findings underscore the importance of dietary selections within the framework of a plant-based dietary pattern, particularly when incorporating healthful, plant-based foods, which may have potential benefits in reducing the T2DM risk.

PROSPERO registration no. CRD42023459851.

Limiting and/or slowing down the starch digestion process and consequently the release of glucose can be an important strategy for the prevention of type 2 diabetes (T2D). The aim of the current in vitro study was to assess the anti-diabetic and antioxidant potential of red radish leaves of the Carmen, Jutrzenka, Saxa, and Warta cultivars. In the context of anti-diabetic activity, the effect of leaves on potato starch digestion and free glucose binding, as well as inhibitory effects of leaf extracts against α-amylase and α-glucosidase and non-enzymatic glycation (AGEs) were determined. The basic chemical composition, quantitative composition of phenolic compounds, and antioxidant activity of leaves were also estimated. This study showed that all radish leaves inhibited the breakdown of potato starch and showed their ability to bind glucose. This activity was correlated with the content of hydroxycinnamic acids, protein and dietary fiber while flavones was probably responsible for glucose binding. Leaf extracts inhibited α-glucosidase activity and formation of AGEs but were practically inactive towards α-amylase. Inhibition of α-glucosidase activity was related to the content of proanthocyanidins and inhibition of AGEs formation to flavonols. These results point to radish leaves, especially the Warta and Jutrzenka cultivars, as a potential natural remedy for treating T2D.

Plant-based dietary patterns, including vegetarian and vegan dietary patterns, may help to manage type 2 diabetes (T2DM) by contributing to maintenance of a healthy body weight, improved glycemic control, and reduced risk of diabetes complications. Several diabetes clinical practice guidelines support the use of vegetarian dietary patterns, but there has not been a recently updated systematic review (SR) of evidence from randomized controlled trials (RCTs) to examine efficacy. The primary objective of this SR was to examine the effect of vegetarian dietary patterns compared with nonvegetarian dietary patterns in adults with T2DM. MEDLINE, CINAHL, Cochrane CENTRAL Database of Controlled Trials, Food Science Source, and SportsDiscus databases were searched for RCTs published from 1998 to May 2023. Two independent reviewers extracted data and assessed risk of bias using the Cochrane RoB 2 tool. Data were pooled using a DerSimonian-Laird random-effects model and expressed as mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Full texts of 66 articles were reviewed, and 7 RCTs (n = 770 participants) were included in this SR. Vegetarian dietary patterns likely reduce hemoglobin A1c [MD (95% CI): -0.40% (-0.59, -0.21)] and body mass index [MD (95% CI): -0.96 kg/m2 (-1.58, -0.34)] (moderate certainty evidence); may allow for reduced diabetes medication (in 2 of 3 included studies) (low certainty); and may improve metabolic clearance of glucose (insulin sensitivity) [MD (95% CI): 10% (1.86, 18.14)] (very low certainty), compared with nonvegetarian dietary patterns. There were no effects of vegetarian dietary patterns on fasting blood glucose, fasting insulin, or low-density lipoprotein cholesterol concentrations. These findings support the inclusion of vegetarian or vegan dietary patterns as options in nutrition care plans for adults with T2DM. PROSPERO REGISTRATION: CRD42023396453.

The investigation of dietary micronutrient intakes and risk of alcoholic liver disease (ALD) based on observational studies was limited.

Our study aimed to explore the associations of 30 dietary micronutrients intakes with risk of ALD, interactions between dietary micronutrients and genetic variation, and mediation effects of blood and urinary biomarkers on the associations between dietary micronutrients and risk of ALD.

A case-control study was conducted within the UK Biobank cohort, with 231 incident ALD cases and 1386 controls. Dietary data were collected using a dietary questionnaire that relied on a 24-h dietary recall of the previous day. Logistic regression models were employed to assess the associations of dietary micronutrient intakes with risk of ALD. We conducted stratified analyses on the associations between dietary micronutrient intakes and risk of ALD by PNPLA3 rs738409 and tested the interactions between dietary micronutrients and genetic variation. In addition, we conducted mediation analyses to investigate the mediating effects of biomarkers on the associations between dietary micronutrients and risk of ALD.

Our findings indicated significant inverse associations of thiamin, riboflavin, niacin equivalent, pantothenic acid, vitamin B-6, folate, vitamin E, calcium, magnesium, phosphorus, potassium, copper, iodine, and manganese with risk of ALD (all false discovery rate-Ptrend < 0.050). We also found a significant interaction between PNPLA3 rs738409 and magnesium (Pinteraction = 0.028). Creatinine (enzymatic) in urine, aspartate aminotransferase, and insulin-like growth factor 1 were the top 3 biomarkers with the highest number of significant mediation effects on the associations between the dietary micronutrients and risk of ALD.

Dietary intakes of thiamin, riboflavin, niacin equivalent, pantothenic acid, vitamin B-6, folate, vitamin E, calcium, magnesium, phosphorus, potassium, copper, iodine, and manganese were inversely associated with risk of ALD.

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic kidney disorder with multiple cyst formation that progresses to chronic kidney disease (CKD) and end-stage kidney disease. Plant-based diets have attracted considerable attention because they may prevent CKD development. This study investigated whether adherence to a plant-based diet is associated with kidney function in patients with ADPKD. The overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) were calculated using dietary intake data. Among 106 ADPKD patients, 37 (34.91%) were classified as having advanced CKD (eGFR < 60 mL/min/1.73 m2). The overall PDI and hPDI were lower, but the uPDI was higher in patients with advanced CKD than in those with early CKD. The hPDI was negatively correlated with the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Moreover, the hPDI was inversely associated with advanced CKD [odds ratio (OR): 0.117 (95% confidence interval (CI): 0.039-0.351), p < 0.001], and the uPDI was positively associated with advanced CKD [OR: 8.450 (95% CI: 2.810-25.409), p < 0.001]. The findings of the current study demonstrate that greater adherence to a healthful plant-based diet is associated with improved kidney function in ADPKD patients.

Plant-based diets have gained attention for their potential benefits on both human health and environmental sustainability. The objective of this study was to investigate the association of plant-based dietary patterns with the endogenous metabolites of healthy individuals and identify metabolites that may act as mediators of the associations between dietary intake and modifiable disease risk factors. Adherence to plant-based dietary patterns was assessed for 170 healthy adults using plant-based diet indexes (PDI). Individuals with higher healthful PDI had lower BMI and fasting glucose and higher HDL-C, while those with higher unhealthful PDI had higher BMI, triacylglycerol and fasting glucose and lower HDL-C. Unhealthful PDI was associated with higher levels of several amino acids and biogenic amines previously associated with cardiometabolic diseases and an opposite pattern was observed for healthful PDI. Furthermore, healthful PDI was associated with higher levels of glycerophosphocholines containing very long-chain fatty acids. Glutamate, isoleucine, proline, tyrosine, α-aminoadipate and kynurenine had a statistically significant mediation effect on the associations between PDI scores and LDL-C, HDL-C and fasting glucose. These findings contribute to the growing evidence supporting the role of plant-based diets in promoting metabolic health and shed light on the potential mechanisms explaining their beneficial health effects.