Studies demonstrate that consuming plant-based diets has beneficial effects on several health outcomes. However, the evaluation of the healthiness of plant-based diets and the incidence of hypertension has still been little explored in the literature.

Thus, this study aimed to evaluate the association between plant-based diet indices and the incidence of hypertension in Brazilian adults and test whether the interaction between hPDI, sociodemographic, and lifestyle variables modifies this association.

This longitudinal study included 3192 (F = 2125, average age 34 years) participants from the Cohort of Universities of Minas Gerais (CUME Study, Brazil, 2016-2022). Dietary intakes were assessed using a validated food frequency questionnaire. We measured three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Participants were classified as new cases of hypertension if they were free of this disease at baseline, had a systolic blood pressure ≥ 140 mmHg, a diastolic blood pressure ≥90 mmHg, were using antihypertensive medications, or had a diagnosis of hypertension by a physician in at least one of the follow-ups. Crude and adjusted Cox regression models were used to evaluate the relationship between plant-based diet indices and hypertension incidence and a multiplicative interaction was tested.

The incidence of hypertension was 19,8/1000 person-years total. The mean follow-up time was 3.36 years. There was an inverse association between the highest quintiles of hPDI (HR = 0.56, 95% CI = 0.37-0.86; HR = 0.55, 95% CI = 0.35-0.88) and hypertension. In subgroup analysis, inverse associations between hPDI and hypertension risk were stronger in participants who were insufficiently active and overweight (p-interaction < 0.05).

Greater consumption of healthful plant foods, reduced consumption of animal-source foods, and less consumption of unhealthful plant foods are important for hypertension prevention in the Brazilian population.

Many currently proposed diets for inflammatory bowel disease (IBD) focus on increasing plant-based foods, although a vegetarian diet can still contain products such as emulsifiers and refined grains that are believed to negatively impact IBD incidence and progression. To better inform dietary management in IBD, we investigated the association between plant-based diets and the incidence and complications of IBD.

We leveraged data from the UK Biobank (UKB, 2009-2022) including 187,888 participants free of IBD at baseline and the European Prospective Investigation into Cancer and Nutrition (EPIC, 1991-2010) cohort including 341,539 individuals free of IBD across centres among Denmark, France, Germany, Greece, Italy, the Netherlands, Sweden and UK. Healthy and unhealthy diets were characterised using plant-based diet indexes (PDIs); in individual participants, these were based on the 24-h dietary recalls for UKB and food frequency questionnaires for EPIC. The primary outcome was the incidence of IBD; secondary outcomes evaluated endpoints of disease prognosis (IBD-related surgery, diabetes, cardiovascular diease, and all-cause mortality). Cox regression was applied to estimate hazard ratios (HRs).

In the UKB (925 incident IBD, median follow-up 11.6 years, IQR 1.3 years), higher adherence to healthy PDI was associated with a lower IBD risk (HR 0.75, 95% CI 0.60-0.94), while higher alignment to an unhealthy PDI associated with an increased risk (HR 1.48, 95% CI 1.21-1.82) when comparing extreme quintiles of PDIs. Among individuals with established IBD, healthy PDI was inversely associated (HR 0.50, 95% CI 0.30-0.83) and unhealthy PDI was positively associated (HR 2.12, 95% CI 1.30-3.44) with need for IBD-related surgery. We did not observe significant associations between PDIs and risk of cardiovascular disease, diabetes mellitus or mortality. In the EPIC study (548 incident IBD, median follow-up 14.5 years, IQR 7.0 years), the HR of incident IBD for healthy PDI was 0.71 (95% CI 0.59-0.85) and for unhealthy PDI was 1.54 (95% CI 1.30-1.84).

We provide evidence that the composition of a plant-based diet may be an important determinant of the risk of developing IBD, and of disease course after diagnosis. Further research is needed to explore the mechanistic pathways linking plant-based diets and IBD incidence and prognosis.

National Natural Science Foundation of China, Natural Science Fund for Distinguished Young Scholars of Zhejiang Province, National Undergraduate Training Program for Innovation and Entrepreneurship, CRUK Career Development Fellowship, The "Co-PI" project, Natural Science Fund for Excellent Young Scholars of Hunan Province.

Plant-based diets have grown in popularity owing to multiple health and environmental benefits. Some evidence suggests that plant-based diets are associated with benefits for urological health. In genitourinary oncology, most research has focused on prostate cancer. Clinical trial results suggest a favourable influence of healthy lifestyle modifications including plant-based diets before and after prostate cancer treatment. Epidemiological evidence shows that a diet higher in plant-based and lower in animal-based food is associated with a lower risk of aggressive prostate cancer and better quality-of-life scores than a diet with less plant-based and more animal-based food. Studies on bladder and kidney cancer are scarce, but limited data suggest that vegetarian or plant-forward dietary patterns (increased consumption of fruits and vegetables and minimizing meat) are associated with a lower risk of development of these cancers than dietary patterns with fewer fruits and vegetables and more meat. With respect to benign urological conditions, epidemiological studies suggest that plant-based dietary patterns are associated with a lower risk of benign prostatic hyperplasia and urinary tract infections than non-plant-based dietary patterns. Compared with diets high in animal-based foods and low in plant-based foods, a substantial body of epidemiological evidence also suggests that increased consumption of healthy plant-based food is associated with a lower risk of erectile dysfunction. Plant-based dietary patterns that are high in fruits and vegetables with normal calcium intake, while limiting animal protein and salt, are associated with a lower risk of kidney stone development than dietary patterns that do not follow these parameters. Overall, increasing consumption of plant-based foods and reducing intake of animal-based foods has favourable associations with multiple urological conditions.

Vegetarian diets are increasingly popular worldwide, but their impact on healthy aging in older adults remains unclear. This study examined the association between vegetarian diets and healthy aging among 2,888 healthy older Chinese adults from the Chinese Longitudinal Healthy Longevity Survey. Dietary patterns (vegan, ovo-vegetarian, pesco-vegetarian, omnivorous) were derived from a simplified non-quantitative food frequency questionnaire. Over a median follow-up of 6 years, after accounting for sociodemographic and lifestyle factors, vegetarians had lower odds of achieving healthy aging compared to omnivores (adjusted OR = 0.65, 95% CI: 0.47-0.89), with consistent results across sensitivity analyses and individual health components. Additionally, the health effects of vegetarian diets may vary depending on diet quality, with vegetarians of higher diet quality not significantly differing in terms of overall healthy aging and individual outcomes when compared to omnivores. Accordingly, this finding highlights modest inclusion of animal-based foods may improve the overall health status of healthy older adults.

Existing evidence on the relationship between intake of monounsaturated fatty acids (MUFAs) and type 2 diabetes is conflicting. Few studies have examined whether MUFAs from plant or animal sources (MUFA-Ps and MUFA-As, respectively) exhibit differential associations with type 2 diabetes. We examined associations of intakes of total MUFAs, MUFA-Ps and MUFA-As with type 2 diabetes risk.

We used data from 51,290 women in the Nurses' Health Study (1990-2016), 61,703 women in the Nurses' Health Study II (1991-2017) and 29,497 men in the Health Professionals Follow-up Study (1990-2016). Using food frequency questionnaires and food composition tables, we calculated MUFA-P and MUFA-A intakes every 4 years and modelled their associations with type 2 diabetes using Cox regression models.

During 3,268,512 person-years of follow-up, we documented 13,211 incident type 2 diabetes cases. After multivariate adjustment, total MUFA intake was associated with higher type 2 diabetes risk, with HR for Q5 vs Q1 of 1.10 (95% CI 1.01, 1.22). MUFA-Ps and MUFA-As demonstrated divergent associations, with HRs of 0.87 (95% CI 0.81, 0.94) and 1.34 (1.23, 1.45), respectively. In substitution analyses, HRs were 0.92 (95% CI 0.86, 0.99) for replacing 2% of energy from trans fatty acids or 0.72 (0.66, 0.78) and 0.82 (0.77, 0.88) for replacing 5% from MUFA-As and 5% from the sum of saturated fatty acids and MUFA-As with MUFA-Ps, respectively. Substituting MUFA-As for saturated fatty acids and refined carbohydrates was associated with a 43% and 33% higher risk, respectively.

Higher intake of MUFA-Ps was associated with lower type 2 diabetes risk, whereas increased intake of MUFA-As was associated with higher risk. Replacing saturated fatty acids, trans fatty acids and MUFA-As with MUFA-Ps may be beneficial for type 2 diabetes prevention.

In addition to the health effects of plant-based diets, their impact on the environment is becoming increasingly important. This study was conducted to assess the impact of adherence to a plant-based diet on sustainable eating behaviors.

This cross-sectional study was conducted on 2122 Turkish adults, 73% female and 27% male. The plant-based diet index (PDI), healthy plant-based diet index (hPDI) and unhealthy plant-based diet index (uPDI) were obtained from a validated semi-quantitative food frequency questionnaire (FFQ). After the index scores were calculated, the sample was divided into tertiles for each index. The sustainable eating behaviors of the participants were determined with the 'Behaviors Scale towards Sustainable Nutrition'.

The PDI and hPDI levels of female participants were found to be higher than those of male participants. Factors such as age, exercise and educational status were also found to affect adherence to a plant-based diet. In regression models, PDI (Model 1; β: 0.413, Model 2; β: 0.369, Model 3; β: 0.367) and hPDI (Model 1; β: 0.462, Model 2; β: 0.366, Model 3; β: 0. 351) scores had a positive effect on sustainable eating behavior scores, whereas uPDI (Model 1; β: -0.496, Model 2; β: -0.471, Model 3; β: -0.459) scores had a negative effect (P < 0.001).

Our findings suggest that individuals with higher adherence to overall plant-based and healthy plant-based diets exhibit more sustainable eating behaviors. Promoting healthy plant-based diets presents a promising approach to advancing sustainable nutrition, and mitigating environmental challenges. © 2024 Society of Chemical Industry.

The gut microbiome can modulate nutrient metabolism to produce many metabolites interacting with the host. However, the intricate interactions among dietary intake, the gut microbiome and metabolites, and host metabolites need to be further explored although some studies have been devoted to it. Here, in a cross-sectional studies, 88 children aged 2-12 years were enrolled from northwestern China. The dietary intake data were collected via a designed food frequency questionnaire to calculate plant-based diet indices (PDIs). Stool and plasma samples were collected for metagenomic and broad-targeted metabolomic analysis. Spearman's rank correlation was used to describe the associations between nutrients/PDIs and the gut microbiota and metabolites. PDI was significantly positively associated with Bilophila wadsworthia, Bacteroides thetaiotaomicron, and Alistipes indistinctus, etc., but was obviously negatively correlated with Roseburia intestinalis, Faecalibacterium prausnitzii, etc. However, these species showed no significant associations with either healthy PDI (hPDI) or unhealthy PDI (uPDI). Interestingly, hPDI was significantly positively related to species, including Ruminococcus bicirculans, and was significantly negatively associated with uPDI, and vice versa. The above correlation trends were also observed between PDIs and predicted gut microbial functional pathways, microbial metabolites and the host metabolome. Notably, the significantly related pathways were focused mainly on substances and energy metabolism. PDI was significantly positively associated with the fecal contents of P-aminobenzoate, chenodeoxycholic acid, 4,6-dihydroxyquinoline, quinoline-4,8-diol, etc., but was significantly negatively associated with those of TMAO, FFA, creatine phosphate, etc. In plasma, PDI was significantly positively associated with sarcosine, ornithine, L-histidine, etc., but was distinctly negatively correlated with FFAs, carnitine C2:0, etc. Strikingly, the healthy plant-based diet index (hPDI) is correlated with increased levels of metabolites related to tryptophan metabolism, whereas the unhealthy PDI (uPDI) is linked to increased levels of metabolites associated with tyrosine and sphingolipid metabolism, which are pathways commonly associated with Western diets. Our studies provide reliable data support and a comprehensive understanding of the effects of dietary intake on the gut microbiome and microbial and host metabolites and lay a foundation for further studies of the diet-gut microbiota-microbial metabolites and host metabolism.

This study aimed to evaluate associations between plant-based diets and the prevalence of depressive symptoms (DepS) among Chinese middle-aged and older adults. This study included 3153 participants aged 45 and older. Dietary intake was collected using a food frequency questionnaire, and DepS was evaluated using the 9-item Patient Health Questionnaire. Foods were classified into 17 groups and three plant-based diet indices were created, including the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Compared to the lowest quartile, participants in the highest quartile of hPDI had lower odds of DepS (OR = 0.60; 95% CI: 0.40, 0.89). Conversely, the highest quartile of the uPDI was associated with higher odds of DepS (OR = 1.81; 95% CI: 1.16, 2.82). These findings supported that the quality of plant-based diets matters for mental health.

The quest to decipher the determinants of human longevity has intensified with the rise in global life expectancy. Long-lived individuals (LLIs), who exceed the average life expectancy while delaying age-related diseases, serve as a unique model for studying human healthy aging and longevity. Longevity is a complex phenotype influenced by both genetic and non-genetic factors. This review paper delves into the genetic, epigenetic, metabolic, immune, and environmental factors underpinning the phenomenon of human longevity, with a particular focus on LLIs, such as centenarians. By integrating findings from human longevity studies, this review highlights a diverse array of factors influencing longevity, ranging from genetic polymorphisms and epigenetic modifications to the impacts of diet and physical activity. As life expectancy grows, understanding these factors is crucial for developing strategies that promote a healthier and longer life.

Background: recent dietary guidelines recommend a diet that mainly includes plant-based foods and a moderate amount of animal products. Therefore, we hypothesized that plant-based diet indices (overall plant-based diet index (oPDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI)) might be associated with risk of all-cause and cause-specific mortality. Methods: a systematic review was conducted using PubMed, Web of Science, Scopus, and Embase databases until December 2024. Meta-analysis was performed utilizing random-effects models to calculate relative risk (RR) with the corresponding 95% confidence intervals (95% CIs). Results: from 436 initial records, 25 prospective studies met the inclusion criteria. The findings of our study indicated a modest inverse association between the adherence to oPDI and risk of all-cause mortality (RR [95% CI]: 0.89 [0.83-0.94]; n = 15 studies) as well as mortality related to cardiovascular diseases, chronic heart disease, and total cancer. Also, adherence to hPDI was found to reduce risk of all-cause (RR [95% CI]: 0.86 [0.82-0.90]; n = 21 studies), cardiovascular disease, chronic heart disease, total-cancer, and prostate cancer mortality, whereas uPDI was associated with higher risk of all-cause (RR [95% CI]: 1.20 [1.13-1.27]; n = 19 studies), cardiovascular disease, chronic heart disease, and total-cancer mortality. Our dose-response meta-analysis showed a monotonic inverse association between adherence to oPDI and hPDI and a positive linear association between adherence to uPDI and risk of all-cause mortality. Conclusion: our findings highlight the importance of evaluating the quality of plant-based foods as either healthy or unhealthy in relation to the risk of all-cause and cause-specific mortality.

Most previous research on plant-based diets and hypertension primarily focused on the general population, with limited data available among adults with type 2 diabetes (T2DM). Therefore, the present study was designed to investigate the association between plant-based dietary patterns and hypertension among adults with T2DM.

Cross-sectional study.

The AZAR cohort is part of the Persian Cohort, an Iranian screening programme, and includes participants who were residing in Shabestar county, East Azerbaijan Province, Iran for a minimum of 9 months PARTICIPANTS: A total of 1947 participants with T2DM were included in the current analysis.

Hypertension was the outcome measure. This was defined as blood pressure ≥140/90 mm Hg, self-reported physician-diagnosed hypertension (supported by medical records) or use of antihypertensive medications.

The mean age of the participants was 54.90±8.25 years, with 61% being female. The prevalence of hypertension among the participants was 48.6% (n=946). Adherence to plant-based diet index (PDI) showed a significant inverse association with hypertension in the crude model (OR: 0.60, 95% CI: 0.46 to 0.80, P-trend<0.001), but this association became non-significant after adjusting for confounders (OR: 0.88, 95% CI: 0.63 to 1.24, P-trend: 0.54). Moreover, healthful plant-based diet index displayed a significant positive association with hypertension in unadjusted analysis (OR: 2.03, 95% CI: 1.52 to 2.70, P-trend<0.001), which also disappeared after controlling for potential confounders (OR: 0.86, 95% CI: 0.61 to 1.21, P-trend: 0.35). However, no significant relationship was found between adherence to unhealthful plant-based diet index and hypertension in crude or fully adjusted models. Findings remained consistent across different subgroups, as well as sensitivity analyses.

The present study did not find a significant association between adherence to PDIs and hypertension in T2DM patients. Future studies are needed to investigate this association and to explore potential mechanisms linking plant-based dietary pattern with hypertension in diverse populations.

We aimed to assess associations between black carbon (BC) and nonaccidental mortality among advance-aged adults in China.

We conducted a prospective cohort study in 22 provinces of Chinese Longitudinal Healthy Longevity Survey. We calculated concentrations of 3-year average BC, fine particulate matter (PM2.5), and other PM2.5 components (SO42-, NO3-, NH4+, and organic matter) at individual levels. We used Cox proportional hazards models to assess dose-response BC exposure on nonaccidental mortality, adjusted for total PM2.5, green space, temperature, humidity, and demographic covariates.

We studied 12 873 participants, with a median age of 88 years and 57.4% females. For a median follow-up of 4 years, we observed 7 426 mortality events. The mean 3-year average BC and total PM2.5 exposure concentrations were 3.49 and 66.97 μg/m3, respectively. An increase of 1 μg/m3 in BC was associated with a 39% increase in mortality risks (HR: 1.39, 95% CI: 1.36, 1.43), notably higher than the corresponding increase in mortality risks linked to total PM2.5 (HR: 1.003, 95% CI: 1.002, 1.004) in the adjusted model. The stratified analyses show that people living in rural areas, with lower social and leisure activity index, and lower physical activity, were at greater risk from BC exposure.

BC is a strong predictor of mortality, with a higher effect estimate compared with total PM2.5 and other PM2.5 components, particularly in rural populations. Although total PM2.5 has been a target indicator of clean air policy interventions, our results indicate that BC concentration should be routinely measured, reported, and studied to improve public health.

To present the outcomes of the EGEA Conference on the state of knowledge regarding the contribution of diets rich in fruit and vegetables (FV) to human and planetary health, commonly included in the One Health concept.

The 9th edition of EGEA Conference (20-22 September 2023, Barcelona) provided a transversal and multidisciplinary perspective on the contribution of FV to One Health, in particular to the health of individuals, society and the planet. Nearly 150 international scientists and stakeholders discussed the current state of knowledge. These proceedings are based both on a literature review and the scientific studies presented by the speakers.

Scientific evidence confirms the role of FV in preventing cardiovascular diseases and type 2 diabetes; more evidence is needed on the effects and mechanisms of FV in cancer prevention. FV production and consumption helps ensure territorial cohesion and provides a denser, nutrient-rich diet with less environmental impact (except water use) than other food groups, but use of synthetic pesticides in FV production remains a challenge that could be addressed with agro-ecological solutions. Various factors influence consumer choice and behaviour towards FV consumption across the lifespan, with specific periods being more conducive to change. New research is emerging on the role of FV consumption in regulating gut microbiota and on both mental and brain health; the potential role of FV production and supply in tackling biodiversity loss and climate change; and better monitoring of FV consumption.

Sufficient evidence confirms the contribution of diet rich in FV to One Health, with some emerging research on this topic. Concerted actions are required towards an increased consumption of FV and a more diversified and environmentally neutral FV production.

Chronic inflammation is associated with an increased risk of noncommunicable diseases, prompting an intensified interest in the diet-disease relationship for modulating inflammation. Diet quality indexes are widely used to quantify dietary patterns. However, the optimal tool for assessing dietary quality in relation to chronic inflammation remains unclear. The objective of this study was to synthesize the literature on food-based diet quality indexes and their association with chronic inflammation. A systematic scoping review of scientific databases was conducted from inception to March 2024. Studies describing the development and validation of original dietary inflammatory indexes or assessed associations between established indexes and inflammatory biomarkers were included. Studies that predominantly focused on nutrient-based indexes were excluded. Forty-three food-based indexes, evaluated across 65 studies, were categorized into 4 distinct groups based on dietary patterns (n = 18), dietary guidelines (n = 14), dietary inflammatory potential (n = 6), and therapeutic diets (n = 5). Established indexes based on the Mediterranean diet and dietary guidelines were the most extensively utilized, demonstrating inverse associations with several inflammatory biomarkers across diverse populations. The Anti-Inflammatory Diet Index, Dietary Inflammation Score, and Empirical Dietary Inflammatory Index were identified as robust, empirically derived indexes to assess diet quality based on their inflammatory potential. The dietary composition of the evaluated indexes ranged from 4 to 28 dietary components, with fruits, vegetables, whole grains, and legumes consistently classified as favorable, whereas red/processed meats and added sugars were unfavorable. This scoping review identified several promising food-based indexes for assessing inflammation-related diet quality. Methodological variations and inconsistencies in algorithms underscore the need for further validation across diverse populations. Future research should consider the scoring methods, dietary composition, and validated inflammatory biomarkers when selecting indexes to evaluate diet-inflammation associations. Understanding the characteristics that underpin these indexes informs their application in nutrition research and clinical practice.

The role of plant-based diets in preventing premature death among patients with cardiovascular disease (CVD) has remained unknown. We aim to explore the association of plant-based dietary patterns with all-cause and cause-specific mortality among patients with CVD. A total of 10 824 participants with CVD at the baseline were followed up in the UK Biobank. We constructed three types of plant-based diet indexes [an overall plant-based diet index (PDI), a healthful PDI (hPDI), and an unhealthful PDI (uPDI)] by assigning different weights to various food groups from web-based 24 h dietary recall questionnaires. The national death registry documented the primary causes of death. The Cox proportional hazards regression models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Over a median of 9.5 years follow-up, 1273 death cases were ascertained. After multivariable adjustment, PDI had an inverse correlation with all-cause mortality [HRT3 vs. T1: 0.81 (0.70-0.94), Ptrend = 0.005] and marginal inverse association with CVD mortality [HRT3 vs. T1: 0.78 (0.61-0.99), Ptrend = 0.038], while uPDI displayed a positive correlation with all-cause mortality [HRT3 vs. T1: 1.33 (1.16-1.53), Ptrend < 0.001], CVD, and cancer mortality. Additionally, in mediation analyses, serum concentration of C-reactive protein (CRP) accounted for 6.2%, 4.0%, and 5.1% of the relationship between uPDI and all-cause, CVD, and cancer mortality, respectively. No significant associations were detected between hPDI and mortality. Our findings support dietary guidelines that recommend limiting the consumption of unhealthy plant-based foods.

Plant-based diets (PBD) are generally promoted as beneficial for health. However, whether this is also the case at older ages, when energy deficits, muscle loss and frailty affect health, is unclear. Research has shown that among older adults, particularly in men, a healthful PBD is associated with a lower frailty risk. This relation was however, not studied in the context of socio-economic status (SES), a major factor influencing the risk of frailty. Therefore, we aim to assess whether plant-based diets associate with frailty risk at older ages and whether this association is moderated by sex and income in a large population-based dataset.

We investigated baseline data from the UK Biobank cohort study (UKB) cross-sectionally (n = 73 180, mean age = 55.48 ± 7.87). We applied a plant-based diet index [range 17-85], differentiating between a healthful (hPDI) and unhealthful plant-based diet (uPDI). Frailty was assessed by the Fried frailty phenotype and categorized into 0-4 symptoms of frailty. Average annual household income was divided into three categories: low (<18.000 £), medium (18.000-52.000 £) and high (>52.000 £). We applied an ordinal logistic regression model with frailty as the categorical outcome and PDI as continuous predictor while adjusting for age, sex, ethnicity, education, BMI and UKB assessment center. Secondly, we included an interaction term (PDI*sex*income). To identify subgroups driving any interactions, we stratified by sex and subsequently by income group to determine the effect of PDI in subgroups while additionally adjusting for lifestyle factors.

A 10-unit increase in hPDI was associated with 3.4% lower odds for frailty (OR = 0.966, 95%CI [0.946, 0.987]), whereas a 10-unit increase in uPDI was associated with 7.7% greater odds for frailty (OR = 1.077, 95%CI [1.054, 1.101]). The association between uPDI and frailty was moderated by income and sex (uPDI*income*sex, p = 0.002), whereas no such moderation was found for hPDI (p = 0.602). Subsequent stratification reveals a significant effect of uPDI on frailty particularly among men with low income (OR = 1.177, 95% CI [1.069, 1.298]), but not for women. This association in men largely persisted after adjustment for additional lifestyle factors (OR = 1.119, 95%CI [0.995, 1.258]).

We observed that adherence to an unhealthful plant-based diet was associated with a higher risk for frailty. This relation was especially observed for men with lower incomes and not explained by other lifestyle factors. While future research may investigate more specific determinants of health and diet behavior in men of low household income, this group in particular may profit from diet intervention improving diet quality.

The global shift towards vegan and vegetarian diets has garnered attention for their ethical, environmental, and potential health benefits. These diets are often rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6), suggesting a potential protective effect against systemic inflammation and oxidative stress. However, despite these benefits, concerns remain regarding their impact on neurological health due to the possible deficiencies of critical nutrients such as vitamin B12, DHA, EPA, and iron. This review critically evaluates the influence of these dietary patterns on neurological outcomes, emphasizing their nutritional composition, potential deficiencies, and their interplay with inflammation and oxidative stress.

A systematic review of the literature published between 2010 and 2023 was conducted, focusing on studies that explore the relationship between vegan and vegetarian diets and neurological health. Key nutrients such as vitamin B12, omega-3 fatty acids, iron, and zinc were analyzed alongside antinutritional factors and their effects on the nervous system.

Evidence suggests that vegan and vegetarian diets, when well planned, can be rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings indicate a potential role in reducing systemic inflammation and oxidative stress, both of which are linked to neurodegenerative diseases. However, deficiencies in critical nutrients such as vitamin B12, DHA, EPA, and iron have been consistently associated with an increased risk of cognitive decline, mood disturbances, and neurodegenerative disorders. Additionally, the presence of antinutritional factors like phytates and oxalates may further impair nutrient absorption, necessitating careful dietary planning and supplementation.

While plant-based diets provide anti-inflammatory and antioxidant benefits, their neurological implications depend on nutrient adequacy. Proper planning, supplementation, and food preparation techniques are essential to mitigate risks and enhance cognitive health. Further research is needed to explore long-term neurological outcomes and optimize dietary strategies.

Plant-based diets emphasize higher intake of plant foods and are low in animal products. Individuals following plant-based diets have a lower risk of chronic conditions; however, the mechanisms underlying these associations are not completely understood. Omics data have opened opportunities to investigate the mechanistic effect of dietary intake on health outcomes. Here, we review omics analyses of plant-based diets in feeding and observational studies, showing that although metabolomics and proteomics identified candidate biomarkers and distinct pathways modifiable by plant-based diets, current evidence from transcriptomics and methylomics is limited. We also argue that future studies should examine how unhealthful plant-based diets are associated with a higher risk of health outcomes and integrate multiple omics data from feeding studies to provide further mechanistic insights.

We aimed to examine the associations between plant-based dietary patterns, genetic risk, proteins, and lung cancer risk.

189,541 participants of the UK Biobank were included. The Cox proportional hazards models and restricted cubic splines were performed to assess the associations between overall plant-based diet index(PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) and lung cancer risk. Polygenic risk score (PRS) was constructed to assess its joint effect with PDIs on lung cancer risk. Mediation analysis was conducted to examine which proteins mediated the associations of PDIs with incident lung cancer.

Higher PDI was significantly correlated with reduced lung cancer risk(HR:0.90, 95% CI: 0.85-0.96, per SD). An elevated uPDI showed a significant correlation with an increased lung cancer risk(HR:1.08, 95% CI: 1.01-1.15, per SD). Individuals with a combination of high PRS and low PDI (HR: 2.09 [95% CI: 1.48-2.95]) or high uPDI (HR: 1.86 [95% CI: 1.36-2.53]) exhibited a notably higher lung cancer risk compared to those with low PRS and a high PDI or low uPDI. 42 proteins mediated the effect of PDI on lung cancer risk, and the association between uPDI with lung cancer was mediated by 117 proteins. The number of proteins displaying pathway enrichment within the cytokine-cytokine receptor interaction was the highest of the proteins mediated the effect of associations of PDI and uPDI with lung cancer risk.

A higher PDI correlated with reduced lung cancer risk, while a higher uPDI correlated with an elevated lung cancer risk. Low PDI jointing with high genetic risk increased lung cancer risk. Proteins enriched in cytokine-cytokine receptor interaction may mediate the association between plant-based dietary patterns with lung cancer risk.

Unhealthy diets contribute to the onset and progression of chronic kidney disease (CKD), with poor dietary habits identified as significant lifestyle factors that elevate CKD risk.

Data from the UK Biobank cohort, which included over 500,000 participants aged 40-69 from diverse regions of England, Wales, and Scotland, were analyzed. Participants, who completed at least one online 24-hour dietary recall assessment, were included in the study. The baseline for analysis was the first 24-hour dietary recall in 2011, with follow-up extending until the earliest occurrence of CKD diagnosis, death, or the end of the study period.

A total of 207,268 British individuals who completed at least one online 24-hour dietary recall assessment were included in this study. Four healthy dietary pattern scores were evaluated: the Healthy Plant-based Diet Index (hPDI), the Healthy Eating Index (HEI)-2015, the Mediterranean Diet (MED) Score, and the Alternative Mediterranean Diet (AMED) Score. These scores assessed the association between dietary patterns and the incidence of CKD. Relative to the lowest dietary scores, the HR for CKD was 0.79 (95% CI, 0.73-0.87) for the hPDI, 0.80 (95% CI, 0.73-0.87) for the HEI-2015, 0.86 (95% CI, 0.81-0.93) for the MED, and 0.84 (95% CI, 0.78-0.90) for the AMED (all p < 0.001).

This study provides robust evidence linking healthy dietary patterns to a reduced risk of CKD. Further clinical trials are needed to confirm whether adherence to such diets can lower the risk of CKD.

It is the position of the Academy of Nutrition and Dietetics that, in adults, appropriately planned vegetarian and vegan dietary patterns can be nutritionally adequate and can offer long-term health benefits such as improving several health outcomes associated with cardiometabolic diseases. Vegetarian dietary patterns exclude meat, poultry, and seafood, and vegan dietary patterns exclude all foods of animal origin. Registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs) play a pivotal role in providing meal-planning strategies and evidence-based nutrition information to clients currently following vegetarian or vegan dietary patterns or who may benefit from and express interest in following vegetarian or vegan dietary patterns. RDNs and NDTRs can work with their clients to create tailored, lifestyle-oriented, nutritionally balanced, and culturally suitable vegetarian and vegan dietary patterns that optimize health benefits while reducing concerns about nutrient inadequacies. Adults follow vegetarian and vegan dietary patterns for various reasons. The aim of this Position Paper is to inform health care practitioners, including RDNs and NDTRs, about the evidence-based benefits and potential concerns of following vegetarian and vegan dietary patterns for different populations of nonpregnant, nonlactating adults. This Position Paper is supported by current evidence, including several systematic reviews. As leaders in evidence-based nutrition care, RDNs and NDTRs should aim to support the development and facilitation of vegetarian and vegan dietary patterns and access to nutrient-dense plant-based meals. Promoting a nutrient-balanced vegetarian dietary pattern on both individual and community scales may be an effective tool for preventing and managing many diet-related conditions. This Position was approved in January 2025 and will remain in effect until December 31, 2032.

The United States, and many modern nations, represent assemblies of many cultural groups. Such groups are often influenced, sometimes profoundly, by the culinary traditions of their countries of origin, resulting in a diversity of cultural dietary patterns. Such patterns all derive key elements of nutritional quality from essential food groups-such as vegetables and fruits-but vary in their inclusion of "discretionary" food groups, such as dairy. The application of robust, validated, and standardized diet quality scoring is important in nutrition research, and in the food-as-medicine movement at large if what is being "managed" is to be measured. While robustly validated, the Healthy Eating Index is closely aligned with the Dietary Guidelines for Americans, and thus may not readily account for all multicultural dietary variations. Other diet quality metrics account for deviation from the prevailing American dietary pattern, but none does so in a way that expressly adapts to food components included or excluded so that "credit" for nutritional quality is appropriately assigned in all cases using a standard metric. In this context, we introduce and explain Adaptive Component Scoring as applied to the Healthy Eating Index in the service of advancing fair and universal diet quality scoring. Implications for nutrition research and food-as-medicine initiatives are briefly enumerated.

Background: A plant-based dietary pattern has been recently suggested to have health benefits. However, its relationship with mortality is not completely consistent in prior studies. We aimed to investigate whether a plant-based diet was associated with a lower death risk in a Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening study. Methods: We included 91 414 participants from the PLCO study. Dietary data were collected using a diet history questionnaire (DHQ). We used three plant-based diet indices including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard regression model. Results: During a median of 17.1 years of follow-up, we documented 19 456 deaths, including 5489 deaths from cardiovascular disease (CVD) and 6172 deaths from cancer. Comparing the highest versus lowest quintiles of the PDI, the multivariable-adjusted HR of all-cause mortality was 0.83 (95% CI 0.80-0.87, P for trend < 0.001). Those in the highest quintile of the PDI also had lower risks of CVD mortality (HR 0.87, 95% CI 0.80-0.95, P for trend < 0.001) and cancer mortality (HR 0.89, 95% CI 0.82-0.96, P for trend = 0.003) compared to those in the lowest quintile. Participants in the highest quintile of the hPDI had a decreased risk of all-cause and cause-specific mortality, whereas participants with the highest uPDI scores had an increased death risk. Conclusion: Greater adherence to a plant-based dietary pattern was significantly associated with lower all-cause and cause-specific mortality.

Prostate cancer (PCa) remains a leading cause of cancer-related death among men in the US.

To evaluate the association of healthy lifestyle and dietary behaviors with survival after a nonmetastatic PCa diagnosis in a multiethnic population.

This prospective cohort study was conducted among men aged 45 to 75 years enrolled between 1993 and 1996 in the Multiethnic Cohort study. Participants with nonmetastatic PCa completed a questionnaire after diagnosis (2003-2008) and were followed up until death or loss to follow-up. Data were analyzed from January 10, 2023, to May 20, 2024.

Lifestyle and dietary patterns were assessed after diagnosis using 3 PCa behavior scores and 13 dietary indices (4 prioritized scores: the Healthy Eating Index-2015, Healthful Plant-Based Diet Index, Dietary Inflammatory Index, and Empirical Dietary Index for Hyperinsulinemia).

Cox proportional hazards models were used to evaluate multivariable-adjusted associations of each PCa behavior score with all-cause, cardiovascular disease (CVD), and PCa-specific mortality.

A total of 2603 men with nonmetastatic PCa (mean [SD] age, 69.6 [7.1] years) were followed up, and 1346 deaths were documented, including 356 (24.6%) from CVD and 197 (14.6%) from PCa. The median (IQR) follow-up was 10.9 (IQR, 6.8-12.7) years from questionnaire return and 14.5 (IQR, 11.8-18.0) years from diagnosis. The 2021 PCa Behavior Score was associated with reduced risks of all-cause (hazard ratio [HR] per point, 0.69; 95% CI, 0.63-0.77) and CVD-related (HR, 0.67; 95% CI, 0.56-0.79) mortality. This score was also associated with a lower risk of PCa-specific mortality among African American men (HR, 0.46; 95% CI, 0.24-0.88) but not in the other racial and ethnic groups. Comparing quintile 5 (highest score) with 1 (lowest score), the Empirical Dietary Index for Hyperinsulinemia was positively associated with all-cause (HR, 1.37; 95% CI, 1.02-1.84) and CVD-related (HR, 1.96; 95% CI, 1.15-3.33) mortality, whereas the Healthful Plant-Based Diet Index was associated with a reduced risk of all-cause (HR, 0.75; 95% CI, 0.58-0.97); findings for CVD-related mortality were not statistically significant (HR, 0.67; 95% CI, 0.44-1.03). No associations were found between lifestyle or dietary patterns and PCa mortality.

In this multiethnic cohort of patients with nonmetastatic PCa, healthier lifestyles were associated with improved overall survival but not with PCa-specific survival. Given the predominance of non-PCa-specific deaths, these findings support the need for health behavior counseling to treat comorbidities in men with PCa.

The Overall Plant-based Diet Index (PDI), the Healthful Plant-based Diet Index (hPDI), and the Unhealthful Plant-based Diet Index (uPDI) are relatively new tools for characterizing the quality of plant-based dietary patterns in epidemiologic studies. Reproducibility and validity of these indices have not been assessed across populations.

The objective of this study was to evaluate the reproducibility and validity of PDI, hPDI, and uPDI in a racially and ethnically diverse population.

Participants (n = 433 women, n = 244 men, n = 417 non-Hispanic White, n = 159 non-Hispanic Black, and n = 101 Hispanic) from the 2015-2016 Cancer Prevention Study 3 Dietary Assessment Substudy (CPS-3 DAS) completed the CPS-3 Food Frequency Questionnaire (FFQ) on 2 occasions (FFQ1 and FFQ2) and ≤6 24-h dietary recalls (24HRs) over 1 y. Plant-based diet scores were calculated using energy-adjusted food group intakes from each FFQ and mean 24HRs. Pearson correlations were used to evaluate reproducibility of each score between FFQs. Validity of the scores derived from FFQ2 was assessed relative to the mean of the 24HRs and blood and urine biomarkers.

Pearson correlations for reproducibility between FFQs for men and women were 0.64 and 0.66 for PDI, 0.85 and 0.80 for hPDI, and 0.84 and 0.78 for uPDI. Pearson correlations for validity between FFQ2 and the mean 24HRs for PDI, hPDI, and uPDI for men were 0.54, 0.68, and 0.60, respectively, and for women were 0.49, 0.0.62, and 0.62, respectively. Biomarkers of most carotenoids, total protein, sodium, and potassium showed correlations ≥0.20 with certain plant-based diet scores. Reproducibility and validity were moderate to good in all racial/ethnic subgroups and were highest in non-Hispanic White adults.

There was good reproducibility and moderate to good validity of PDI within the CPS-3 FFQ. Future work should continue to validate these indices across populations with varied diets and dietary measurement tools.

Epigenetic mechanisms, which can be modulated by dietary factors, have been proposed as a possible factor in understanding interindividual differences in disease susceptibility. We aimed to determine the relationships between DNA methylation (DNAm), diet quality, and metabolic health in Spanish individuals. This is a transversal study encompassing 337 male and female participants in the Obekit study. Diet quality was assessed using a validated semiquantitative food frequency questionnaire and seven previously established scores: overall, healthy and unhealthy Plant-Based Diet Index (PDI, hPDI and uPDI, respectively), dietary diversity score (DDS), unprocessed/minimally processed foods (MPF) and ultra-processed foods (UPF) consumption and Mediterranean diet (MD) score. DNAm was analyzed in white blood cells using the Infinium MethylationEPIC v1.0 BeadChip kit. After filtering by a variance >0.36, we have worked with 5,261 CpG sites. We found four false discovery rate (FDR)-significant correlations between nutrients and CpGs sites: cg00167275 (GLUD1) correlated with alcohol, cg05218090 with folic acid, cg16682935 (PAPSS2) with selenium, and cg09821790 (SLC7A6) with fish food. One differentially methylated region (DMR) located at zinc finger protein gene 57 (ZFP57) was closely related to obesity and specific nutrients, food groups, and diet quality indices. The regression models of diet quality based on DNAm demonstrated that the most predictive values were when UPF and hPDI were considered. Also, UPF and hPDI were the best indices for predicting the main cardiometabolic risk factors. Our finding suggests that specific nutrients and diet quality indices may influence the degree of DNAm and putatively, the metabolic health in Spanish individuals.

Excess body adiposity, referred to as overweight and obesity, represents a major health concern given that it increases the risk of various diseases, including cardiovascular diseases, type 2 diabetes, and cancer. Body weight reduction can be achieved via a wide variety of dietary strategies as long as an energy deficit is achieved. However, the effect of such diets on disease risk and mortality will depend on the foods included. Increasing evidence shows that consumption of whole plant foods (e.g., fruits, vegetables, whole grains, nuts, seeds, legumes) in place of animal foods (e.g., meat, poultry, dairy, fish, eggs, and seafood and their derivatives) and non-whole plant foods (e.g., refined grains, French fries, sugar-sweetened beverages) is associated with improvements in cardiometabolic risk factors and lower risk of chronic diseases and mortality. This review focuses on the effect of a whole plant-foods diet on overweight and obesity from observational to clinical studies and discusses the potential mechanisms involved. According to existing evidence, a whole plant foods diet seems to be more advantageous than other dietary approaches for the prevention and treatment of excess adiposity given that it is composed of the foods that lead to the best health outcomes.

Plant-based meat alternatives (PBMAs) are emerging in global markets. However, the effects of substituting meat for PBMAs on cardiometabolic health are uncertain.

This study aimed to determine the effects of replacing meat consumption by PBMAs on cardiometabolic parameters in adults.

Five databases were systematically explored from inception to July 2024, searching for RCTs assessing the effects of replacing meat consumption by PBMAs on cardiometabolic parameters in adults without cardiovascular diseases. Meta-analyses were conducted when ≥4 studies addressed the same outcome (i.e. blood lipids, blood pressure, fasting glucose, and body weight). Pooled raw mean differences (MDs) with their 95% CIs were estimated using a random-effects method. Sensitivity analyses were conducted to assess the robustness of our estimates.

Eight publications from 7 RCTs comprising 369 adults (60% females; mean age range: 24-61 y) were included. The substitution of PBMAs for meat was associated with significant reductions in LDL-cholesterol: -0.25 mmol/L (95% CI: -0.42, -0.08 mmol/L; I2 = 65.8%; n = 7), total cholesterol (TC): -0.29 mmol/L (95% CI: -0.52, -0.06 mmol/L; I2 = 64.8.%; n = 6), and body weight: -0.72 kg (95% CI: -1.02, -0.42 kg; I2 = 0%; n = 5). No significant changes were shown in HDL-cholesterol, triglycerides, blood pressure, or fasting glucose concentrations. Sensitivity analyses considering mycoprotein-based alternatives showed a significant reduction in LDL-cholesterol (MD: -0.37 mmol/L; 95% CI: -0.61, -0.13 mmol/L; I2 = 52.5%; n = 4), and TC (MD: -0.39 mmol/L; 95% CI: -0.56, -0.21 mmol/L; I2 = 0%; n = 4).

Our findings suggest substituting PBMAs for meat for ≤8 wk lowered TC (6%), LDL-cholesterol (12%), and body weight (1%) in adults without cardiovascular diseases. PBMAs may facilitate the transition to a plant-based diet, but long-term studies are needed to evaluate their cardiometabolic effects. This trial was registered at PROSPERO as CRD42024556191.

Bacterial vaginosis (BV) is a common inflammatory condition affecting the vaginal microbiome. In the present study we aimed to explore the relationship between dietary inflammatory index, plant-based dietary index, and BV.

In this case-control study, 143 individuals with BV and 151 healthy participants aged 15-45 years were included. Bacterial vaginosis diagnosis was based on the Amsel criteria by a gynecologist. Participants' dietary intakes over the past year were assessed using a 168-item food frequency questionnaire. Logistic regression models were employed to analyze the association between dietary inflammatory index, plant-based dietary index, and BV odds.

Our study revealed that elevated dietary inflammatory index scores were strongly associated with higher BV odds in the crude model (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.57-5.30, P value <0.001), and even after accounting for potential confounding factors (adjusted OR: 3.52, 95% CI: 1.66-7.46, P value = 0.001). While no significant relationship was observed between total plant-based dietary index and healthy plant-based dietary index scores with BV odds, a clear positive association existed between unhealthy plant-based dietary index and the odds of BV (aOR: 2.13, 95% CI: 1.09-4.15, P value = 0.018).

A positive correlation may exist between unhealthy plant-based dietary index and the likelihood of BV. Furthermore, the dietary inflammatory index may remain linked to increased BV odds.

A comparison of commonly used diet quality indexes (DQIs) and their association with multiple indicators of sustainability has not been performed, which limits policy action.

To evaluate the associations between 8 DQIs and 7 sustainability indicators in a nationally representative sample in the United States.

In this cross-sectional analysis, dietary data from the National Health and Nutrition Examination Survey (2011-2018, n = 18,522 ≥20 y) were merged with data on greenhouse gas emissions (GHGE), cumulative energy demand (CED), water scarcity footprint (WSF), land, fertilizer nutrients, pesticides, and food prices from multiple publicly available databases. Diet quality was measured using the Healthy Eating Index-2020 (HEI-2020), Alternate Healthy Eating Index-2010 (aHEI-2010), Mediterranean Diet Score (Med), Alternate Mediterranean Diet Score (aMed), Healthful Plant-Based Diet Index (hPDI), Planetary Health Diet Index (PHDI) for the United States, Dietary Approaches to Stop Hypertension Index (DASH), and Nutrient-Rich Foods Index 9.3 (NRF9.3). The relationship between each DQI and sustainability indicator was assessed using linear regression.

Greater scores on most or all DQIs were associated with lower daily per capita GHGE (β = -0.908 to -0.250 carbon dioxide equivalents per 1 unit increment in diet quality z-score), CED (β = -2.699 to 0.202 MJ), land (β = -0.002 to <-0.001 ha), and fertilizer nutrients (β= -0.026 to 0.007 kg). By contrast, greater scores on most or all DQIs were associated with greater WSF (β = 343-649 L equivalents) and diet cost (β = 0.037-1.125 US$), and had mixed associations with pesticide use (β = -0.001 to <-0.001 kg). Greater scores on aHEI-2010 and hPDI were associated with the greatest ratio of favorable-to-unfavorable sustainability outcomes (5:2 each), followed by PHDI (4:1), Med and aMed (4:2 each), HEI-2020 and DASH (3:2 each), and NRF9.3 (3:4).

All DQIs had sustainability trade-offs, but those that emphasized plant-based foods, rather than nutrients or animal-based foods, were associated with more favorable sustainability outcomes.

The global incidence of prediabetes and type 2 diabetes mellitus (T2DM) has increased substantially in recent years. Among the established, modifiable lifestyle factors associated with favorable prediabetes and T2DM risk, healthy dietary patterns have attracted considerable attention.

The association between adherence to plant-based dietary pattern indices (PDIs), including the overall PDI (O-PDI), healthy PDI (H-PDI), and unhealthy PDI (U-PDI), and the risk of prediabetes and T2DM was investigated in this study.

A literature search was conducted of the PubMed/Medline, Scopus, and Web of Sciences databases from their inception to February 2024. A systematic review and meta-analysis were conducted using random effects models and dose-response analyses. The Cochran Q test and the I2 statistic were used to evaluate heterogeneity between studies.

A total of 16 publications, with data on a total of 721 012 participants, were identified for the meta-analysis.

According to a pooled analysis, compared with the lowest category of O-PDI and H-PDI adherence, the highest category was associated with a 14% and 19% reduction in T2DM risk, respectively, for O-PDI (effect size [ES] = 0.86; 95%CI, 0.82-0.90; I2 = 57.7) and H-PDI (ES = 0.81; 95%CI, 0.75-0.88; I2 = 82.6). Greater adherence to U-PDI was significantly associated with an 10% increase in the risk of T2DM (ES = 1.10; 95%CI, 1.04-1.16). Consistent associations were found within the predetermined subgroups. As well, there was a nonlinear inverse association between O-PDI, H-PDI, and T2DM risk. No significant association was found between adherence to O-PDI (ES = 0.87; 95%CI, 0.75-1.01; I2 = 68%), H-PDI (ES = 0.99; 95%CI, 0.87-1.13; I2 = 0.0%), and U-PDI (ES = 1.09; 95%CI, 0.94-1.21; I2 = 22.9%) and risk of prediabetes.

These findings underscore the importance of dietary selections within the framework of a plant-based dietary pattern, particularly when incorporating healthful, plant-based foods, which may have potential benefits in reducing the T2DM risk.

PROSPERO registration no. CRD42023459851.

Transitioning to more plant-based diets promotes environmental sustainability and has health benefits for adults. However, associations with nutrient intake adequacy and growth in children remain unknown. This study aimed to examine associations of plant-based diets with nutrient intake levels among children, and with longitudinal growth and body composition up to adolescence.

We included 3340 children in the Generation R Study, a population-based cohort. Food and nutrient intake were assessed at the age of 8 years, and anthropometrics and body composition (using dual-energy X-ray absorptiometry) were measured at the ages of 10 and 13 years. Plant-based diets were quantified using three plant-based diet indices (PDIs): overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI). Modified Poisson regression and linear mixed models were used to estimate the associations of PDIs with nutrient intake levels, and with sex- and age-standardized measures of anthropometrics and body composition.

Higher scores on each of the three PDIs were associated with lower intake of vitamin B2, B12, and calcium, while higher hPDI score was associated with higher intake levels of fiber, vitamin C, magnesium, and copper. Higher hPDI score was also associated with higher fat-free mass index (FFMI) z-score (0.05 per 10-hPDI score increment, 95 % CI: 0.01, 0.10), and with lower body fat percentage z-score (-0.05, 95 % CI: -0.09, -0.01), while higher uPDI score was associated with lower height, weight, and FFMI z-score (FFMI: -0.08, 95 % CI: -0.12, -0.03) up to age of 13 years.

In this cohort study, higher adherence to healthful plant-based diets, rather than unhealthful ones, was associated with better nutrient intakes, and subsequent healthy body composition throughout childhood to adolescence. Our findings suggest that consuming healthful plant-based foods may contribute to children's diets' nutrient quality and subsequent body composition. Still, attention should be given to ensuring balanced and adequate nutrient intake for optimal plant-based eating.

Only a few studies have investigated the role of diet on the risk of chronic kidney disease (CKD) in European populations and have mainly focused on the Mediterranean diet. This is the first study to evaluate the association between various diet quality indices and CKD incidence in British adults.

To study the relationship between a set of 6 different diet quality indices and CKD incidence among British adults.

A prospective cohort with 106,870 participants from the UK Biobank, followed from 2009 to 2012 through 2021. Food consumption was obtained from ≥2 24-h dietary assessments. Dietary patterns were assessed using previously established indices: Alternate Mediterranean Index (aMED), Alternative Healthy Eating Index 2010, dietary approaches to stop hypertension (DASH), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), and dietary inflammatory index (DII). Incident CKD was obtained from clinical records, death registries, and self-reports. Analyses were performed with Cox regression models and adjusted for the main confounders.

After a median follow-up of 9.27 y, 2934 cases of CKD were ascertained. Hazard ratios (95% confidence interval) of CKD for the highest compared with lowest tertile of adherence to each diet score were 0.84 (0.76, 0.93) for aMED, 0.94 (0.85, 1.03) for alternative healthy eating index 2010, 0.77 (0.70, 0.85) for DASH, 0.79 (0.72, 0.87) for hPDI, 1.27 (1.16, 1.40) for uPDI, and 1.20 (1.18, 1.33) for DII. The results were robust in sensitivity analyses.

In British adults, higher adherence to the aMED, DASH, and hPDI patterns was associated with lower risk of CKD, whereas greater adherence to the uPDI and DII patterns was associated with greater risk.

The purpose of the present research was to deliver new knowledge of consumer expectations for plant-based (PB) alternatives to cream cheese (PBCCA) by conducting a category appraisal study. Around 1100 consumers from the United Kingdom (UK) who followed omnivore and flexitarian diets participated in an online survey. They evaluated 13 written stimuli presented as product names encompassing dairy cream cheese and PBCCAs in different flavours (original/natural, garlic/herb, salmon, strawberry, chocolate) and different product formulations (low-fat, lactose-free). A multi-response approach was used that obtained sensory, emotional, conceptual, and versatility product evaluations. The research findings, which matched predictions, showed: (1) negative product expectations for PBCCAs replicated across flavour variants, providing evidence of a systematic PB effect relative to cream cheese; (2) sensory and non-sensory drivers of expected product liking resembled those established for the cream cheese category with actual product experience; (3) sensory and non-sensory drivers of expected product versatility strongly resembled those of expected product liking; (4) groups of consumers existed with different preferences, including flavour and product type preferences (dairy, PBCCA); and (5) negative product expectations for PBCCAs translated to a stated behavioural preference for cream cheese over PBCCA, and dairy-based samples were chosen over their PB counterparts regardless of flavour. The category appraisal approach confirmed the systematic negative appeal of PBCCAs relative to their dairy counterparts. This was in line with findings from past research on other PB alternative foods and invites a rethinking of the appeal of this class of products to participants in this research, who represent a large segment of UK consumers.

The food system significantly affects the environment through land use, emissions from livestock, deforestation, and food waste. Diet sustainability considers the environmental effects of food production, distribution, and consumption. Animal products emit more greenhouse gases than plant-based foods, prompting a shift towards plant-focused diets for reduced emissions. Sustainable diets, like the EAT-Lancet model, prioritize plant-based foods, adjusting for regional eating habits. These diets aim to be both environmentally friendly and conducive to human health, addressing concerns like obesity and chronic diseases. Obesity is a major global health challenge, and its complex relationship with food production and consumption patterns calls for sustainable solutions to reduce pressure on ecosystems and promote healthier lifestyles. Tackling obesity requires holistic strategies that address not only individual health but also the broader environmental impacts of food systems. A systematic review examined the link between plant-based diets and obesity focusing on studies assessing Body Mass Index (BMI) and body fat assessment. Despite limited research, evidence suggests that adherence to a plant-based diet, particularly a healthy one, is associated with lower obesity rates. More longitudinal and intervention studies are necessary for a stronger consensus on the matter.

The present study evaluated the association between plant-based diet index (PDI) and psychological symptoms, including depressive symptoms, stress, and anxiety among Iranian women diagnosed with migraine headaches.

A cross-sectional study was conducted on 262 patients with migraine (aged 20-50 years; body mass index, 18.5-30 kg/m²). Three versions of the PDI were calculated: overall PDI, healthy PDI (hPDI), and unhealthy PDI (uPDI) based on dietary data collected via a 168-item food frequency questionnaire (FFQ). Psychological symptoms, including depressive symptoms, anxiety, and stress, were assessed using the Depression, Anxiety, Stress Scale-21 (DASS-21) questionnaire.

After adjustment for potential confounders, patients in the highest tertile of the PDI showed a lower risk of depressive symptoms [odds ratio (OR) = 0.41, 95% confidence interval (CI): 0.22, 0.77]. Furthermore, inverse associations were evident between the PDI score and the risk of stress (OR = 0.46, 95% CI: 0.24, 0.85).

Higher adherence to a plant-based eating pattern is associated with a reduced risk of psychological symptoms. However, future longitudinal studies and clinical trials should replicate our observations and delineate the underlying mechanisms driving these associations.

This review aims to summarise recent evidence on the effects of dietary patterns on the risk of bone fractures and sarcopenia.

Several dietary patterns have been investigated in relation to musculoskeletal health, including Mediterranean Dietary Patterns (MDP), Dietary Inflammatory Indices, vegetarian and vegan diets. Adherence to 'healthier' dietary patterns appears to be protective against fractures and sarcopenia, with the strongest protective associations found between the MDP and fractures. Individuals following vegan or vegetarian eating patterns need to be aware of calcium and vitamin D requirements to maintain musculoskeletal health. Although more healthy dietary patterns may be protective for musculoskeletal health the current evidence base is limited by variation in the construction of dietary pattern scores and reported outcome measures. Future research should fully report scoring methods, intakes of dietary components across scoring groups or categories, and consider outcome measures that allow for better comparison between studies.

The adherence to plant-based diets has been shown to positively impact longevity by reducing the incidence and severity of lifestyle-related diseases. Previous studies on the association of plant-based dietary pattern, as evaluated by plant-based dietary index (PDI), healthy plant-based dietary index (hPDI) and unhealthy plant-based dietary index (uPDI), with mortality risk have reported inconsistent results. We performed the present meta-analysis to summarize evidence on this association and to quantify the potential dose-response relationship based on all available cohort studies.

A comprehensive literature search and systematic review of relevant articles up to October 2024 was performed in PubMed and Scopus. The summary risk estimates (RR) with 95% confidence interval (CI) for the highest versus the lowest category of PDIs, hPDIs and uPDIs were calculated. Dose-response meta-analysis was also performed for studies reporting categorical risk estimates for at least three quantitative levels of PDIs, hPDIs and uPDIs.

A total of 11 eligible cohort studies (13 datasets) were eventually included in this meta-analysis. Participants in the highest quintile of both the PDI and hPDI had a significantly decreased risk of all-cause mortality (pooled HRPDI = 0.85; 95% CI: 0.80-0.90; pooled HRhPDI = 0.86; 95% CI: 0.81-0.92) compared to participants in the lowest quintile. In contrast, the highest uPDI was associated with an increased risk of mortality (pooled HRuPDI = 1.20; 95% CI: 1.11-1.31). Dose-response meta-analysis showed that there was a non-linear relationship between PDI or hPDI level and all-cause mortality (p = 0.001 and p < 0.001 for non-linearity, respectively). No evidence of a non-linear relationship was observed for uPDI (p = 0.596 for non-linearity).

Greater adherence to PDI or hPDI dietary pattern was associated with a lower risk of mortality, whereas uPDI dietary pattern was positively associated with mortality risk. Thus, promoting a plant-based dietary pattern may be a key strategy in improving public health and reducing the burden of diet-related mortality.

Few studies have examined the underlying mechanisms of education, diets, and cognitive function in older adults. This study analyses the relationship between cognitive trajectories, education, and different dietary patterns in older adults from a network perspective, and further explores their longitudinal associations and mediation effects.

Data on cognitive trajectories were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2008 and 2018. Group-Based Trajectory Model (GBTM) was used to identify potential heterogeneity in the longitudinal changes in cognitive function. Multinomial logistic regression and network analysis were then applied to examine the relationships between different cognitive trajectories and years of education, food variety (FV), and plant-based dietary patterns. Cross-lagged panel model was used to examine the longitudinal associations between education, FV, and plant-based diet patterns. Furthermore, we constructed a mediation model based on categorical variables for cognitive trajectories to investigate the mediating effect of FV and plant-based diet index on education and cognitive.

A total of 2,115 older adults were included in this study, revealing three distinct cognitive function trajectories. After controlling for potential confounders, education and dietary-related variables were associated with a cognitive stable decline trajectory (OR: 0.857/0.929/1.027) and a cognitive rapid decline trajectory (OR: 0.859/0.914, 95% CI: 0.775-0.882) compared to the cognitive stable trajectory. In the education, diet, and cognition network model, overall Plant-Based Diet Index (PDI) [expected influence (EI) = 1.82] and years of education (EI = 0.54) were the most central domains. There were longitudinal associations between education, FV, and plant-based dietary patterns, which were significant only in the slow decline group. FV acting as a mediator between education and cognitive trajectories.

Years of education are longitudinally associated with the diet of older adults in the slow cognitive decline group. Food diversity partially mediates the relationship between years of education and cognitive trajectories. Interventions targeting education and dietary behaviors may help alleviate cognitive decline in older adults.

Background/Objectives: Understanding the relationship between dietary patterns, nutrient intake, and chronic disease risk is critical for public health strategies. However, confounding from lifestyle and individual factors complicates the assessment of diet-disease associations. Emerging machine learning (ML) techniques offer novel approaches to clarifying the importance of multifactorial predictors. This study investigated the associations between animal-sourced and plant-based dietary patterns and Type 2 diabetes (T2D) history, accounting for diet-lifestyle patterns employing the XGBoost algorithm. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016, individuals consuming animal-sourced foods (ASF) and plant-based foods (PBF) were propensity score-matched on key confounders, including age, gender, body mass index, energy intake, and physical activity levels. Predictors of T2D history were analyzed using the XGBoost classifier, with feature importance derived from Shapley plots. Lifestyle and dietary patterns derived from principal component analysis (PCA) were incorporated as predictors, and high multicollinearity among predictors was examined. Results: A total of 2746 respondents were included in the analysis. Among the top predictors of T2D were age, BMI, unhealthy lifestyle, and the ω6: ω3 fatty acid ratio. Higher intakes of protein from ASFs and fats from PBFs were associated with lower T2D risk. The XGBoost model achieved an accuracy of 83.4% and an AUROC of 68%. Conclusions: This study underscores the complex interactions between diet, lifestyle, and body composition in T2D risk. Machine learning techniques like XGBoost provide valuable insights into these multifactorial relationships by mitigating confounding and identifying key predictors. Future research should focus on prospective studies incorporating detailed nutrient analyses and ML approaches to refine prevention strategies and dietary recommendations for T2D.

Reducing meat consumption is crucial for improving population and planetary health. Millions of students regularly eat at university cafeterias, which offer a unique opportunity to promote meat-free meals to new generations by addressing barriers such as accessibility, price, and cooking skills. This study aimed to analyse the individual characteristics associated with the proportion of vegetarian main dish choices in a university cafeteria and to determine whether this behaviour influenced the nutritional quality and environmental impact of student meals. A sample of 257 French students who ate regularly at a large university cafeteria took part in an observational study with repeated measures. They took pictures of their meal trays each time they ate at the cafeteria for three months. They completed an online questionnaire to assess their sociodemographic characteristics and various behavioural determinants of the choice of a vegetarian main dish based on the Capability, Opportunity, Motivation Behaviour (COM-B) framework. Being a woman was the only sociodemographic characteristic significantly associated with more frequent vegetarian main dish selection. The proportion of vegetarian choices was negatively associated with attachment to meat (p < 0.001, η2 = 0.189) and positively associated with environmental knowledge (p = 0.034, η2 = 0.018) and the following food choice motives: animal welfare (p < 0.001, η2 = 0.062), health (p < 0.001, η2 = 0.044), ethics (p = 0.002, η2 = 0.039), natural content (p = 0.010, η2 = 0.026), religion (p = 0.014, η2 = 0.025), and mood (p = 0.022, η2 = 0.020). Students who chose vegetarian main dishes more frequently composed healthier (p = 0.023, η2 = 0.020) and more environmentally friendly meal trays (p < 0.001, η2 = 0.349). These findings highlight the variability in the students' propensity to choose vegetarian main dishes in a university cafeteria and its association with motivational factors in a food environment bound by design.

Few studies have evaluated the impact of branched-chain amino acid (BCAA) intake on the risk of obesity in adults. The results are contradictory, and the causality has not been explored. This study assessed the association between BCAA intake and obesity incidence among Brazilian adults and investigated the potential moderating role of the plant-based index (PDI) in this relationship.

A longitudinal study was conducted between 2016 and 2022, with 3090 participants (2043 women, 1047 men; mean age 34 years) from the Cohort of Universities of Minas Gerais (CUME) Study. Data were collected through an online questionnaire. The relationship between BCAA intake and obesity incidence was assessed using crude and adjusted Cox regression models. Restricted cubic spline analysis (RCS) was used to estimate the nonlinearity. The multiplicative interaction with PDI was tested.

The overall incidence of obesity was 192 cases (6.21%). The incidence was 16.4/1000 person-years in females; 21.8/1000 person-years in males; and 18.3/1000 person-years total, with a mean follow-up period of 3.4 years. Compared to the first tertile, the highest intake tertiles for BCAA (HR = 1.50, 95% CI = 1.03-2.18), isoleucine (HR = 1.52, 95% CI = 1.04-2.22), and leucine (HR = 1.51, 95% CI = 1.03-2.20) were independently associated with obesity risk. BCAA intake above 16 g/day increases the risk of obesity.

There was a positive association between the intake of BCAA, isoleucine, and leucine with the risk of obesity. The PDI accentuated the association between BCAA intake and obesity in both the lowest and highest quintiles.