Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality.
TL;DR: Improving plant-based diet quality over a 12-year period was associated with a lower risk of total and CVD mortality, whereas increased consumption of an unhealthful plantbased diet wasassociated with a higher risk oftotal and CVB mortality.
Abstract: Background: Plant-based diets have been associated with lower risk of type 2 diabetes mellitus and cardiovascular disease (CVD) and are recommended for both health and environmental benefits. Howev...
Citations
More filters
TL;DR: A survey of existing statistical methods used to derive dietary patterns, especially the finite mixture model, treelet transform, data mining, least absolute shrinkage and selection operator and compositional data analysis, in terms of their underlying concepts, advantages and disadvantages can be found in this article.
Abstract: Dietary pattern analysis is a promising approach to understanding the complex relationship between diet and health. While many statistical methods exist, the literature predominantly focuses on classical methods such as dietary quality scores, principal component analysis, factor analysis, clustering analysis, and reduced rank regression. There are some emerging methods that have rarely or never been reviewed or discussed adequately. This paper presents a landscape review of the existing statistical methods used to derive dietary patterns, especially the finite mixture model, treelet transform, data mining, least absolute shrinkage and selection operator and compositional data analysis, in terms of their underlying concepts, advantages and disadvantages, and available software and packages for implementation. While all statistical methods for dietary pattern analysis have unique features and serve distinct purposes, emerging methods warrant more attention. However, future research is needed to evaluate these emerging methods’ performance in terms of reproducibility, validity, and ability to predict different outcomes. Selection of the most appropriate method mainly depends on the research questions. As an evolving subject, there is always scope for deriving dietary patterns through new analytic methodologies.
78 citations
TL;DR: Directions for future revisions of sustainable FBDGs include a stronger emphasis on the intake of legumes, nuts and seeds, fruit and vegetables including dark green vegetables, whole-grain products and vegetable oils as well as lowering meat intake.
Abstract: Plant-based diets have been linked to both health benefits and a lower climate impact. However, plant-based diets may represent both healthy and unhealthy dietary practices. The present study aimed to develop a nationally adapted healthy plant-based diet based on the global EAT-Lancet reference diet. Development took place in a series of steps. First, the original EAT-Lancet reference diet was evaluated based on food availability, i.e., using Danish food data (Model 1). Then, the model was further modified to reflect national food based dietary guidelines (FBDG) and characteristics of current consumption pattern, e.g., by including processed food, discretionary foods and beverages in the diet (Model 2). The contents of macronutrients, vitamins and minerals, except for vitamin D and iodine, were found to be sufficient for Model 2, according to the recommended nutrient density to be used for planning diets for groups of individuals aged 6-65 years. In addition, the study gave an insight into the nutrients and foods to be aware of in planning a predominantly plant-based diet, thereby providing directions for future revisions of sustainable FBDGs. These include a stronger emphasis on the intake of legumes, nuts and seeds, fruit and vegetables including dark green vegetables, whole-grain products and vegetable oils as well as lowering meat intake.
56 citations
Cites background from "Changes in Plant-Based Diet Quality..."
...points out that public health efforts towards lower chronic disease risk should account for the quality of plant foods [20] and Tuomisto et al....
[...]
Center for Nutrition Policy and Promotion1, Wake Forest University2, Purdue University3, Tulane University4, University of Hawaii5, United States Department of Agriculture6, United States Department of Health and Human Services7, University of North Carolina at Chapel Hill8, College of Tropical Agriculture and Human Resources9, Loma Linda University10, University of Iowa11, Northwestern University12, Pennington Biomedical Research Center13
TL;DR: In this article, the authors conducted a systematic review of existing research on diet and health to inform the current Dietary Guidelines for Americans and found that consuming a nutrient-dense dietary pattern was associated with reduced risk of death from all causes.
Abstract: Importance The 2020 Dietary Guidelines Advisory Committee conducted a systematic review of existing research on diet and health to inform the current Dietary Guidelines for Americans. The committee answered this public health question: what is the association between dietary patterns consumed and all-cause mortality (ACM)? Objective To ascertain the association between dietary patterns consumed and ACM. Evidence Review Guided by an analytical framework and predefined inclusion and exclusion criteria developed by the committee, the US Department of Agriculture’s Nutrition Evidence Systematic Review (NESR) team searched PubMed, the Cochrane Central Register of Controlled Trials, and Embase and dual-screened the results to identify articles that were published between January 1, 2000, and October 4, 2019. These studies evaluated dietary patterns and ACM in participants aged 2 years and older. The NESR team extracted data from and assessed risk of bias in included studies. Committee members synthesized the evidence, developed conclusion statements, and graded the strength of the evidence supporting the conclusion statements. Findings A total of 1 randomized clinical trial and 152 observational studies were included in the review. Studies enrolled adults and older adults (aged 17-84 years at baseline) from 28 countries with high or very high Human Development Index; 53 studies originated from the US. Most studies were well designed, used rigorous methods, and had low or moderate risks of bias. Precision, directness, and generalizability were demonstrated across the body of evidence. Results across studies were highly consistent. Evidence suggested that dietary patterns in adults and older adults that involved higher consumption of vegetables, fruits, legumes, nuts, whole grains, unsaturated vegetable oils, fish, and lean meat or poultry (when meat was included) were associated with a decreased risk of ACM. These healthy patterns were also relatively low in red and processed meat, high-fat dairy, and refined carbohydrates or sweets. Some of these dietary patterns also included intake of alcoholic beverages in moderation. Results based on additional analyses with confounding factors generally confirmed the robustness of main findings. Conclusions and Relevance In this systematic review, consuming a nutrient-dense dietary pattern was associated with reduced risk of death from all causes.
49 citations
National Institutes of Health1, Agricultural Research Service2, University of California, Irvine3, University of Wisconsin-Madison4, British Columbia Institute of Technology5, University of Pennsylvania6, Center for Food Safety and Applied Nutrition7, University of Arizona8, University of Iowa9, North Carolina State University10, University College Cork11, Eindhoven University of Technology12, University of California, Santa Cruz13, University of Chicago14, University of Florida15, Drexel University16, Harvard University17, Indiana University – Purdue University Indianapolis18, Cincinnati Children's Hospital Medical Center19, Louisiana State University20, University of Pittsburgh21, University of California, San Diego22, University of Minnesota23, University of Illinois at Chicago24
TL;DR: More effective bridging from NP research to CT was the goal of a September, 2018 transdisciplinary workshop, and participants emphasized that replicability and likelihood of successful translation depend on rigor in experimental design, interpretation, and reporting across the continuum of NP research.
Abstract: While great interest in health effects of natural product (NP) including dietary supplements and foods persists, promising preclinical NP research is not consistently translating into actionable clinical trial (CT) outcomes. Generally considered the gold standard for assessing safety and efficacy, CTs, especially phase III CTs, are costly and require rigorous planning to optimize the value of the information obtained. More effective bridging from NP research to CT was the goal of a September, 2018 transdisciplinary workshop. Participants emphasized that replicability and likelihood of successful translation depend on rigor in experimental design, interpretation, and reporting across the continuum of NP research. Discussions spanned good practices for NP characterization and quality control; use and interpretation of models (computational through in vivo) with strong clinical predictive validity; controls for experimental artefacts, especially for in vitro interrogation of bioactivity and mechanisms of action; rigorous assessment and interpretation of prior research; transparency in all reporting; and prioritization of research questions. Natural product clinical trials prioritized based on rigorous, convergent supporting data and current public health needs are most likely to be informative and ultimately affect public health. Thoughtful, coordinated implementation of these practices should enhance the knowledge gained from future NP research.
38 citations
TL;DR: Whether plant-based diets before or after a cancer diagnosis prevent negative cancer-related outcomes needs to be researched further, in order to define dietary guidelines for cancer survivors.
Abstract: Long-term cancer survivors represent a sizeable portion of the population Plant-based foods may enhance the prevention of cancer-related outcomes in these patients We aimed to synthesize the current evidence regarding the impact of plant-based dietary patterns (PBDPs) on cancer-related outcomes in the general population and in cancer survivors Considered outcomes included overall cancer mortality, cancer-specific mortality, and cancer recurrence A rapid review was conducted, whereby 2234 original articles related to the topic were identified via Pubmed/Medline We selected 26 articles, which were classified into studies on PBDPs and cancer outcomes at pre-diagnosis: vegan/vegetarian diet (N = 5), provegetarian diet (N = 2), Mediterranean diet (N = 13), and studies considering the same at post-diagnosis (N = 6) Pooled estimates of the associations between the aforementioned PBDPs and the different cancer outcomes were obtained by applying random effects meta-analysis The few studies available on the vegetarian diet failed to support its prevention potential against overall cancer mortality when compared with a non-vegetarian diet (eg, pooled hazard ratio (HR) = 097; 95% confidence interval (CI): 088–106) The insufficient number of studies evaluating provegetarian index scores in relation to cancer mortality did not permit a comprehensive assessment of this association The association between adherence to the Mediterranean diet and cancer mortality reached statistical significance (eg, pooled HR = 084; 95% CI: 079–089) However, no study considered the influence of prognostic factors on the associations In contrast, post-diagnostic studies accounted for prognostic factors when assessing the chemoprevention potential of PBDPs, but also were inconclusive due to the limited number of studies on well-defined plant-based diets Thus, whether plant-based diets before or after a cancer diagnosis prevent negative cancer-related outcomes needs to be researched further, in order to define dietary guidelines for cancer survivors
37 citations
Cites background or result from "Changes in Plant-Based Diet Quality..."
...Our literature search retrieved two studies on the association between provegetarian diets and cancer mortality [52,53]....
[...]
...[53] distinguished the quality of plant-based foods in the scoring....
[...]
...However, with only two studies evaluating how these scores affect cancer mortality risk [52,53], it has been difficult to arrive at any concrete conclusion....
[...]
...Recently, a priori-defined plant-based scores have been proposed to allow comparisons between different levels of compliance with vegetable-derived foods against animal-derived foods [53]....
[...]
...Thus, 26 studies were included in this review: 5 VD-like studies [34–38], 12 MD-like studies [39–51], 2 provegetarian diet studies [52,53], and 6 post-diagnosis studies [54–59]....
[...]
References
More filters
Harvard University1, Potsdam Institute for Climate Impact Research2, Stockholm Resilience Centre3, University of Oxford4, City University London5, Chatham House6, World Wide Fund for Nature7, Environmental Change Institute8, University of Minnesota9, University of California, Santa Barbara10, CGIAR11, Johns Hopkins University12, American University of Beirut13, Wageningen University and Research Centre14, Institute for Health Metrics and Evaluation15, ETH Zurich16, Indian Institute of Technology Kanpur17, Commonwealth Scientific and Industrial Research Organisation18, University of Indonesia19, World Health Organization20, Food and Agriculture Organization21, International Food Policy Research Institute22, Royal Swedish Academy of Sciences23, University of Auckland24, Public Health Foundation of India25, Centre for Science and Environment26
TL;DR: Food in the Anthropocene : the EAT-Lancet Commission on healthy diets from sustainable food systems focuses on meat, fish, vegetables and fruit as sources of protein.
4,710 citations
Additional excerpts
...Median –10 (–20, –7) –4 (–6, –2) 0 (–1, 2) 4 (3, 6) 10 (7, 21)...
[...]
...Median (range) –9 (–20, –6) –3 (–5, –2) 0 (–1, 1) 3 (2, 5) 9 (6, 18)...
[...]
...Median –10 (–20, –7) –4 (–6, –3) 0 (–2, 1) 3 (2, 5) 9 (6, 18)...
[...]
...Median (range) –9 (–19, –6) –4 (–5, –3) 0 (–2, 1) 3 (2, 5) 8 (6, 18)...
[...]
...Median –9 (–19, –6) –3 (–5, –2) 0 (–1, 2) 4 (3, 6) 10 (7, 19)...
[...]
TL;DR: Data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.
Abstract: The aim of this study was to evaluate the reproducibility and validity of a 61-item semiquantitative food frequency questionnaire used in a large prospective study among women. This form was administered twice to 173 participants at an interval of approximately one year (1980-1981), and four one-week diet records for each subject were collected during that period. Intraclass correlation coefficients for nutrient intakes estimated by the one-week diet records (range = 0.41 for total vitamin A without supplements to 0.79 for vitamin B6 with supplements) were similar to those computed from the questionnaire (range = 0.49 for total vitamin A without supplements to 0.71 for sucrose), indicating that these methods were generally comparable with respect to reproducibility. With the exception of sucrose and total carbohydrate, nutrient intakes from the diet records tended to correlate more strongly with those computed from the questionnaire after adjustment for total caloric intake. Correlation coefficients between the mean calorie-adjusted intakes from the four one-week diet records and those from the questionnaire completed after the diet records ranged from 0.36 for vitamin A without supplements to 0.75 for vitamin C with supplements. Overall, 48% of subjects in the lowest quintile of calorie-adjusted intake computed from the diet records were also in the lowest questionnaire quintile, and 74% were in the lowest one of two questionnaire quintiles. Similarly, 49% of those in the highest diet record quintile were also in the highest questionnaire quintile, and 77% were in the highest one or two questionnaire quintiles. These data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.
4,012 citations
Additional excerpts
...Median –9 (–19, –6) –3 (–5, –2) 0 (–1, 2) 4 (3, 6) 10 (7, 19)...
[...]
...Median –10 (–19, –7) –4 (–6, –3) –1 (–2, 1) 3 (2, 5) 9 (6, 19)...
[...]
TL;DR: This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality.
Abstract: Objective To examine and quantify the potential dose-response relation between fruit and vegetable consumption and risk of all cause, cardiovascular, and cancer mortality. Data sources Medline, Embase, and the Cochrane library searched up to 30 August 2013 without language restrictions. Reference lists of retrieved articles. Study selection Prospective cohort studies that reported risk estimates for all cause, cardiovascular, and cancer mortality by levels of fruit and vegetable consumption. Data synthesis Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals and to incorporate variation between studies. The linear and non-linear dose-response relations were evaluated with data from categories of fruit and vegetable consumption in each study. Results Sixteen prospective cohort studies were eligible in this meta-analysis. During follow-up periods ranging from 4.6 to 26 years there were 56 423 deaths (11 512 from cardiovascular disease and 16 817 from cancer) among 833 234 participants. Higher consumption of fruit and vegetables was significantly associated with a lower risk of all cause mortality. Pooled hazard ratios of all cause mortality were 0.95 (95% confidence interval 0.92 to 0.98) for an increment of one serving a day of fruit and vegetables (P=0.001), 0.94 (0.90 to 0.98) for fruit (P=0.002), and 0.95 (0.92 to 0.99) for vegetables (P=0.006). There was a threshold around five servings of fruit and vegetables a day, after which the risk of all cause mortality did not reduce further. A significant inverse association was observed for cardiovascular mortality (hazard ratio for each additional serving a day of fruit and vegetables 0.96, 95% confidence interval 0.92 to 0.99), while higher consumption of fruit and vegetables was not appreciably associated with risk of cancer mortality. Conclusions This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality.
1,289 citations
TL;DR: The hypothesis that the inverse relation between alcohol consumption and risk of coronary disease is causal is supported.
1,224 citations
Additional excerpts
...Median (range) –9 (–19, –6) –4 (–5, –3) 0 (–2, 1) 3 (2, 5) 8 (6, 18)...
[...]
...Median (range) –9 (–20, –6) –3 (–5, –2) 0 (–1, 1) 3 (2, 5) 9 (6, 18)...
[...]
...Median –10 (–20, –7) –4 (–6, –3) 0 (–2, 1) 3 (2, 5) 9 (6, 18)...
[...]
TL;DR: The moderate degree of measurement error for the ratio of self-reported waist and hip circumferences implies that previously reported associations based on self-report of these measures may have been appreciably underestimated.
Abstract: Recent epidemiologic evidence indicates an association between fat distribution and many diseases. To assess the validity of circumference measurements obtained by self-report, the authors analyzed data from 123 men aged 4C75 years and 140 women aged 41–65 years, drawn from two large ongoing prospec
986 citations