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Reducing the Burden of Chronic Diseases Through Plant-Based Diets
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Reducing the Burden of Chronic Diseases Through Plant-Based Diets

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: 20 January 2026 | Viewed by 13191

Special Issue Editors

Dr. Rami Salim Najjar

E-Mail Website
Guest Editor
Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA
Interests: plant-based diets; cardiovascular disease; molecular biology; inflammation; oxidative stress
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Thomas Ziegler

E-Mail Website
Guest Editor
1. Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
2. Department of Medicine, Emory University, Atlanta, GA 30322, USA
Interests: plant-based diets; micronutrients; nutrition support; inflammation; metabolomics

Special Issue Information

Dear Colleagues,

Plant-based diets have emerged as efficacious nutritional strategies in the treatment of various chronic diseases associated with lifestyle. These include cardiovasacular disease, obesity, diabetes, some cancers, and related conditions. However, research remains limited, and much more investigation is needed. The purpose of this Special Issue entitled “Reducing the Burden of Chronic Diseases Through Plant-Based Diets” is to provide a platform for research of high rigor that explores the effects of plant-based diets in various chronic diseases. This Special Issue focuses on clinical research with human subjects; however, epidemiological studies and comprehensive reviews are also welcome. While this Special Issue is focused on human research, preclinical animal and in vitro studies are also welcome if novel molecular mechanisms are elucidated.

Dr. Rami Salim Najjar
Prof. Dr. Thomas Ziegler
Guest Editors

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Keywords

  • vegan diet
  • vegetarian diet
  • cardiovascular disease
  • hypertension
  • obesity
  • cancer
  • diabetes
  • stroke
  • alzheimers disease
  • metabolic syndrome
  • polyphenols
  • phytochemicals
  • fiber

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Published Papers (4 papers)

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Research

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19 pages, 7474 KiB  
Article
Association of Healthy Predominantly Plant-Based Diet with Reduced Cardiovascular Disease Incidence and Mortality and Development of Novel Heart-Protective Diet Index
by Tian Wang, Andrea Nova, Sophie Cassidy, Katherine M. Livingstone, Teresa Fazia, Sayan Mitra, Cynthia M. Kroeger, Andrius Masedunskas, Luisa Bernardinelli, Walter C. Willett and Luigi Fontana
Nutrients 2025, 17(16), 2675; https://doi.org/10.3390/nu17162675 - 19 Aug 2025
Viewed by 304
Abstract
Background: Previous research examining the effects of omnivorous and plant-based diets on cardiovascular disease (CVD) outcomes has produced inconsistent findings, and the importance of diet quality is overlooked. Our study aimed to develop a novel heart-protective diet index to assess the association of [...] Read more.
Background: Previous research examining the effects of omnivorous and plant-based diets on cardiovascular disease (CVD) outcomes has produced inconsistent findings, and the importance of diet quality is overlooked. Our study aimed to develop a novel heart-protective diet index to assess the association of a high-quality, predominantly plant-based diet—including fish, eggs, and low-fat dairy products—with CVD incidence and mortality. Methods: This study included 192,274 participants in the UK Biobank (mean age: 56.3 ± 7.9 years) without CVD at baseline who completed a 24 h recall Oxford WebQ questionnaire. Using the Oxford WebQ questionnaire, we developed and validated a novel heart-protective diet score (HPDS) based on 22 food groups. Cox proportional hazard models were used to study the associations between HPDS and outcomes. Results: During a median follow-up of 12.3 years, 20,692 CVD events and 1131 CVD deaths were observed. After adjusting for demographics, Townsend deprivation index, lifestyle, and history of chronic diseases, participants in the top HPDS quartile were at lower risk, compared to those in the bottom quartile, of overall CVD (HR: 0.92 [95%CI: 0.88, 0.95]), IHD (HR: 0.89 [95%CI: 0.84, 0.94]), MI (HR: 0.85 [95%CI: 0.77, 0.94]), and HF (HR: 0.86 [95%CI: 0.77, 0.95]). Conclusions: Adherence to a healthy, predominantly plant-based heart-protective diet rich in non-starchy vegetables, fruits, wholegrains, fish, eggs, and low-fat dairy products is associated with a reduced cardiovascular disease incidence and mortality. Further research in diverse ethnic populations is necessary to examine the reproducibility of our findings and enhance generalizability. Full article
(This article belongs to the Special Issue Reducing the Burden of Chronic Diseases Through Plant-Based Diets)
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15 pages, 1325 KiB  
Article
The OMNIVEG Study: Effects of Transitioning from a Traditional to a Vegan Mediterranean Diet on Fat Oxidation During Exercise
by Miguel López-Moreno, Ujué Fresán, Juan Del Coso, Alejandro Muñoz, Millán Aguilar-Navarro, María Teresa Iglesias-López, Francisco J. Amaro-Gahete and Jorge Gutiérrez-Hellín
Nutrients 2025, 17(14), 2274; https://doi.org/10.3390/nu17142274 - 9 Jul 2025
Viewed by 744
Abstract
Background: This study aimed to evaluate the changes in fat utilization associated with transitioning from a traditional to a vegan Mediterranean diet in healthy, physically active men during a ramp exercise test. Methods: In a controlled crossover design, fourteen healthy, physically active men [...] Read more.
Background: This study aimed to evaluate the changes in fat utilization associated with transitioning from a traditional to a vegan Mediterranean diet in healthy, physically active men during a ramp exercise test. Methods: In a controlled crossover design, fourteen healthy, physically active men followed a traditional Mediterranean diet for three weeks (baseline). Then, participants transitioned to a four-week isocaloric vegan version of the Mediterranean diet, matched for macronutrient distribution but excluding all animal foods. Immediately after each dietary intervention, participants completed an incremental exercise test (from 30% to 70% of VO2peak) on a cycle ergometer in a fasted state to determine peak fat oxidation (PFO) and its associated exercise intensity (Fatmax). Exercise heart rate and the rating of perceived exertion were also recorded at each exercise intensity. Results: The traditional and vegan Mediterranean diets provided comparable amounts of energy (2599.6 ± 180.8 and 2634.9 ± 148.3 kcal/day, p = 0.140) and total fat (97.0 ± 17.8 and 99.0 ± 13.2 g/day; p = 0.620). However, the vegan Mediterranean diet contained a lower proportion of saturated fat (25.2 ± 6.8 vs. 13.6 ± 4.4% of total fat, p < 0.010). Still, the dietary transition was not associated with modifications in PFO (0.323 ± 0.153 and 0.347 ± 0.147 g/min; p = 0.678) or Fatmax (40.51 ± 7.30 and 40.51 ± 10.71%VO2peak; p = 1.000) during exercise. Moreover, the dietary transition did not significantly change the response curves across exercise intensities for fat oxidation (p = 0.553), heart rate (p = 0.280), or the rating of perceived exertion (p = 0.433). Conclusions: Switching from a traditional to a vegan Mediterranean diet did not affect fat oxidation, exercise intensity at peak fat oxidation, or perceptual responses during exercise in healthy, active men. These findings suggest that physically active individuals can adopt a vegan version of the Mediterranean diet without compromising fat utilization during submaximal aerobic exercise. Clinical Trial Registry: NCT06008886. Date of registration: 28 July 2023. Full article
(This article belongs to the Special Issue Reducing the Burden of Chronic Diseases Through Plant-Based Diets)
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Review

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26 pages, 3043 KiB  
Review
Dos and Don’ts in Kidney Nutrition: Practical Considerations of a Panel of Experts on Protein Restriction and Plant-Based Diets for Patients Living with Chronic Kidney Disease
by Massimo Torreggiani, Carla Maria Avesani, Barbara Contzen, Adamasco Cupisti, Sylwia Czaja-Stolc, Claudia D’Alessandro, Liliana Garneata, Abril Gutiérrez, Françoise Lippi, Carmen Antonia Mocanu, Alice Sabatino and Giorgina Barbara Piccoli
Nutrients 2025, 17(12), 2002; https://doi.org/10.3390/nu17122002 - 14 Jun 2025
Viewed by 2192
Abstract
Dietary management is a pillar of chronic kidney disease (CKD) treatment. While some rules are the same as dietary prescriptions for the general population and those suffering from other chronic diseases (energy intake, salt intake, avoidance of ultra-processed food and limited intake of [...] Read more.
Dietary management is a pillar of chronic kidney disease (CKD) treatment. While some rules are the same as dietary prescriptions for the general population and those suffering from other chronic diseases (energy intake, salt intake, avoidance of ultra-processed food and limited intake of animal fats), in non-dialysis-dependent patients living with CKD, the specific focus is on protein intake. Low-protein diets (LPDs) and supplemented very low protein diets (sVLPDs) have been successfully employed to decrease the symptoms of people living with non-dialysis-dependent CKD, delay the progression of the disease and retard the need for dialysis. Randomized clinical trials have yielded conflicting results on efficacy, resulting in conflicting guidelines. Concerns about the risk of malnutrition (specifically when the main source of proteins is plant-derived), electrolyte imbalances, and energy intake, and the idea that adherence is difficult, jeopardize the use and wide application of LPDs and sVLPDs. That dietary management focuses mainly on nutrients while dietary quality occupies second place is also an erroneous concept that requires discussion. In September 2023, a group of experts composed of nephrologists and dieticians gathered in Frankfurt, Germany, to try to reconcile the different guideline indications and address most of the common doubts of final dispatchers to increase the prescription of “renal diets” and improve people living with CKD’s adherence to them. Full article
(This article belongs to the Special Issue Reducing the Burden of Chronic Diseases Through Plant-Based Diets)
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15 pages, 1047 KiB  
Review
Assessing the Roles of Retinol, Vitamin K2, Carnitine, and Creatine in Plant-Based Diets: A Narrative Review of Nutritional Adequacy and Health Implications
by David M. Goldman, Cassandra B. Warbeck, Robby Barbaro, Cyrus Khambatta and Matthew Nagra
Nutrients 2025, 17(3), 525; https://doi.org/10.3390/nu17030525 - 31 Jan 2025
Viewed by 9353
Abstract
Plant-based diets are associated with numerous health benefits, including reduced risks of chronic diseases. However, questions persist regarding the implications of lower dietary intakes of certain non-essential nutrients, such as retinol, vitamin K2, carnitine, and creatine, which are primarily found in animal-derived foods. [...] Read more.
Plant-based diets are associated with numerous health benefits, including reduced risks of chronic diseases. However, questions persist regarding the implications of lower dietary intakes of certain non-essential nutrients, such as retinol, vitamin K2, carnitine, and creatine, which are primarily found in animal-derived foods. This narrative review evaluates the roles of these nutrients in human physiology and examines whether their absence in plant-based diets is likely to impact health outcomes. Retinol requirements can be met through the consumption of provitamin A carotenoids in plant foods, even in individuals with reduced conversion efficiency. Endogenous synthesis adequately supports physiological needs for vitamin K2, and currently available evidence does not consistently demonstrate that dietary vitamin K2 provides additional benefits for bone or cardiovascular health. Carnitine and creatine levels may differ between individuals following omnivorous and plant-based diets, but these differences do not result in compromised muscle function, cognitive health, or metabolic outcomes. Current evidence does not indicate that the absence of these non-essential nutrients in plant-based diets adversely affects health or confers disadvantages compared to omnivorous diets. Full article
(This article belongs to the Special Issue Reducing the Burden of Chronic Diseases Through Plant-Based Diets)
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