Metabolic diseases including type 2 diabetes and obesity pose a significant global health burden. Plant-based diets, including vegan diets, are linked to favorable metabolic outcomes, yet the underlying mechanisms remain unclear. In a randomized trial involving 21 pairs of identical twins, we investigated the effects of vegan and omnivorous diets on the host metabolome, immune system, and gut microbiome. Vegan diets induced significant shifts in serum and stool metabolomes, cytokine profiles, and gut microbial composition. Despite lower dietary glycine intake, vegan diet subjects exhibited elevated serum glycine levels linked to reduced abundance of the gut pathobiont Bilophila wadsworthia. Functional studies demonstrated that B. wadsworthia metabolizes glycine via the glycine reductase pathway and modulates host glycine availability. Removing B. wadsworthia from a complex microbiota in mice elevated glycine levels and improved metabolic markers. These findings reveal a previously underappreciated mechanism by which diet regulates host metabolic status via the gut microbiota.

To investigate the effect of a 16-week whole-food plant-based diet (WPBD) on periodontal parameters in patients with increased cardiometabolic risk.

A total of 36 participants from a randomized clinical trial received additional periodontal assessment. The intervention group (n = 17) followed a WPBD for 16 weeks, whereas the control group (CG) (n = 19) was instructed not to change their diet. Measurements were assessed at baseline (t1), week 8 (t2) and week 16 (t3). Periodontal examination included bleeding on probing (BOP), periodontal inflamed surface area (PISA) and plaque index (PI) on six index teeth, salivary pH and matrix-matalloproteinase-8 (MMP-8).

At t3, the mean PISA of the index teeth was reduced by 32 mm2 (53.8) in the WPBD group and increased by 22.6 mm2 (45.1) in the CG group (intra-group p = 0.255 and p = 0.977, respectively), BOP changes were similar (intra-group p = 0.89 and p = 0.839, respectively). MMP-8 values reduced in the WPBD group by 50.73 ng/mL (117) and in the CG by 5.40 ng/mL (96.6) (intra-group p = 0.066, p = 0.837, respectively). Difference in change (t3 - t1) between the groups was p = 0.001, p = 0.003 and p = 0.032, respectively. Saliva pH increased in the WPBD group only (intra-group p = 0.007).

A trend towards stabilization of the inflammatory parameters (BOP, PISA) was observed in the WPBD group. Because of the non-significant changes within the groups, this study highlights the imperative for future studies.

NCT03901183.

Diet significantly influences the risk of developing cardiovascular disease (CVD), the leading cause of death in the United States. As vegetarian dietary patterns are increasingly being included within clinical practice guidelines, there is a need to review the most recent evidence regarding if and how these dietary patterns mitigate CVD risk.

This umbrella review of systematic reviews compared the relationships between vegetarian, vegan and non-vegetarian dietary patterns and CVD health outcomes and risk factors among presumably healthy adults (≥18 years) in the general population.

MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, Food Science Source and SportsDiscus databases were searched for systematic reviews (SRs) published from 2018 until March 2024. Eligible SRs and meta-analyses examined relationships between vegetarian or vegan diets and CVD risk factors and disease outcomes compared to non-vegetarian diets. SRs were screened in duplicate, and SR quality was assessed with AMSTAR2. The overall certainty of evidence (COE) was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) method.

There were 758 articles identified in the databases' search and 21 SRs met inclusion criteria. SRs targeting the general population had primarily observational evidence. Vegetarian, including vegan, dietary patterns were associated with reduced risk for CVD incidence [Relative Risk: 0.85 (0.79, 0.92)] and CVD mortality [Hazard Ratio: 0.92 (0.85, 0.99)] compared to non-vegetarian diets. Vegan dietary patterns were associated with reductions in CVD risk factors including blood pressure [systolic mean difference (95 % CI): -2.56 mmHg (-4.66, -0.445)], low-density lipoprotein cholesterol [-0.49 mmol/l (-0.62, -0.36)], and body mass index [-1.72 kg/m2 (-2.30, -1.16)] compared to non-vegetarian dietary patterns, as well as c-reactive protein concentrations in a novel meta-analysis [-0.55 mg/l (-1.07, -0.03)].

Practitioners can consider recommending vegetarian dietary patterns to reduce cardiometabolic risk factors and risk of CVD incidence and mortality.

Globally, cardiovascular diseases remain a predominant cause of mortality. Effective fluid management is particularly critical in older adults undergoing cardiac surgery, due to their heightened risk of postoperative complications. Tolvaptan, an oral vasopressin V2 receptor antagonist, has emerged as a promising agent for fluid regulation in cardiac patients. However, its efficacy in the elderly undergoing cardiac surgery is not thoroughly evaluated.

This single-center retrospective analysis included 146 older adults (≥ 65 years) who underwent cardiac surgery between January 2018 and December 2022. Patients were categorized into two groups: those receiving tolvaptan and a control group receiving traditional diuretics post-surgery. We assessed several outcomes, including hospital length of stay, 30-day mortality, postoperative renal function, and complications.

The study found a significantly reduced hospitalization duration in the tolvaptan group (P=0.044), with no escalation in adverse events. The tolvaptan cohort exhibited a considerable increase in urine output on the postoperative day (POD) three (P=0.003), indicating enhanced renal function and fluid management. Serum creatinine levels notably declined by POD3 (P=0.012), and blood urea nitrogen levels were appreciably lower by POD5 (P<0.001) in the tolvaptan group. Furthermore, serum sodium levels significantly escalated on POD3 and POD5 (P<0.01) in this group, while serum potassium levels remained unchanged.

Tolvaptan significantly optimizes postoperative fluid management in older adults undergoing cardiac surgery. Its administration is linked to improved renal function and a shortened hospital stay, without amplifying adverse effects. These insights could enhance clinical practices and facilitate the management of fluid overload in this vulnerable demographic.

This large, longitudinal follow-up cohort study aimed to explore how being a vegetarian and related factors impacted the incident gastroesophageal reflux disease (GERD) in a comprehensive Taiwanese cohort.

The study cohort was enrolled from the Taiwan Biobank. Vegetarian status, duration of being a vegetarian, type of vegetarian diet, and whether or not the participants had GERD were recorded from self-reported surveys. Associations between vegetarian status, duration, and type of diet with incident GERD were analyzed with multivariate logistic regression with adjustments for confounding variables.

After excluding participants with pre-existing GERD, we included 23,714 participants into the study. Multivariable analysis showed that vegetarian status (current vs. never; hazard ratio [HR], 0.697; 95% confidence interval [CI], 0.546 to 0.889; p = 0.004) was significantly inversely associated with incident GERD; conversely, ever being a vegetarian was not associated (p = 0.489). In addition, those who had been a vegetarian for 6 years or more had 0.72 times lower risk of GERD compared to those who had never been a vegetarian (HR, 0.717; 95% CI 0.558 to 0.922, p = 0.009). No significant differences were observed regarding the type of vegetarian diet with incident GERD.

The results showed that following a vegetarian diet was an independent protective factor for incident GERD, with a significant protective effect observed in those who adhered to a vegetarian diet for at least 6 years. Future research is warranted to explore the underlying mechanisms and whether adopting a vegetarian diet can decrease the incidence of GERD.

Despite the beneficial effects of "vegetarian style" diet on atherosclerosis, it is also proven potentially detrimental to bone health. The influence of muscle health or atherosclerosis on major osteoporotic fracture (MOF) risk in vegetarians has rarely been explored. This prospective study aimed to investigate an association of MOF risk with muscle health and atherosclerosis in vegetarians.

We conducted a questionnaire survey with the Mini-Nutritional Assessment (MNA) on 39 vegetarians. The 10-year probability of MOF was determined using the Taiwanese Fracture Risk Assessment (FRAX®) calculator. Appendicular skeletal muscle (ASM) mass and bone mineral density were measured with dual-energy X-ray absorptiometry. Physical performance was evaluated using the 6-min walk test (6MWT). Common carotid artery intima-media thickness (ccIMT) was determined using sonography. Serum levels of parathyroid hormone (PTH), Vitamin D, adiponectin, and leptin were measured.

Eleven (28.2%) of 39 vegetarians had a moderate-high risk of MOF, defined by FRAX-calculated risk ≥10%. These subjects had lower ASM (P < 0.005) and 6MWT distances (P < 0.01) but greater ccIMT than those with low risk. The MOF risk was negatively correlated with ASM (r = -0.51, P < 0.001) and 6MWT distances (r = -0.62, P < 0.001) but positively correlated with ccIMT (r = 0.56, P < 0.001). Linear regression analysis revealed that MOF risk scores were negatively associated with ASM and 6MWT distance while positively associated with ccIMT. There was no significant association of MOF risk with MNA scores, serum levels of PTH, Vitamin D, adiponectin, or leptin.

Decreased ASM mass, reduced physical performance, and atherosclerosis are significantly associated with MOF risk in vegetarians.

Heart disease remains a prominent global health concern, with cardiovascular disease (CVD) standing as a leading cause of death worldwide. Preventing heart disease not only decreases the risk of premature death but also mitigates complications like heart attacks, strokes, and arrhythmias, thereby enhancing overall health and quality of life. The economic burden of heart disease treatment highlights the importance of implementing preventive measures, such as lifestyle changes and early interventions, which can alleviate healthcare costs. These strategies, targeting risk factors like hypertension (HTN), diabetes mellitus (DM), dyslipidemia, and obesity, not only prevent heart disease but also reduce the risk of other health issues. Herein, this review covers various preventive measures, including dietary interventions, exercise, controlling HTN, DM, cholesterol, and weight, smoking cessation, and pharmacological interventions. By critically analyzing the guidelines and leveraging robust data alongside variations in recommendations, this review aims to elucidate effective primary prevention strategies for CVD.

In recent years, although life expectancy has increased significantly, non-communicable diseases (NCDs) continue to pose a significant threat to the health of the global population. Therefore, eating habits have been recognized as key modifiable factors that influence people's health and well-being. For this reason, it is interesting to study dietary patterns, since the human diet is a complex mixture of macronutrients, micronutrients, and bioactive compounds, and can modulate multiple physiological processes, including immune function, the metabolism, and inflammation. To ensure that the data we acquired were current and relevant, we searched primary and secondary sources, including scientific journals, bibliographic indexes, and databases in the last 15 years with the most relevant articles. After this search, we observed that all the recent research on NCDs suggests that diet is a critical factor in shaping an individual's health outcomes. Thus, cardiovascular, metabolic, mental, dental, and visual health depends largely on the intake, habits and patterns, and nutritional behaviors. A diet high in processed and refined foods, added sugars, and saturated fats can increase the risk of developing chronic diseases. On the other hand, a diet rich in whole, nutrient-dense foods, such as vegetables, fruits, nuts, legumes, and a high adherence to Mediterranean diet can improve health's people.

In this article, we discuss the ethics of veganism by looking at the moral implications of having a vegan diet or plant-based diet. Veganism is a way of diet that forbids or avoids consuming any animal products. It has drawn a lot of interest recently due to awareness or trends of vegan diet, human health, and ethical behavior benefits. The aim of the research is to look into the moral values that talk about veganism, such as animal welfare, environmental sustainability, and human welfare. In this study, we conduct a thorough assessment of ethical theories and actual evidence in an effort to know about the ethical reasons for veganism and its larger societal impacts. Through an analysis of existing literature and clinical studies, we discuss the various challenges, advantages, lifestyle modification, and nutritional concerns related to a vegan diet.

Background: Non-Dairy (ND) food consumption is rapidly increasing in the UK and for many consumers plant-based diets are presumed to be healthier than standard diets. ND alternatives have different nutritional compositions, and their consumption could present challenges on a public-health level. Aim: To compare the price and nutritional composition of dairy and ND milks and cheeses in UK supermarkets. Methods: Macro and micronutrient data was recorded from Alpro's website and the 6 leading UK grocers for their own-label ND milks and cheeses. For missing micronutrient values the McCance & Widdowson's dataset was used. 99 total products were extracted: 57 ND milks, 7 dairy milks, 10 dairy cheeses and 25 ND cheeses. Dairy milk and cheese were used as control against which all ND products were compared. Results: Soya and coconut milks had lower values of carbohydrates, sugars, calcium, iodine, and potassium (p < 0.01) than dairy. Almond milk had lower values of carbohydrates (p = 0.01), sugars, calcium, iodine, and potassium (p < 0.01) compared to dairy milk. Protein was significantly (p < 0.01) lower for all ND except soya. Dairy cheeses had higher values for energy, protein, iodine, potassium, riboflavin, vitamin B12 and calcium (p < 0.01) than ND. Median prices were similar between dairy and ND milks, whereas ND cheeses were significantly more expensive compared to dairy (p < 0.01). Conclusions: ND alternatives fall short in several key nutrients compared to dairy. Fortification, accurate labelling and nutrition education are needed to help consumers make healthy and informed choices.

Cardiovascular disease (CVD) remains the first cause of mortality globally. Diet plays a fundamental role in cardiovascular health and is closely linked to the development of CVD. Numerous human studies have provided evidence on the relationship between diet and CVD. By discussing the available findings on the dietary components that potentially influence CVD progression and prevention, this review attempted to provide the current state of evidence on healthy dietary choices for CVD. We focus on the effects of individual macronutrients, whole food products, and dietary patterns on the risks of CVD, and the data from population-based trials, observational studies, and meta-analyses are summarized. Unhealthy dietary habits, such as high intake of saturated fatty acids, sugar-sweetened beverages, red meat, and processed meat as well as high salt intake are associated with the increased risk of CVD. Conversely, increased consumption of plant-based components such as dietary fiber, nuts, fruits, and vegetables is shown to be effective in reducing CVD risk factors. The Mediterranean diet appears to be one of the most evidence-based dietary patterns beneficial for CVD prevention. However, there is still great debate regarding whether the supplementation of vitamins and minerals confers cardioprotective benefits. This review provides new insights into the role of dietary factors that are harmful or protective in CVD, which can be adopted for improved cardiovascular health.

Vegan diet has emerged as a popular dietary choice for people worldwide in recent times, due to concerns such as health issues, animal rights and welfare, and the sustainability of the environment. The purpose of this literature review was to explain how a vegan diet may affect the health of adults and to point out beneficial components found in it as well as any difficulties associated with its implementation. Evidence supports that a vegan diet can reduce the risk of chronic diseases, such as type 2 diabetes, hypertension, and certain types of cancer. A well-planned vegan diet must include adequate calories and nutrients, as well as the necessary supplements, such as vitamin B12, vitamin D and EPA/DHA. Given the current growing interest in plant-based diets among the general population, it is crucial to understand both the barriers, risks, and benefits of the vegan diet among physicians, policy makers, and the general population.

Increasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds).

To compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention.

This single-center, population-based randomized clinical trial of 22 pairs of twins (N = 44) randomized participants to a vegan or omnivorous diet (1 twin per diet). Participant enrollment began March 28, 2022, and continued through May 5, 2022. The date of final follow-up data collection was July 20, 2022. This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins. Primary analysis included all available data.

Twin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks. Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks.

The primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8). Secondary outcome measures were changes in cardiometabolic factors (plasma lipids, glucose, and insulin levels and serum trimethylamine N-oxide level), plasma vitamin B12 level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being.

A total of 22 pairs (N = 44) of twins (34 [77.3%] female; mean [SD] age, 39.6 [12.7] years; mean [SD] body mass index, 25.9 [4.7]) were enrolled in the study. After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration (-13.9 [5.8] mg/dL; 95% CI, -25.3 to -2.4 mg/dL), fasting insulin level (-2.9 [1.3] μIU/mL; 95% CI, -5.3 to -0.4 μIU/mL), and body weight (-1.9 [0.7] kg; 95% CI, -3.3 to -0.6 kg).

In this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet. Clinicians can consider this dietary approach as a healthy alternative for their patients.

ClinicalTrials.gov Identifier: NCT05297825.

Plant-based diets reduce the risk of cardiovascular disease but also increase the risk of certain micronutrient deficiencies, particularly, of vitamin B12 (B12). The extent to which the unsupervised use of oral nutrient supplements is sufficient to prevent these deficiencies is not well established. We analyzed nutrient intake, laboratory biomarkers, supplementation behavior, and B12 status adequacy amongst young, healthy, physically active omnivores, lacto-ovo-vegetarians and vegans from Germany.

We recruited 115 participants (n = 40 omnivores; n = 37 lacto-ovo-vegetarians, and n = 38 vegans) with comparable age, sex, marital status, physical activity and educational levels through online advertisements and local newspapers in Freiburg, Germany.

Energy intake and macronutrient distribution were comparable across diets. Major differences included intake of fiber, cholesterol, and several vitamins. Vegans had the lowest intake of B12 from foods (0.43 (0.58) µg/d), compared to omnivores (2.14 (2.29) µg/d) and lacto-ovo-vegetarians (0.98 (1.34) µg/day). Multivariate analysis of 36 blood biomarkers revealed that three major classes of biomarkers contributed the most to the clustering of individuals by dietary group, namely, biomarkers of B12 status (B12, holoTC, Hcy), iron (iron, ferritin, transferrin) and lipid metabolism (vitamin A, HDL, LDL, total cholesterol, TAG). This suggests that nutrients that modify the metabolic pathways represented by these biomarkers have the most penetrating effect on health status across diets. Analysis of B12 status (including 4cB12) revealed adequacy in omnivores and vegans, and a poorer B12 status amongst lacto-ovo-vegetarians. Fewer lacto-ovo-vegetarians used B12 supplements compared to vegans (51% versus 90%).

Even amongst homogeneously healthy Germans, each diet manifested with measurable differences in dietary intakes and biomarkers of health. Plant-based diets, in particular the vegan diet, exhibited the most favorable patterns of lipid metabolism and glycemic control, but the lowest food intake of B12. Supplementation of healthy vegans with B12 (median 250 µg B12/day, over 2 years) secured an adequate B12 status that was comparable to that of healthy omnivores.Clinical Trial Registry: German Clinical Trial register number: DRKS00027425.

Numerous studies have reported that adopting a plant-based diet can significantly reduce the risk of cardiovascular diseases (CVDs). Not only does a vegetarian diet help mitigate the risk of these diseases, but it also contributes to enhancing environmental sustainability. However, it is not necessary to universally recommend a vegetarian diet as a preventive measure against CVDs. More research is needed to determine whether completely excluding animal products is necessary, or if adhering to a predominantly plant-based diet is sufficient. In this opinion paper, the potential adverse health effects of a vegetarian diet and the barriers associated with adopting it will be discussed, in order to provide a rationale for the disadvantages of using a vegetarian diet for CVD risk reduction.

Nutritional intervention is worldwide recognized as a first step treatment for subjects with increased cardiovascular risk and it is of utmost importance especially for children and adolescents. Currently scientific evidence supports the role of dietary patterns instead of simple single nutrients or foods in cardiovascular risk prevention. Indeed, the American Heart Association dietary guidelines have expanded beyond nutrients to dietary pattern, that comprise not only single food items but also behavioral or cultural habits of specific populations. The aim of our narrative review is to analyze the most frequently adopted dietary patterns in children and adolescents and to evaluate their effect on cardiovascular risk factors and in cardiovascular risk prevention. Literature review showed that children cannot be considered as little adults: nutritional intervention must always grant adequate growth and neurodevelopment before reaching the proposed goals, therefore dietary patterns considered heart-healthy for adult subjects might not be suitable for pediatric patients. Mediterranean diet, DASH diet, Nordic diet and some plant-based diets seem to be the most promising dietary patterns in terms of cardiovascular health in the developmental age, even if further studies are needed to better standardize and analyze their effect on growing up individuals.

Coronary artery disease (CAD), a primary component of cardiovascular diseases, is one of the top contributors to mortality rates worldwide. In 2021, dietary risk was estimated to be attributed to 6.58 million cardiovascular deaths. Plant-based diets (PBDs), which encourage higher consumption of plant foods and lower intake of animal-based foods, have been shown to reduce the risk of CAD by up to 29% when compared to non-vegetarian diets in a meta-analysis. This article aims to summarize the array of PBDs and compare them with conventional Western diets that include meat. We review the various proposed mechanisms for how the bioactive nutrients of PBDs aid in preventing atherosclerosis and CAD events, as well as other cardiac diseases. We conducted a detailed search of PubMed using our exclusive search strategy using the keywords plant-based diet, vegan diet, phytosterols, CAD, myocardial ischemia, and atherosclerosis. A total of 162 pertinent articles published within the past decade were identified for qualitative synthesis. To ensure the accuracy and reliability of our review, we included a total of 55 full-text, peer-reviewed articles that demonstrated the effects of plant-based diets on CAD and were written in English. We excluded animal studies, in vitro or molecular studies, and non-original data like editorials, letters, protocols, and conference abstracts. In this article, we emphasize the importance of dietary interventions, such as PBDs, to prevent CAD and their benefits on environmental sustainability. Integrating plant foods and whole grains into one's daily eating habits leads to an increase in the intake of nutrient-rich foods while reducing the consumption of processed food could not only prevent millions of premature deaths but also provide prevention against many chronic gastrointestinal and metabolic diseases.

Guidelines for cardiovascular (CV) risk assessment among young adults are uncertain. Researchers are still looking for new tools for earlier diagnosis of cardiovascular diseases (CVD), the leading cause of mortality in the modern world. This study aimed to assess whether CV risk estimation is possible in groups of healthy individuals under the age of 40 on different dietary patterns (vegans-VEGAN (n = 48), lacto-/ovo-vegetarians-VEGE (n = 49), pescatarians-PESCA (n = 23), and omnivores-OMN (n = 35)) during the pandemic period. Four metrics containing selected risk classifiers were created, and participants were assessed using them. Groups including meat consumption showed increased CV risk predictions in the metrics assessment. The next analyzes showed statistically significant relationships between the results from the created metrics and selected non-basic biomarkers for ApoA1 (OMN group, p = 0.028), IL-6 (PESCA group, p = 0.048), HCY (VEGAN group, p = 0.05), and hsCRP (OMN + PESCA groups, p = 0.025). We found that predicting CV risk among healthy people under 40 adhering to different dietary patterns, taking into account basic and non-basic laboratory assessments and created metrics, is challenging but feasible. Furthermore, the OMN group appeared to be at the highest risk of increased CV risk in the future, while risk tended to be the lowest in the VEGAN group.

A plant-based diet (PBD) can provide numerous health benefits for patients with cardiovascular risk factors. However, an inadequately planned PBD also bear the potential for deficiencies in certain macro- and micronutrients. The present study analyzed nutrient profiles of individuals who adopted a PBD as part of the CardioVeg study. Participants with cardiovascular risk factors were randomly assigned to either a whole-food PBD intervention (n = 36; eight 90 min group meetings including two 120 min cooking sessions) or a control group asked to maintain an omnivorous diet (n = 34) for eight weeks. Food intake data were collected using three-day weighed food records and analyzed with NutriGuide software, including the German Nutrient Data Base (German: Bundeslebensmittelschlüssel). Nutrient intake was compared before and after eight weeks as well as between the groups. The results for both groups were then contrasted to the current dietary recommendations published by the societies for nutrition in Germany, Austria, and Switzerland. Moreover, anthropometric/laboratory data and ambulatory blood pressure monitoring were determined at baseline and after 8 weeks. Data of a subsample (n = 18 in the PBD group and n = 19 in the control group) were used for the present analyses of the dietary intake data. A PBD yielded several benefits including (but not limited to) a lower energy density, a lower intake of cholesterol and saturated fat, an increased consumption of fiber, and a lower intake of salt. Recommended intakes of most vitamins and minerals were generally met, except for vitamin B12 in the PBD group. A low intake of several other critical nutrients (vitamin D, iodine) was observed in both groups. Compared with the control group, PBD resulted in a significant decrease in body weight, body mass index, waist circumference, HbA1c, and fasting blood glucose after 8 weeks. Overall, it can be concluded that a PBD had a more favorable nutrient composition for cardiovascular health than the omnivorous dietary pattern of the control group.

Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.

To summarize and evaluate the evidence on the health impact of a vegan diet, we conducted an umbrella review of systematic reviews and meta-analyses. PubMed, Cochrane Library, Web of Science and Epistemonikos were searched up to September 2021. Meta-analyses were recalculated by using a random effects model. The certainty of evidence (CoE) was evaluated by the GRADE approach. For the general healthy population, a vegan diet was effective for reducing body weight [MD (95% CI): -2.52 kg (-3.06, -1.98), n = 8 RCTs; moderate CoE] and was associated with further health benefits (with low CoE), including a lower risk of cancer incidence [SRR (95% CI): 0.84 (0.75, 0.95), n = 2] and a trend for lower risk of all-cause mortality [SRR (95% CI): 0.87 (0.75, 1.01), n = 2], as well as lower ApoB levels [MD (95% CI): -0.19 µmol/L (-0.23, -0.15), n = 7 RCTs). The findings suggested adverse associations for a vegan diet with risk of fractures [SRR (95% CI): 1.46 (1.03, 2.07), n = 3; low CoE]. For persons with diabetes or at high CVD risk, a vegan diet reduced measures of adiposity, total cholesterol, LDL and improved glycemic control (CoE moderate to low). A vegan diet may have the potential for the prevention of cardiometabolic health, but it may also impair bone health. More well-conducted primary studies are warranted.