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Plant-Based Dietary Patterns, Health and Sustainability

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

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 38632

Special Issue Editors


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Guest Editor
Foodlab Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
Interests: food; public health; dietary patterns; sustainability; Mediterranean Diet
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
Interests: dietary patterns; Mediterranean diet; public health nutrition; traditional diets
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Plant-based dietary patterns consist mostly or entirely of plant-based foods and they have been linked to various benefits when the diet includes minimally processed foods, fruits, vegetables, whole grains, legumes, nuts and seeds, herbs, and spices and a low or minimal presence or absence of animal foods.

The health benefits include reductions in the risk of developing metabolic diseases, such as cardiovascular diseases and type 2 diabetes, and cancer and slowing the progression of neurodegenerative diseases. Moreover, plant-based dietary patterns have been linked to a lower risk of all-cause mortality. The potential role of plant-based diets in the severity of Covid-19 has also recently been studied.

In addition to the effects on health, plant-based diets are beneficial in terms of sustainability, as plant-based foods have a lower environmental impact than animal-based foods in terms of greenhouse gasses, water use, land use, and nitrogen and phosphorus emissions.

In the past, the consumption of traditional plant-based patterns, such as the Mediterranean diet, was common in Europe and most parts of the world. However, in the last 60 years food patterns of modern societies have suffered from occidentalization. These changes have also affected some of the risk factors for non-communicable diseases (NCDs) in these populations. Nevertheless, potential nutritional deficiencies (proteins, iron, calcium, iodine, omega 3, vitamin D, and vitamin B12) should be considered when following a plant-based diet.

Therefore, we look for articles that answer the following questions and themes:

- What are the benefits of plant-based dietary patterns on sustainability and on metabolic health and other non-communicable diseases?

- What are the risks and benefits of plant-based diets? How could possible deficiencies be avoided?

We will also welcome articles that investigate the role of plant-based dietary patterns in COVID-19.

Prof. Dr. Anna Bach-Faig
Dr. Angeliki Papadaki
Guest Editors

Manuscript Submission Information

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Keywords

  • plant based-Diet
  • plant based dietary patterns
  • metabolic Health
  • Mediterranean diet
  • DASH diet
  • vegetarian diet
  • vegan diet
  • NCDs
  • COVID-19
  • sustainability

Published Papers (11 papers)

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14 pages, 2258 KiB  
Article
The Potential of Food Fortification as an Enabler of More Environmentally Sustainable, Nutritionally Adequate Diets
by Alessandra C. Grasso, Julia J. F. Besselink, Marcelo Tyszler and Maaike J. Bruins
Nutrients 2023, 15(11), 2473; https://doi.org/10.3390/nu15112473 - 25 May 2023
Cited by 6 | Viewed by 4469
Abstract
Policies encouraging shifts towards more plant-based diets can lead to shortfalls in micronutrients typically present in animal products (B-vitamins, vitamin D, calcium, iodine, iron, selenium, zinc, and long-chain omega-3 fatty acids). We modelled the effect of fortifying foods with these critical micronutrients, with [...] Read more.
Policies encouraging shifts towards more plant-based diets can lead to shortfalls in micronutrients typically present in animal products (B-vitamins, vitamin D, calcium, iodine, iron, selenium, zinc, and long-chain omega-3 fatty acids). We modelled the effect of fortifying foods with these critical micronutrients, with the aim of achieving nutrition and sustainability goals, using food consumption data from Dutch adults (19–30 years). Three dietary scenarios were optimized for nutritional adequacy and 2030 greenhouse gas emissions (GHGE-2030) targets, respectively, with the fewest deviations from the baseline diet: (i) the current diet (mainly vitamin A- and D-fortified margarine, iodized bread, and some calcium- and vitamin D-fortified dairy alternatives and iron- and vitamin B12-fortified meat alternatives); (ii) all plant-based alternatives fortified with critical micronutrients; and (iii) fortified bread and oils. Optimizing the current diet for nutrition and GHGE-2030 targets reduced animal-to-plant protein ratios from ~65:35, to 33:67 (women) and 20:80 (men), but required major increases in legumes and plant-based alternatives. When fortifying all plant-based alternatives and, subsequently, bread and oil, smaller dietary changes were needed to achieve nutrition and GHGE-2030 targets. Fortifying food products with critical micronutrients, ideally with complementary education on plant-based foods, can facilitate the transition to healthier and more sustainable diets. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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12 pages, 316 KiB  
Article
Food Sustainability Knowledge, Attitudes, and Dietary Habits among Students and Professionals of the Health Sciences
by Ainhoa Irazusta-Garmendia, Emma Orpí, Anna Bach-Faig and Carlos A. González Svatetz
Nutrients 2023, 15(9), 2064; https://doi.org/10.3390/nu15092064 - 25 Apr 2023
Cited by 5 | Viewed by 3193
Abstract
The importance of a sustainable diet is an emerging concept within sustainable food systems. Food systems emit 30% of greenhouse gases, which needs to change. A cross-sectional study was carried out to determine the knowledge, attitudes, and habits of students and professionals in [...] Read more.
The importance of a sustainable diet is an emerging concept within sustainable food systems. Food systems emit 30% of greenhouse gases, which needs to change. A cross-sectional study was carried out to determine the knowledge, attitudes, and habits of students and professionals in the health sciences regarding a sustainable diet, comparing these to the Spanish population. We further aimed to analyse the consistency between the knowledge and attitudes of these individuals and their dietary habits and analyse the consumption of different food groups that are typical of a sustainable diet. A survey was completed by a total of 415 participants, both university students in the health sciences and health professionals. These two groups were more knowledgeable of sustainable diets than the general population, although certain concepts are unfamiliar to both populations. A positive attitude towards sustainable food habits was also observed among the population studied. The health sector reported having better eating habits than the overall population. A significant positive correlation was observed between higher fruit and vegetable consumption and deeper knowledge and more favourable attitudes. People with less knowledge and worse attitudes reported consuming more red and processed meat. The findings of this study could inform targeted interventions for health professionals given the need to promote a healthy diet but also a healthy and sustainable diet for planetary health. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
22 pages, 871 KiB  
Article
The Association between Plant-Based Diets and Dietary Patterns with Cardiometabolic Risk in a Sample of Commercial Taxi Drivers in South Africa
by Tatum Lopes, Annalise Edith Zemlin, Machoene Derrick Sekgala, Zandile June-Rose Mchiza, Rajiv Timothy Erasmus and Andre Pascal Kengne
Nutrients 2023, 15(7), 1789; https://doi.org/10.3390/nu15071789 - 6 Apr 2023
Viewed by 2252
Abstract
The consumption of unhealthy foods and a sedentary lifestyle predispose individuals to non-communicable diseases. This study investigated the distribution and the association of plant-based diets (PBDs) and dietary patterns in relation to the cardiometabolic risks in commercial taxi drivers. A cross-sectional analysis was [...] Read more.
The consumption of unhealthy foods and a sedentary lifestyle predispose individuals to non-communicable diseases. This study investigated the distribution and the association of plant-based diets (PBDs) and dietary patterns in relation to the cardiometabolic risks in commercial taxi drivers. A cross-sectional analysis was conducted among males (≥19 years) who consumed street foods sold by vendors in the Cape Metropole. A validated questionnaire was administered, including a quantified 24 h dietary recall, and fasting blood samples were collected for biochemical analyses. Statistical analyses were performed to investigate the association between dietary habits and cardiometabolic risks, while adjusting for confounding variables. The analytic sample consisted of 189 males with a median age of 38 years. The taxi drivers who ranked in the top-third of the healthy plant-based diet index (hPDI) had a 1–4% lower likelihood of having raised triglycerides (TG). Furthermore, consumption patterns including refined grains and meat conferred a 33% lower likelihood of dysglycaemia (p = 0.049), while fish/seafood, potatoes, and vegetables conferred a 43% greater likelihood of low high-density lipoprotein cholesterol (HDL-C) (p = 0.026) and 44% greater probability of raised low-density lipoprotein cholesterol (LDL-C) (p = 0.027). Consumption patterns, including sugar-sweetened beverages and eggs, conferred a 37% greater probability of hypertension (p = 0.047) and 53% greater likelihood of subclinical inflammation (p = 0.017). These preliminary findings require larger and more elaborate studies to explore the associations between PBDs and dietary patterns in at-risk African populations, with or without sedentary lifestyles, and exposure to unhealthy food environments. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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11 pages, 307 KiB  
Article
Nutritional Assessment of Plant-Based Meat Alternatives: A Comparison of Nutritional Information of Plant-Based Meat Alternatives in Spanish Supermarkets
by Lucía Rizzolo-Brime, Alicia Orta-Ramirez, Yael Puyol Martin and Paula Jakszyn
Nutrients 2023, 15(6), 1325; https://doi.org/10.3390/nu15061325 - 8 Mar 2023
Cited by 16 | Viewed by 4903
Abstract
Since the classification of processed meat as carcinogenic by the International Agency for Research on Cancer (IARC) in 2015, an increase in consumption of plant-based meat alternatives (PBMAs) has been observed worldwide. This occurs in a context characterized by concern for health, animal [...] Read more.
Since the classification of processed meat as carcinogenic by the International Agency for Research on Cancer (IARC) in 2015, an increase in consumption of plant-based meat alternatives (PBMAs) has been observed worldwide. This occurs in a context characterized by concern for health, animal welfare, and sustainability; however, evidence of their nutritional quality is still limited. Therefore, our objective was to evaluate the nutritional profile and processing degree of PBMAs available in Spain. In 2020, products from seven Spanish supermarkets were analyzed for their nutritional content and ingredients. Of the 148 products, the majority were low in sugars but moderate in carbohydrates, total and saturated fat, and high in salt. The main vegetable protein sources were soy (91/148) and wheat gluten (42/148). Comparatively, 43/148 contained animal protein, the most common being egg. Overall, PBMAs had a long list of ingredients and additives, and they were classified as ultra-processed foods (UPFs) according to the NOVA system. This study shows that the PBMAs available in Spanish supermarkets have a variable nutritional composition within and between categories. Further research is needed to determine if replacing meat with these UPFs could be a good alternative towards healthier and more sustainable dietary patterns. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
14 pages, 1089 KiB  
Article
Does a Plant-Based Diet Stand Out for Its Favorable Composition for Heart Health? Dietary Intake Data from a Randomized Controlled Trial
by Justina Dressler, Maximilian Andreas Storz, Carolin Müller, Farid I. Kandil, Christian S. Kessler, Andreas Michalsen and Michael Jeitler
Nutrients 2022, 14(21), 4597; https://doi.org/10.3390/nu14214597 - 1 Nov 2022
Cited by 10 | Viewed by 5128
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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17 pages, 955 KiB  
Article
Adherence to the Mediterranean Diet Is Inversely Associated with the Prevalence of Metabolic Syndrome in Older People from the North of Spain
by Gloria Cubas-Basterrechea, Iñaki Elío, Guzmán Alonso, Luis Otero, Luis Gutiérrez-Bardeci, Jesús Puente and Pedro Muñoz-Cacho
Nutrients 2022, 14(21), 4536; https://doi.org/10.3390/nu14214536 - 28 Oct 2022
Cited by 7 | Viewed by 1937
Abstract
Background: The aim of this study was to relate adherence to the Mediterranean diet (MedDiet) to the prevalence of metabolic syndrome (MetS) in an elderly population from the north of Spain. Methods: We carried out an observational, descriptive, cross-sectional, and correlational study involving [...] Read more.
Background: The aim of this study was to relate adherence to the Mediterranean diet (MedDiet) to the prevalence of metabolic syndrome (MetS) in an elderly population from the north of Spain. Methods: We carried out an observational, descriptive, cross-sectional, and correlational study involving 556 non-institutionalised individuals aged 65 to 79 years. The MEDAS-14 questionnaire score was used to define the degree of adherence to the Mediterranean diet. The diagnosis of MetS was conducted using the International Diabetes Federation (IDF) criteria. Results: In 264 subjects with an average age of 71.9 (SD: ±4.2), 39% of whom were men, 36.4% had good adherence (score ≥ 9 in MEDAS-14), with no differences by gender or age. The prevalence of MetS was 40.2%, with 47.6% in men and 35.4% in women (p < 0.05). The prevalence of MetS was 2.4 times more frequent among individuals who consumed less than two servings (200 g) of vegetables daily compared with those who consumed two or more servings of vegetables daily (OR: 2.368, 95%CI: 1.141–4.916, p = 0.021). Low adherence to the MedDiet (MEDAS-14 score ≤ 8) was associated with an 82% higher prevalence of MetS (OR: 1.817, 95%CI: 1.072–3.081, p = 0.027). Conclusion: An inverse relationship was established between adherence to the MedDiet and the prevalence of MetS. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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10 pages, 262 KiB  
Article
Nutritional Content of Non-Dairy Frozen Desserts
by Winston J. Craig and Cecilia J. Brothers
Nutrients 2022, 14(19), 4150; https://doi.org/10.3390/nu14194150 - 6 Oct 2022
Cited by 4 | Viewed by 2766
Abstract
There is a growing interest in non-dairy alternatives fueled by concerns about personal health and the health of the planet. Sales of non-dairy frozen desserts have increased along with other non-dairy alternatives such as plant-based beverages, cheeses, yogurts and creamers. The aim of [...] Read more.
There is a growing interest in non-dairy alternatives fueled by concerns about personal health and the health of the planet. Sales of non-dairy frozen desserts have increased along with other non-dairy alternatives such as plant-based beverages, cheeses, yogurts and creamers. The aim of this study was to conduct a cross-sectional survey of plant-based frozen desserts to determine their nutritional content. A total of 358 plant-based frozen desserts were analyzed from the nutrition label listed on the commercial container. The various products were based upon coconut (n = 126), oat milk (n = 63), almonds (n = 42), cashews (n = 25), soy (n = 11), macadamia milk (n = 9), olive oil (n = 8), faba bean (n = 8), canola oil (n = 8), rice milk (n = 6), sunflower milk (n = 6), avocado (n = 5), pea protein (n = 5) and various fruits, nuts and mixed blends (n = 36). While 90% of the frozen desserts had high sugar levels, 73% had high levels of saturated fat (due to the presence of coconut oil) and only one in four had high levels of fat. None of the products were fortified with calcium, vitamin D or B12, but one in six products had iron levels/serving of at least 10% of Daily Value (DV) and 1 in 6 had protein levels/serving similar to regular dairy ice cream. Food manufacturers need to produce new non-dairy frozen desserts that are more nutritious, since few brands (such as those based upon avocado, apple and hemp protein, or fava bean) presently provide consumers choices with lower saturated fat and sugar levels and/or higher protein levels. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
16 pages, 947 KiB  
Article
Prevalence of Female and Male Vegan and Non-Vegan Endurance Runners and the Potential Associations of Diet Type and BMI with Performance—Results from the NURMI Study (Step 1)
by Katharina Wirnitzer, Derrick Tanous, Mohamad Motevalli, Gerold Wirnitzer, Claus Leitzmann, Renato Pichler, Thomas Rosemann and Beat Knechtle
Nutrients 2022, 14(18), 3803; https://doi.org/10.3390/nu14183803 - 15 Sep 2022
Cited by 6 | Viewed by 4016
Abstract
This study aims to investigate vegetarian and mixed diet type prevalences among distance runners at running events around the world and associations with running-related patterns and performance. Following a cross-sectional approach, linear regression analyses were carried out to identify potential associations among body [...] Read more.
This study aims to investigate vegetarian and mixed diet type prevalences among distance runners at running events around the world and associations with running-related patterns and performance. Following a cross-sectional approach, linear regression analyses were carried out to identify potential associations among body mass index (BMI), diet type, and average best performance times of half-marathon and marathon events for males and females. From a sample of 3835 runners who completed an online questionnaire, 2864 all-distance runners (age: 37 years; 57% females) were included in inferential analyses and categorized into dietary subgroups according to self-reports: 994 vegans (34.7%), 598 vegetarians (20.9%), and 1272 omnivores (44.4%). Significant associations were identified between kind of diet and best average time to finish (i) half-marathons in females where vegans (p = 0.001) took longer than omnivores, (ii) half-marathons in males where vegans (p < 0.001) and vegetarians (p = 0.002) took longer than omnivores, and (iii) marathons in males where vegans (p < 0.001) and vegetarians (p = 0.043) averaged slower than omnivores. Increased units of BMI (+1.0) in males influenced best runtimes: 2.75 (3.22–2.27) min slower for HM and 5.5 (5.69–4.31) min slower for M. The present study did not take detailed confounders into account such as runner motives or training behaviors; however, the results may provide valuable insight for running event organizers, nutrition experts, coaches, and trainers advising runners who adhere to a general diet type regarding the basic question of who participates in running events around the world. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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23 pages, 1386 KiB  
Article
Application of a Modified Healthy Eating Index (HEI-Flex) to Compare the Diet Quality of Flexitarians, Vegans and Omnivores in Germany
by Anja Bruns, Mattea Mueller, Inga Schneider and Andreas Hahn
Nutrients 2022, 14(15), 3038; https://doi.org/10.3390/nu14153038 - 24 Jul 2022
Cited by 11 | Viewed by 2837
Abstract
Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, [...] Read more.
Interest in plant-based nutrition has steadily increased in the western world in the recent years. The number of people following a meat-reduced, flexitarian diet is growing continuously. However, little is known about the diet quality of flexitarians compared to vegans or omnivores. Therefore, in this cross-sectional study, the food intake of 94 participants aged between 25–45 years was recorded via a validated food frequency questionnaire and 28 self-designed questions about the consumption of plant-based alternatives. An adapted Healthy Eating Index, HEI-flex, was developed to evaluate the diet quality of flexitarians, vegans and omnivores. Higher score points (SP) of the HEI-flex are associated with higher compliance with the official diet recommendations (Vmax = 100 SP). Finally, flexitarians scored significantly more highly when compared to omnivores (54 ± 8 vs. 47 ± 9 SP; p = 0.008) but lower than vegans (54 ± 8 vs. 61 ± 10 SP; p = 0.010). The results showed that the HEI-flex is a useful tool for assessing and comparing the diet quality of flexitarians, vegans and omnivores. Despite the consumption of highly processed plant-based alternatives, reduction in meat and meat products seems to be accompanied by increased overall diet quality. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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Review

Jump to: Research

23 pages, 2178 KiB  
Review
The Role of the Mediterranean Diet in Breast Cancer Survivorship: A Systematic Review and Meta-Analysis of Observational Studies and Randomised Controlled Trials
by Ge Chen, Sam Leary, Jizhao Niu, Rachel Perry and Angeliki Papadaki
Nutrients 2023, 15(9), 2099; https://doi.org/10.3390/nu15092099 - 27 Apr 2023
Cited by 5 | Viewed by 2948
Abstract
Female breast cancer is the most frequently diagnosed cancer. The long-term survival rates for this disease have increased; however, the unique demand for high-quality healthcare to improve breast-cancer survivorship are commonly unmet. The Mediterranean diet (MD) is associated with reduced breast-cancer risk and [...] Read more.
Female breast cancer is the most frequently diagnosed cancer. The long-term survival rates for this disease have increased; however, the unique demand for high-quality healthcare to improve breast-cancer survivorship are commonly unmet. The Mediterranean diet (MD) is associated with reduced breast-cancer risk and various health-related benefits in the general population, but its effect on breast-cancer survivors remains uncertain. The objective of this systematic review and meta-analysis was to assess current evidence from randomised controlled trials (RCTs) and observational studies (cohort, cross-sectional and case-control) regarding the effect of the MD on survival, quality of life (QoL) and health-related outcomes in female breast-cancer survivors. MEDLINE, EMBASE, Web of Science and the Cochrane library were searched for studies published before and including April 2022. Two reviewers independently screened the literature and completed the data extraction and risk-of-bias assessment. Eleven studies (fifteen reports) were included, including two RCTs, four cohort and five cross-sectional studies. The meta-analysis of the cohort studies showed strong evidence of an inverse association between high adherence to the MD and all-cause mortality (hazard ratio (HR) 0.78, 95% confidence interval (CI) 0.66–0.93, I2: 0%, Grading of Recommendations Assessment, Development and Evaluation (GRADE) = low certainty of evidence) and non-breast-cancer mortality (HR 0.67, 95% CI 0.50–0.90, I2: 0%, GRADE = very low certainty of evidence). The associations between high adherence to the MD and QoL and health-related parameters were not consistent. These findings highlight the potential of adherence to the MD to reduce the risk of mortality. Future research with better study designs, as well as more consistent measurements of QoL and MD adherence, taking into account changes in MD adherence over time and population subgroups, is needed to provide more robust evidence on the survival, QoL and health-related outcomes in BC survivors. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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18 pages, 450 KiB  
Review
Dietary Patterns, Dietary Interventions, and Mammographic Breast Density: A Systematic Literature Review
by Elisa Pastore, Saverio Caini, Benedetta Bendinelli, Domenico Palli, Ilaria Ermini, Nora de Bonfioli Cavalcabo’, Melania Assedi, Daniela Ambrogetti, Miriam Fontana and Giovanna Masala
Nutrients 2022, 14(24), 5312; https://doi.org/10.3390/nu14245312 - 14 Dec 2022
Cited by 3 | Viewed by 2283
Abstract
Background: Breast cancer (BC) is the most common and deadliest malignancy among women. High mammographic breast density (MBD) is an established modifiable risk marker for BC, and it is of interest, for prevention purposes, to consider lifestyle factors that may modulate both MBD [...] Read more.
Background: Breast cancer (BC) is the most common and deadliest malignancy among women. High mammographic breast density (MBD) is an established modifiable risk marker for BC, and it is of interest, for prevention purposes, to consider lifestyle factors that may modulate both MBD and BC risk. Here, we conducted a systematic review of the most up-to-date evidence on the association between diet as a whole and MBD. Methods: We considered as eligible for inclusion in our review (PROSPERO registration code CRD42022335289) the studies published until 31 December 2021, that reported on the association between a priori or a posteriori dietary patterns (in observational studies) or dietary interventions (in randomized controlled trials) and MBD. Results: In total, twelve studies were included. MBD tended to be inversely associated with adherence to dietary patterns characterized by high consumption of plant-based foods and low in meat, animal fats, and alcohol, defined both a priori (e.g., Mediterranean diet and WCRF/AICR guidelines) or a posteriori (e.g., “fruit-vegetable-cereal” and “salad-sauce-pasta/grains” patterns). Findings from intervention studies were in fair agreement with those from observational studies. Conclusions: While further studies are needed, we found suggestive evidence that the adoption of a healthy diet is associated with lower MBD. Full article
(This article belongs to the Special Issue Plant-Based Dietary Patterns, Health and Sustainability)
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