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Plant-Based Diets: Benefits and Concerns

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

Deadline for manuscript submissions: closed (20 November 2023) | Viewed by 34838

Special Issue Editor


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Guest Editor
School of Public Health, Loma Linda University, Loma Linda, CA, USA
Interests: plant-based diets and chronic diseases; health-promoting properties of phytochemicals; healthy sustainable diets; non-dairy alternatives
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Consumer interest in plant-based diets has markedly increased over the past few years. Segments of the population desire food products that improve human and planetary health and protect against major chronic diseases. As non-dairy and non-meat alternatives become mainstream, questions have emerged concerning how sustainable these plant-based diets are: What impact do they have on food security? Do these plant-based meat and dairy alternatives help lessen environmental degradation? Are these products nutritious and healthy? Do plant-based diets put populations at risk for any vitamin or mineral deficiencies? Do plant-based diets help diminish malnutrition and overnutrition (leading to obesity)? We invite research papers that discuss such issues and provide some answers to these important questions.

Prof. Dr. Winston Craig
Guest Editor

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Keywords

  • vitamin B12 and D
  • calcium, iron, iodine
  • planetary health
  • chronic disease
  • meat alternatives
  • dairy alternatives
  • intestinal microbiota

Published Papers (9 papers)

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Research

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15 pages, 721 KiB  
Article
Nutritional Status, Intentions and Motivations towards Adopting a Planetary Health Diet—A Cross-Sectional Study
by Urszula Ambroży, Ewa Błaszczyk-Bębenek, Dorota Ambroży, Paweł Jagielski, Łukasz Rydzik and Tadeusz Ambroży
Nutrients 2023, 15(24), 5102; https://doi.org/10.3390/nu15245102 - 13 Dec 2023
Viewed by 1283
Abstract
The planetary health diet is a proposition of a diet that is healthy for both people and the environment. The aim of this study was to investigate the nutritional behaviours among people who follow the planetary health diet and those who do not [...] Read more.
The planetary health diet is a proposition of a diet that is healthy for both people and the environment. The aim of this study was to investigate the nutritional behaviours among people who follow the planetary health diet and those who do not and assess the source of motivation that drives a willingness to follow sustainable diet guidelines. Using a self-administered questionnaire, data were collected from Polish adult volunteers. For analysis, respondents were divided into the following two groups: those following a planetary health diet (PD) and those who were not (O). Of the 216 respondents, 39.4% followed the PD. Non-adherence to the PD was linked to a higher prevalence of overweight and obesity. Taste was the most important factor for both groups during grocery shopping. However, sustainable agriculture and the health benefits of products were significantly more important for the PD followers. It can be concluded that adherence to the planetary diet is associated with lower body mass. This highlights the need for increased awareness and education about a diet’s health benefits and environmental impact. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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22 pages, 387 KiB  
Article
A Comprehensive Analysis of the Nutritional Composition of Plant-Based Drinks and Yogurt Alternatives in Europe
by Elphee Medici, Winston J. Craig and Ian Rowland
Nutrients 2023, 15(15), 3415; https://doi.org/10.3390/nu15153415 - 31 Jul 2023
Cited by 7 | Viewed by 4038
Abstract
Concerns for human and planetary health have led to a shift towards healthier plant-based diets. Plant-based dairy alternatives (PBDA) have experienced exponential market growth due to their lower environmental impact compared to dairy products. However, questions have arisen regarding their suitability as dairy [...] Read more.
Concerns for human and planetary health have led to a shift towards healthier plant-based diets. Plant-based dairy alternatives (PBDA) have experienced exponential market growth due to their lower environmental impact compared to dairy products. However, questions have arisen regarding their suitability as dairy substitutes and their role in food-based dietary guidelines (FBDG). Our study aimed to analyse the nutritional profiles of leading PBDA across Europe and compare them with their dairy counterparts. We examined the nutritional profiles of 309 unflavoured PBDA representing the European market leaders, including 249 plant-based drinks (PBD) and 52 plant-based alternatives to yogurt (PBAY). PBD and PBAY, excluding coconut varieties, were low in saturated fat (<1 g per serving). Seventy percent of PBDA were unsweetened, and most had sugar levels comparable to dairy. Except for soya varieties, PBDA protein levels were lower than dairy. Organic PBDA lacked micronutrients due to legal restrictions on fortification. Among non-organic PBDA, 76% were fortified with calcium, 66% with vitamin D, and 60% with vitamin B12. Less than half were fortified with vitamin B2, and a few with iodine (11%) and vitamin A (6%). PBAY were less frequently fortified compared to PBD. PBDA displayed a favourable macronutrient profile despite lower protein levels, which would be compensated for by other protein-dense foods in a usual mixed diet. Enhancing fortification consistency with dairy-associated micronutrients would address concerns regarding PBDA’s integration into FBDG. Our analysis supports the inclusion of fortified PBDA in environmentally sustainable FBDG for healthy populations. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
14 pages, 722 KiB  
Article
Patient-Reported Outcomes from a Pilot Plant-Based Lifestyle Medicine Program in a Safety-Net Setting
by Rachel E. Massar, Michelle McMacken, Lorraine Kwok, Shivam Joshi, Sapana Shah, Rebecca Boas, Robin Ortiz, Lilian Correa, Krisann Polito-Moller and Stephanie L. Albert
Nutrients 2023, 15(13), 2857; https://doi.org/10.3390/nu15132857 - 24 Jun 2023
Cited by 2 | Viewed by 2279
Abstract
Lifestyle medicine interventions that emphasize healthy behavior changes are growing in popularity in U.S. health systems. Safety-net healthcare settings that serve low-income and uninsured populations most at risk for lifestyle-related disease are ideal venues for lifestyle medicine interventions. Patient-reported outcomes are important indicators [...] Read more.
Lifestyle medicine interventions that emphasize healthy behavior changes are growing in popularity in U.S. health systems. Safety-net healthcare settings that serve low-income and uninsured populations most at risk for lifestyle-related disease are ideal venues for lifestyle medicine interventions. Patient-reported outcomes are important indicators of the efficacy of lifestyle medicine interventions. Past research on patient-reported outcomes of lifestyle medicine interventions has occurred outside of traditional healthcare care settings. In this study, we aimed to assess patient-reported outcomes on nutrition knowledge, barriers to adopting a plant-based diet, food and beverage consumption, lifestyle behaviors, self-rated health, and quality-of-life of participants in a pilot plant-based lifestyle medicine program in an urban safety-net healthcare system. We surveyed participants at three time points (baseline, 3 months, 6 months) to measure change over time. After 6 months of participation in the program, nutrition knowledge increased by 7.2 percentage points, participants reported an average of 2.4 fewer barriers to adopting a plant-based diet, the score on a modified healthful plant-based diet index increased by 5.3 points, physical activity increased by 0.7 days per week while hours of media consumption declined by 0.7 h per day, and the percentage of participants who reported that their quality of sleep was “good” or “very good” increased by 12.2 percentage points. Our findings demonstrate that a lifestyle medicine intervention in a safety-net healthcare setting can achieve significant improvements in patient-reported outcomes. Key lessons for other lifestyle medicine interventions include using a multidisciplinary team; addressing all pillars of lifestyle medicine; and the ability for patients to improve knowledge, barriers, skills, and behaviors with adequate support. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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26 pages, 3646 KiB  
Article
Vegetables with Enhanced Iron Bioavailability—German Consumers’ Perceptions of a New Approach to Improve Dietary Iron Supply
by Ann-Kristin Welk, Clara Mehlhose, Diemo Daum and Ulrich Enneking
Nutrients 2023, 15(10), 2291; https://doi.org/10.3390/nu15102291 - 12 May 2023
Cited by 4 | Viewed by 2381
Abstract
Iron deficiency is still widespread as a major health problem even in countries with adequate food supply. It mainly affects women but also vegans, vegetarians, and athletes and can lead to various clinical pictures. Biofortification of vitamin C-rich vegetables with iron may be [...] Read more.
Iron deficiency is still widespread as a major health problem even in countries with adequate food supply. It mainly affects women but also vegans, vegetarians, and athletes and can lead to various clinical pictures. Biofortification of vitamin C-rich vegetables with iron may be one new approach to face this nutritional challenge. However, so far, little is known about the consumer acceptance of iron-biofortified vegetables, particularly in developed countries. To address this issue, a quantitative survey of 1000 consumers in Germany was conducted. The results showed that depending on the type of vegetable, between 54% and 79% of the respondents were interested in iron-biofortified vegetables. Regression analysis showed a relationship between product acceptance, gender, and area of residence. In addition, relationships were found between consumer preferences for enjoyment, sustainability, and naturalness. Compared to functional food and dietary supplements, 77% of respondents would prefer fresh iron-rich vegetables to improve their iron intake. For a market launch, those iron-rich vegetables appear especially promising, which can additionally be advertised with claims for being rich in vitamin C and cultivated in an environmentally friendly way. Consumers were willing to pay EUR 0.10 to EUR 0.20 more for the iron-biofortified vegetables. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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13 pages, 1093 KiB  
Article
Yellow Pea Pasta Enhances the Saltiness and Suppression of Postprandial Blood Glucose Elevation
by Yoshihiro Tsuchiya, Joto Yoshimoto, Hiroto Kobayashi, Sho Ishii and Mikiya Kishi
Nutrients 2023, 15(2), 283; https://doi.org/10.3390/nu15020283 - 5 Jan 2023
Cited by 1 | Viewed by 1913
Abstract
Salt and carbohydrates, two causes of elevated blood glucose, are essential components for survival; however, excessive intake of either is a known health risk. In a previous study, we reported the usefulness of pasta prepared from yellow pea (YPP) as a functional staple [...] Read more.
Salt and carbohydrates, two causes of elevated blood glucose, are essential components for survival; however, excessive intake of either is a known health risk. In a previous study, we reported the usefulness of pasta prepared from yellow pea (YPP) as a functional staple food that is beneficial for blood sugar control. In this study, we investigated the usefulness of YPP in reducing health risks by examining its effects on saltiness, postprandial satisfaction, and second meal. The results showed that YPP tasted saltier than conventional pasta made from semolina wheat when prepared with a 0.75% salt concentration. In addition, we examined blood glucose levels, insulin secretion, and postprandial hunger over a longer period than in previous studies. We observed that when the same amount of YPP and wheat pasta were eaten, the elevation in blood glucose and insulin secretion was lower after YPP consumption while maintaining a similar level of satiety. Furthermore, YPP was also observed to be able to suppress elevated insulin levels at the second meal. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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Review

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21 pages, 1976 KiB  
Review
Plant-Based Dairy Alternatives Contribute to a Healthy and Sustainable Diet
by Winston J. Craig, Virginia Messina, Ian Rowland, Angelina Frankowska, Jane Bradbury, Sergiy Smetana and Elphee Medici
Nutrients 2023, 15(15), 3393; https://doi.org/10.3390/nu15153393 - 30 Jul 2023
Cited by 7 | Viewed by 5608
Abstract
Plant-based foods are increasing in popularity as more and more people are concerned about personal and planetary health. The consumption of plant-based dairy alternatives (PBDAs) has assumed a more significant dietary role in populations shifting to more sustainable eating habits. Plant-based drinks (PBDs) [...] Read more.
Plant-based foods are increasing in popularity as more and more people are concerned about personal and planetary health. The consumption of plant-based dairy alternatives (PBDAs) has assumed a more significant dietary role in populations shifting to more sustainable eating habits. Plant-based drinks (PBDs) made from soya and other legumes have ample protein levels. PBDs that are appropriately fortified have adequate levels of important vitamins and minerals comparable to dairy milk. For the PBDs examined, the greenhouse gas emissions were diminished by 59–71% per 250 mL, and the land use and eutrophication impact was markedly less than the levels displayed by dairy milk. The water usage for the oat and soya drinks, but not rice drinks, was substantially lower compared to dairy milk. When one substitutes the 250 mL serving of dairy milk allowed within the EAT Lancet Planetary Health Diet for a fortified plant-based drink, we found that the nutritional status is not compromised but the environmental footprint is reduced. Combining a nutrient density score with an environmental index can easily lead to a misclassification of food when the full nutrition profile is not utilized or only a selection of environmental factors is used. Many PBDAs have been categorized as ultra-processed foods (UPFs). Such a classification, with the implied adverse nutritional and health associations, is inconsistent with current findings regarding the nutritional quality of such products and may discourage people from transitioning to a plant-based diet with its health and environmental advantages. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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20 pages, 1598 KiB  
Review
Beneficial Effects of Plant-Based Diets on Skin Health and Inflammatory Skin Diseases
by Ximena Flores-Balderas, Mario Peña-Peña, Karla M. Rada, Yamnia Q. Alvarez-Alvarez, Carlos A. Guzmán-Martín, José L. Sánchez-Gloria, Fengyang Huang, Dayanara Ruiz-Ojeda, Sofía Morán-Ramos, Rashidi Springall and Fausto Sánchez-Muñoz
Nutrients 2023, 15(13), 2842; https://doi.org/10.3390/nu15132842 - 22 Jun 2023
Cited by 10 | Viewed by 5982
Abstract
The human skin is a crucial organ that protects the organism from the outer environment. Skin integrity and health depend on both extrinsic and intrinsic factors. Intrinsic factors such as aging and genetic background contribute to weakened skin and disease susceptibility. Meanwhile, extrinsic [...] Read more.
The human skin is a crucial organ that protects the organism from the outer environment. Skin integrity and health depend on both extrinsic and intrinsic factors. Intrinsic factors such as aging and genetic background contribute to weakened skin and disease susceptibility. Meanwhile, extrinsic factors including UV radiation, pollution, smoking, humidity, and poor diet also affect skin health and disease. On the other hand, healthy dietary patterns such as plant-based diets have gained popularity as a complementary therapy for skin health. A plant-based diet is defined as all diets based on plant foods, including an abundance of vegetables, fruits, beans, lentils, legumes, nuts, seeds, fungi, and whole grains, with limited or no animal products or processed foods. However, some authors also exclude or limit processed foods in the definition. Recent research has shown that these diets have beneficial effects on inflammatory skin diseases. This review explored the beneficial effects of plant-based diets on inflammatory skin diseases and plant-based functional foods on healthy skin. In conclusion, plant-based diets and plant-based functional foods may have beneficial effects on skin health through the gut microbiome. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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30 pages, 1648 KiB  
Review
Can the Substitution of Milk with Plant-Based Drinks Affect Health-Related Markers? A Systematic Review of Human Intervention Studies in Adults
by Paola Biscotti, Cristian Del Bo’, Catarina Carvalho, Duarte Torres, Emmanuelle Reboul, Beatrice Pellegrini, Valentina Vinelli, Angela Polito, Laura Censi, Marisa Porrini, Daniela Martini and Patrizia Riso
Nutrients 2023, 15(11), 2603; https://doi.org/10.3390/nu15112603 - 1 Jun 2023
Viewed by 3541
Abstract
The consumption of plant-based drinks (PBDs) in substitution for cow’s milk (CM) is increasing due to concerns for human and planet health and animal welfare. The present review aims to analyze the main findings from intervention trials investigating the effect of PBDs in [...] Read more.
The consumption of plant-based drinks (PBDs) in substitution for cow’s milk (CM) is increasing due to concerns for human and planet health and animal welfare. The present review aims to analyze the main findings from intervention trials investigating the effect of PBDs in comparison with CM on markers of human health. Suitable articles published up to July 2022 were sourced from PubMed and Scopus databases. A total of 29 papers were collected, with 27 focusing on soy drinks (1 of which also evaluated the effects of an almond drink), while only 2 focused on rice drinks. Among studies focused on soy drinks, the most investigated factors were anthropometric parameters (n = 13), the lipid profile (n = 8), markers of inflammation and/or oxidative stress (n = 7), glucose and insulin responses (n = 6) and blood pressure (n = 4). Despite some evidence of a beneficial effect of PBDs, especially for the lipid profile, it was not possible to draw any overall conclusions due to some conflicting results. As well as the low number of studies, a wide heterogeneity was found in terms of the characteristics of subjects, duration and markers, which reduces the strength of the available results. In conclusion, further studies are needed to better elucidate the effects of substituting CM with PBDs, especially in the long term. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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21 pages, 701 KiB  
Review
Believe It or ‘Nut’: Why It Is Time to Set the Record Straight on Nut Protein Quality: Pistachio (Pistacia vera L.) Focus
by Emma Derbyshire, Jennette Higgs, Mary Jo Feeney and Arianna Carughi
Nutrients 2023, 15(9), 2158; https://doi.org/10.3390/nu15092158 - 30 Apr 2023
Cited by 5 | Viewed by 6762
Abstract
There are growing public health movements to transition towards diets that are plant-based. However, confusion exists with concerns that plant-based proteins (including nuts) may be inferior with respect to protein quality. The present publication evaluates the evolution of protein quality concepts and explains [...] Read more.
There are growing public health movements to transition towards diets that are plant-based. However, confusion exists with concerns that plant-based proteins (including nuts) may be inferior with respect to protein quality. The present publication evaluates the evolution of protein quality concepts and explains the protein science related to pistachios. Pistachio nuts are a plant-based complete protein providing all nine EAAs in addition to an array of nutrients and phytochemicals. They have a PDCAAS of 73 and 81%, (raw and roasted pistachios, respectively), higher than that of many other tree nuts. From an environmental perspective transitioning towards plant-based diets (including nuts) could have potential to reduce total/green water footprints. Dietary guidelines are evolving yet nuts such as pistachios do not always have a clear place within these. Now appears to be a pertinent time to look at protein quality from the perspective of whole daily diets and dietary patterns, factoring in both health and environmental outcomes. Given updated modes of thinking, nuts such as pistachios have an important role to play in terms of providing ready-to-eat, good-quality, plant-based protein within daily diets. Full article
(This article belongs to the Special Issue Plant-Based Diets: Benefits and Concerns)
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