Search Results (95)

Dietary choices and patterns have enormous consequences along the lines of individual, community, and planetary health. Excess meat consumption has been linked to chronic disease risk, and at large scales, the underlying industries maintain a massive environmental footprint. For these reasons, public and planetary health experts are unified in emphasizing a whole or minimally processed plant-based diet. In response, the purveyors of ultra-processed foods have added “meat alternatives” to their ultra-processed commercial portfolios; multinational corporations have been joined by “start-ups” with new ultra-processed meat analogues. Here, in our Viewpoint, we revisit the 1990s food industry rhetoric and product innovation, a time in which multinational corporations pushed a great “low-fat transition.” We focus on the McLean Deluxe burger, a carrageenan-rich product introduced by the McDonald’s Corporation in 1991. Propelled by a marketing and media-driven fear of dietary fats, the lower-fat burger was presented with great fanfare. We reflect this history off the current “great protein transition,” a period once again rich in rhetoric, with similar displays of industry detachment from concerns about the health consequences of innovation. We scrutinize the safety of carrageenan and argue that the McLean burger should serve as a cautionary tale for planetary health and 21st century food innovation. Full article

Background: Nutritional management has become an integral part of Inflammatory Bowel Disease (IBD) care, with growing evidence supporting specific dietary interventions alongside pharmacologic therapy. However, clinical guidance remains fragmented due to heterogeneous study designs and variable endpoints. Objectives: This review critically examines the current evidence on dietary strategies and oral nutritional supplementation (ONS) in both Crohn’s Disease (CD) and Ulcerative Colitis (UC), highlighting their clinical applications, mechanisms of action, and limitations. Methods: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases, analyzing studies on various dietary approaches and ONS in IBD. Results: Exclusive Enteral Nutrition (EEN) is a first-line therapy in pediatric CD, while partial enteral nutrition (PEN) and the Crohn’s Disease Exclusion Diet (CDED) show promising efficacy and better adherence in both children and adults. Whole-food-based interventions, including the Mediterranean Diet, Specific Carbohydrate Diet, plant-based diets, and emerging strategies such as CD-TREAT and the Tasty & Healthy diet, have demonstrated varying levels of benefit in disease maintenance and symptom control. Targeted exclusion diets—such as low-FODMAP, low-emulsifier, and low-sulfur diets—may relieve functional symptoms and influence inflammatory activity, although evidence remains preliminary. ONS plays a pivotal role in addressing malnutrition and improving outcomes in perioperative and hospitalized patients. Conclusions: Dietary interventions and ONS represent valuable therapeutic tools in IBD management. Future research should prioritize standardized, well-powered clinical trials and personalized nutritional approaches to better define their role within integrated care pathways. Full article

Background/Objectives: Exclusive Enteral Nutrition (EEN) and the Crohn’s Disease Exclusion Diet (CDED) have been shown to induce remission in Crohn’s disease. Low-sulphur, plant-based diets are being explored for ulcerative colitis, and wholefood, low-additive approaches are emerging as significant. Although Inflammatory Bowel Disease (IBD) patients modify their diet, evidence for tolerability and benefit outside clinical trials is limited. The DELECTABLE program aimed to assess satisfaction, adherence, and efficacy of dietary therapies as part of IBD care. Methods: In this dietitian-led, open-label, prospective study, patients with Crohn’s disease were offered the CDED or a whole-food, additive-free diet (WFD), and patients with ulcerative colitis were offered a low-sulphur, plant-based diet (UCD) or WFD. Primary outcomes were 12-week diet satisfaction (modified DSAT-28) and diet adherence, including food additive intake. Secondary outcomes were quality of life (QoL) (IBDQ-9), disease activity (CDAI for Crohn’s disease, partial Mayo score for ulcerative colitis), and biochemical markers (CRP, faecal calprotectin). Analyses were conducted within, rather than between, diet arms due to the non-random nature of the study. Diet adherence and disease activity change across time points (baseline, week 6, week 12) were assessed using repeated measures ANOVA or Friedman’s test, with pairwise paired t-test or Wilcoxon Signed-Rank test. Diet satisfaction and quality of life changes across time (baseline/week 1, week 12) were assessed using a paired t-test or Wilcoxon Signed-Rank test. Results: Of 165 referrals, 76 patients enrolled, with 64 completing the 12-week program (CDED: n = 15, WFD: n = 42, UCD: n = 7). Diet satisfaction was initially high and remained stable over time on CDED (p = 0.212) and improved on WFD (p = 0.03). Patient- and dietitian-rated adherence was high at baseline and did not significantly decrease on any diet arm (p > 0.349). Food additive intake decreased on WFD (p = 0.009). QoL improved on CDED and WFD (p < 0.001). CRP, calprotectin, and CDAI were reduced on CDED (p < 0.045), and CDAI and partial Mayo were reduced on WFD (p < 0.027). Conclusions: Well-balanced therapeutic diets are feasible and well-accepted by patients with IBD, with a promising impact on disease activity. Full article

Background/Objectives: Plant-based diets are associated with human and planetary health. However, the overall quality of these diets may depend on the proportion of ultra-processed foods (UPFs). This study investigates the association between UPF consumption and plant-based diet quality in Australian adults. Methods: Analysis was conducted on 9111 participants (aged ≥ 19 years) from the National Nutrition and Physical Activity Survey 2011–2012. Food items reported from a 24 h recall were classified using the NOVA system, and the contribution of UPFs to total energy intake was calculated. Plant-based diet quality was examined using the overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI). Multiple linear regression models were used to examine the association between the UPF intake and PDI, hPDI, uPDI, and their score components. Results: The proportion of energy from UPFs was positively associated with the uPDI (β = 0.80; 95% CI 0.72, 0.89) and negatively associated with the PDI (β = −0.13; 95% CI: −0.22, −0.04) and the hPDI (β = −0.65; 95% CI: −0.73, −0.57). All score components of the PDI, hPDI and uPDI, except whole grains, legumes and fruit juices, significantly contributed to these associations. The sugars and syrups group contributed most to the positive association between UPFs and the uPDI (β = 6.47; 95% CI: 6.07, 6.87) and the negative association of UPFs and the hPDI (β = −6.47; 95% CI: −6.07, −6.87). Conclusions: Higher consumption of UPFs was associated with a lower plant-based diet quality. These findings have implications for the design of dietary interventions that encourage the consumption of minimally processed plant-based foods. Full article

Background: Culinary medicine (CM) interventions in teaching kitchens have emerged as novel approaches for influencing dietary behaviors, but their efficacy, content, and delivery vary. Objective: The effects of a virtual vegan CM intervention on behavioral determinants, cooking competencies, diet quality, and skin carotenoid status were assessed. Methods: This analysis from a 9-week randomized crossover study evaluated behavioral survey assessments, Whole Plant Food Density (WPFD) as a diet quality indicator utilizing Automated Self-Administered 24 h Dietary Recall data, and skin carotenoid status (SCS) via pressure-mediated reflection spectroscopy at multiple timepoints. Adults at ≥5% atherosclerotic cardiovascular disease (ASCVD) risk followed a vegan diet pattern that was high or low in extra virgin olive oil (EVOO) for 4 weeks each with weekly virtual cooking classes, separated by a 1-week washout period. Qualitative feedback was collected for thematic analysis. Results: In 40 participants (75% female; body mass index, 32 ± 7 kg/m²; age, 64 ± 9 years mean ± SD), perceived control over trajectory of heart disease, knowledge of lifestyle behaviors for heart health, and confidence in cooking skills and preparing a variety of plant-based foods improved post intervention (all p ≤ 0.001). WPFD increased by 69–118% from baseline. Greater SCS changes occurred after high-EVOO (+51.4 ± 13.9 mean ± SEM, p < 0.001) compared to low-EVOO (+6.0 ± 16.4, p = 0.718) diets. Conclusions: A virtual vegan CM intervention improved dietary behaviors and quality, which was associated with reductions in CVD risk factors. SCS is influenced by EVOO intake, warranting consideration when used to estimate fruit and vegetable intake. The potential impacts of CM on behaviors and health outcomes warrant continued research efforts in medical and public health settings. Full article

Introduction: The planetary health diet, introduced by the EAT–Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, including prevention and management of abdominal obesity, carbohydrate metabolism disorders, dyslipidemia, and elevated blood pressure. These metabolic disorders are components of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Objectives: This narrative review aims to gather the most recent findings on the impact of the planetary diet on individual components of metabolic syndrome and on the prevention and treatment of cardiovascular disease. Methods: The available research on the topic was identified via searches in PubMed, Scopus, and Google Scholar. Results: Abdominal obesity, a major risk factor for a range of chronic diseases, can be effectively mitigated by adhering to plant-based dietary patterns, which have been shown to reduce waist circumference and improve overall cardiometabolic health. Furthermore, the planetary diet plays a crucial role in reducing the risk of type-2 diabetes and improving glycemic control, with specific dietary components such as whole grains and fiber, demonstrating positive effects on blood glucose levels. This diet is additionally associated with favorable lipid profiles, including lower levels of LDL cholesterol and total cholesterol, which are critical in the prevention of atherosclerosis and cardiovascular diseases. Conclusions: These multiple benefits highlight that the planetary diet may be an effective strategy for managing and preventing metabolic syndrome and cardiovascular disease. However, further research is needed to confirm its long-term efficacy and applicability across diverse populations. Full article

Background/Objectives: Whole-food plant-based diets (WFPBDs) are beneficial in managing hypertension in the general population but have not been well studied in chronic kidney disease (CKD), potentially due to concerns about hyperkalemia. We hypothesized that individuals with CKD 3 or 4 attending a 15-day WFPBD education program would achieve lower blood pressure compared to those who did not, without an increased risk of hyperkalemia. Methods: This was a pilot trial of 40 subjects with mild-to-moderate CKD and hypertension but without diabetes or proteinuria from a single academic center. The subjects were randomized to the 15-day education program or the control group. The changes in blood pressure, serum potassium, and other anthropometric and biochemical values were assessed. Results: Systolic blood pressure decreased from the baseline to day 15 in the intervention group by 8 mm Hg and increased in the control group by 2.7 mm Hg, although the difference in the blood pressure change did not reach statistical significance (p = 0.12). Diastolic blood pressure was not different between the two groups. Potassium changed by 0.01 mEq/L in the intervention group and −0.07 mEq/L in the control group (p = 0.52). The intervention subjects had significant decreases in body mass (−3.0 vs. −0.12 kg, p < 0.0001), total cholesterol (−39.4 vs. −5.0 mg/dL, p < 0.0001), low-density lipoprotein (−28.4 vs. −0.6 mg/dL, p < 0.0001), and high-density lipoprotein (−8.6 vs. −0.4 mg/dL, p = 0.006) compared to the controls. The changes in albumin and phosphorus were not different between the two groups. Conclusions: The subjects with mild-to-moderate CKD attending a 15-day WFPBD education program had a non-statistically significant reduction in systolic blood pressure without an increased risk of hyperkalemia compared to those who did not attend. The intervention subjects achieved significantly greater reductions in body mass and cholesterol without adverse effects on albumin or phosphorus. Larger and longer-duration trials using this approach in a diverse group of CKD patients are warranted. Full article

Background: In recent years, juicing has often been promoted as a convenient way to increase fruit and vegetable intake, with juice-only diets marketed for digestive cleansing and overall health improvement. However, juicing removes most insoluble fiber, which may diminish the health benefits of whole fruits and vegetables. Lower fiber intake can alter the microbiota, affecting metabolism, immunity, and mental health, though little is known about juicing’s specific effects on the microbiota. This study addresses this gap by exploring how juicing impacts gut and oral microbiome composition in an intervention study. Methods: Fourteen participants followed one of three diets—exclusive juice, juice plus food, or plant-based food—for three days. Microbiota samples (stool, saliva, and inner cheek swabs) were collected at baseline, after a pre-intervention elimination diet, immediately after juice intervention, and 14 days after intervention. Moreover, 16S rRNA gene amplicon sequencing was used to analyze microbiota taxonomic composition. Results: The saliva microbiome differed significantly in response to the elimination diet (unweighted UniFrac: F = 1.72, R = 0.06, p < 0.005; weighted UniFrac: F = 7.62, R = 0.23, p-value = 0.0025) with a significant reduction in Firmicutes (p = 0.004) and a significant increase in Proteobacteria (p = 0.005). The juice intervention diets were also associated with changes in the saliva and cheek microbiota, particularly in the relative abundances of pro-inflammatory bacterial families, potentially due to the high sugar and low fiber intake of the juice-related products. Although no significant shifts in overall gut microbiota composition were observed, with either the elimination diet or the juice intervention diets, bacterial taxa associated with gut permeability, inflammation, and cognitive decline increased in relative abundance. Conclusions: These findings suggest that short-term juice consumption may negatively affect the microbiota. Full article

Background/Objectives: The global population is undergoing a significant demographic shift characterised by an increasing proportion of older individuals. Healthy aging has become a priority for personal well-being and sustainable healthcare systems, with nutrition playing a pivotal role. However, the rise in non-communicable diseases (NCDs), malnutrition, and a shift in eating behaviour underscore the need for tailored, effective nutrition communication strategies. This research is intended to provide the basic data needed to support the development of tailored nutritional communication strategies and practices. Methods: To investigate these aspects, a cross-national survey about nutrition and nutrition communication was conducted within the framework of the Innovative Training Network SmartAge, focusing on older adults aged 60 years and above in Germany, Switzerland, Spain, and France (each 25%; N = 1000 persons). This paper specifically focuses on the development, methodology, and discussion of the survey and aims to investigate the characteristics of the sample in relation to their dietary patterns and food choices within the European context. Results: The analysis identified significant associations between various plant- and animal-based food items and the variables gender, age group, and country. Spanish participants showed a dietary pattern towards the Mediterranean Diet, while German participants showed tendencies towards the Western Diet. Furthermore, the findings revealed that protein-rich foods such as meat, fish, nuts and seeds, legumes, and (whole) grains were infrequently consumed, particularly among German and Swiss participants. Conclusions: This study highlights the need to promote adequate protein intake among older adults, emphasising diverse sources like legumes, nuts and seeds, (whole) grains, and lean meats to support healthy aging. For the development of future nutrition communication strategies, the influence of the specific social, cultural, and traditional factors needs to be considered. Full article

Objective: This single-arm, pre–post interventional trial (clinicaltrials.gov, NCT04515095) investigates the safety, feasibility, and potential effectiveness of prolonged water-only fasting followed by a whole-plant-food diet in the long-term management of hypertension and other cardiometabolic disorders. Methods: Safety was assessed based on adverse events (AEs) that were recorded according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Feasibility was assessed based on retention rate, ability to complete minimal fast length, and intervention acceptability. Twenty-nine participants with stage 1 and 2 hypertension and without type 2 diabetes were enrolled from a residential fasting center. Results: Study retention was 100% at the end of the refeed and 93% at the six-week follow-up visit. Median (range) fasting and refeeding duration were 11 (7–40) and 5 (3–17) days, respectively, and 90% of participants were able to complete at least 7 days of fasting. The majority of AEs were mild (grade 1) and transient and there were no higher-grade or serious AEs. At the end of the intervention, median systolic/diastolic blood pressure had normalized to below 130/80 mmHg, body weight reduced by >5%, and anti-hypertensive medication was completely discontinued. These results were sustained for at least six weeks and potentially up to one year. Conclusions: Our data suggest that the intervention may be a feasible, well-tolerated, low-risk option for lowering and managing high blood pressure, excess body weight, and other cardiometabolic disorders in people with stage 1 and 2 hypertension. Full article

Background/Objectives: The diet quality of younger individuals is decreasing globally, with alarming trends also in the Mediterranean region. The aim of this study was to assess diet quality and adequacy in relation to country-specific dietary recommendations for children and adolescents living in the Mediterranean area. Methods: A cross-sectional survey was conducted of 2011 parents of the target population participating in the DELICIOUS EU-PRIMA project. Dietary data and cross-references with food-based recommendations and the application of the youth healthy eating index (YHEI) was assessed through 24 h recalls and food frequency questionnaires. Results: Adherence to recommendations on plant-based foods was low (less than ∼20%), including fruit and vegetables adequacy in all countries, legume adequacy in all countries except for Italy, and cereal adequacy in all countries except for Portugal. For animal products and dietary fats, the adequacy in relation to the national food-based dietary recommendations was slightly better (∼40% on average) in most countries, although the Eastern countries reported worse rates. Higher scores on the YHEI predicted adequacy in relation to vegetables (except Egypt), fruit (except Lebanon), cereals (except Spain), and legumes (except Spain) in most countries. Younger children (p < 0.005) reporting having 8–10 h adequate sleep duration (p < 0.001), <2 h/day screen time (p < 0.001), and a medium/high physical activity level (p < 0.001) displayed a better diet quality. Moreover, older respondents (p < 0.001) with a medium/high educational level (p = 0.001) and living with a partner (p = 0.003) reported that their children had a better diet quality. Conclusions: Plant-based food groups, including fruit, vegetables, legumes, and even (whole-grain) cereals are underrepresented in the diets of Mediterranean children and adolescents. Moreover, the adequate consumption of other important dietary components, such as milk and dairy products, is rather disregarded, leading to substantially suboptimal diets and poor adequacy in relation to dietary guidelines. Full article

Functional amyloids (protein nanofibrils, PNF) synthesized from plant sources exhibit unique physicochemical and nanomechanical properties that could improve food texture. While environmental factors affecting PNFs are well-known, scientific evidence on how cells (focus on the oral cavity) respond to them under physiological conditions is lacking. Self-assembled PNFs synthesized from fava bean whole protein isolate show a strong pH- and solvent-dependent morphology and elasticity modification measured by atomic force microscopy (AFM). After incubation of PNFs with an oral mechanosensitive model cell line at pH 7.3, difference in cell-surface roughness without significant changes in the overall cell elasticity were measured. The role of cell membrane composition on supported lipid bilayers was also tested, showing an increase in membrane elasticity with increasing fibril concentration and the possible impact of annular phospholipids in binding. Genetic responses of membrane proteins involved in texture and fat perception were detected at the mRNA level by RT-qPCR assay and both mechano- and chemosensing proteins displayed responses highlighting an interface dependent interaction. The outcomes of this study provide a basis for understanding the changing physicochemical properties of PNFs and their effect on flavor perception by altering mouthfeel and fat properties. This knowledge is important in the development of plant-based texture enhancers for sensory-appealing foods that require consumer acceptance and further promote healthy diets. Full article

(1) Background: Healthful plant-based diets, especially those rich in minimally processed plant-based foods such as fruits, vegetables, and whole grains, have been associated with a lower risk of diet-related chronic disease. However, individuals who limit or avoid animal products may be at risk of nutrient deficiencies, especially related to Vitamin B12, Vitamin D, omega-3 fatty acids, calcium, iron, iodine, zinc, and protein. Such deficiencies can result in both short- and long-term health challenges. We used qualitative methods to explore plant-based eaters’ knowledge and awareness of these eight nutrients of concern in diets that limit or exclude animal-source foods. (2) Methods: We conducted interviews with 28 rural flexitarian, pescatarian, vegan, or vegetarian adults in Vermont, USA. (3) Results: The participants positively viewed the healthfulness of plant-based diets, but many recognized limitations to accessing Vitamin B12, Vitamin D, and omega-3 fatty acids. They shared the strategies used to meet their needs including eating a varied diet, seeking out specific foods, and taking dietary supplements. Analyses identified gaps in the participants’ knowledge related to nutrient bioavailability, food sources of specific nutrients, and the importance of zinc and iodine. Vegans—the highest-risk group—generally presented as the most knowledgeable. The participants noted a lack of local plant-based nutrition expertise. (4) Conclusions: Addressing the identified knowledge gaps and challenges to dietary adequacy, especially among those who limit, but do not fully omit, animal-source foods, may support plant-based nutrition. Full article

Background: Flaxseeds are functional foods popular in current diets. Cold-pressing is a solvent-free method to extract flaxseed oil, resulting in a by-product—defatted flour. Objectives/Methods: This study compared whole flaxseeds and defatted flour (proximate composition, fatty acids, vitamin E, total phenolics and flavonoids, antioxidant activity, amino acids, and protein quality) and updated the composition of cold-pressed oil (oxidative stability, peroxide value, UV absorbance, colour, fatty acids, vitamin E, total phenolics and flavonoids, and antioxidant activity) to assess the nutritional relevance and potential for food applications of these samples. Results: The flour had higher ash (6% vs. 4%), fibre (36% vs. 34%), protein (28% vs. 16%), phenolics (205 vs. 143 mg gallic acid equivalents/100 g), and antioxidant activity than seeds (p < 0.05), so it should be valued as a novel high-fibre food ingredient with high-quality plant-based protein, as it contains all essential amino acids (106 mg/g) and a high essential amino acids index (112%), with L-tryptophan as the limiting amino acid. The oil, while low in oxidative stability (1.3 h), due to its high polyunsaturated fatty acids sum (75%), mostly α-linolenic acid (57%), contains a significant amount of vitamin E (444 mg/kg), making it a specialty oil best consumed raw. Conclusions: The exploration of the flour as a minimally processed food ingredient highlights its role in supporting food security, circular economy, and sustainability goals, aligning with consumer preferences for natural, low-fat foods. Future research should investigate the bioactivity and shelf-life of the samples, as well as the bioavailability of compounds after digestion. Full article

The prevalence of obesity has been increasing in the US. Among the multifactorial contributors to obesity, dietary factors stand out as primary drivers. Using data from NHANES, we investigated the trends and disparities in diet quality and nutrient intake among US adults with different bodyweight statuses. Participants were divided into normal weight, overweight, and obese groups based on BMI. Diet quality was examined using HEI-2020. Nutrient intake was estimated based on the USDA Food and Nutrient Database for Dietary Studies. From 1999 to 2020, Despite an overall improvement in diet quality among overweight and obese US adults, disparities persisted for most HEI-2020 components, and worsened for whole grains, seafood and plant proteins, and fatty acids between normal weight and obese participants. Overweight and obese participants tended to consume less energy from total carbohydrates and more from total fat. The estimated total energy intake increased among obese participants over the past two decades, while no significant changes were observed among normal weight and overweight participants. In the 2017–2020 period, obese participants had lower HEI-2020 scores than both normal weight and overweight participants. However, no significant differences in total energy intake were observed among normal weight, overweight, and obese populations. Full article