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A vegan patient: nutritional characteristic of plant-based diet

Czech version

Authors: D. Štruncová 1,4;  R. Dymáčková 2,4;  R. Štícha 3,4
Authors‘ workplace: Ústav ochrany a podpory zdraví LF MU, Brno, Přednosta: Mgr. Bc. Michal Koščík, Ph. D. 1;  Klinika radiační onkologie LF MU a Masarykův onkologický ústav, Brno, Přednosta: prof. MUDr. Pavel Šlampa, CSc. 2;  I. ortopedická klinika 1. LF UK a FN Motol, Praha, Přednosta: prof. MUDr. Ivan Landor, CSc. 3;  Physicians Association for Nutrition Czech Republic z. s., Brno, Předsedkyně: Mgr. Dagmar Štruncová 4
Published in: Prakt. Lék. 2021; 101(2): 74-84
Category: Reviews

Overview

The number of vegetarians, vegans or those who limit their meat consumption is increasing in the world and in the Czech Republic as well. Due to the growing popularity of veganism, one may expect that the number of patients on plant-based diet will continue to grow, even in general practitioners’ surgeries. This article aims to summarize the basic nutritional specifics of a plant-based diet and to name some key nutrients which need more focus in case of vegan patients. We present some laboratory tests which the general practitioner may consider in case of doubt about the proper nutritional status of the vegan patient. The article mentions some non-communicable diseases (NCDs), in which a plant-based diet can be beneficial in both prevention and treatment.

Keywords:

nutrition – Diet – vegan

Sources
  1. Afshin A, Sur PJ, Fay KA, et al. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019; 393(10184): 1958–1972.
  2. Agnoli C, Baroni L, Bertini I, et al. Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition. Nutr Metab Cardiovasc Dis 2017; 27(12): 1037–1052.
  3. American Dietetic Association, Dietitians of Canada. Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets. J Am Diet Assoc 2003; 103(6): 748–765.
  4. Amit M. Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 2010; 15(5): 303–314.
  5. Appleby PN, Key TJ. The long-term health of vegetarians and vegans. Proc Nutr Soc 2016; 75(3): 287–293.
  6. Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr. 2007; 61(12): 1400–1406.
  7. Bahadir A, Reis PG, Erduran E. Oral vitamin B12 treatment is effective for children with nutritional vitamin B12 deficiency. J Paediatr Child Health 2014; 50(9): 721–725.
  8. Barnard ND, Cohen J, Jenkins DJA, et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care 2006; 29(8): 1777–1783.
  9. Baroni L, Goggi S, Battino M. VegPlate: A Mediterranean-based food guide for Italian adult, pregnant, and lactating vegetarians. J Acad Nutr Diet 2018; 118(12): 2235–2243.
  10. Barzel US, Massey LK. Excess dietary protein can adversely affect bone. J Nutr 1998; 128(6): 1051–1053.
  11. Beard JL, Dawson H, Piñero DJ. Iron Metabolism: A Comprehensive Review. Nutr Rev 2009; 54(10): 295–317.
  12. Bischofová S, Dofková M, Blahová J, a kol. Dietární zdroje vitaminu D v české populaci 4–90 let). Výživa a potraviny 2019; č. 3.
  13. Bischofova S, Dofkova M, Blahova J, et al. Dietary Intake of Vitamin D in the Czech Population: A Comparison with Dietary Reference Values, Main Food Sources Identified by a Total Diet Study. Nutrients 2018; 10(10): 1452.
  14. Buettner D, Skemp S. Blue Zones: Lessons From the World’s Longest Lived. Am J Lifestyle Med 2016; 10(5): 318–321.
  15. Butler TL, Fraser GE, Beeson WL, et al. Cohort Profile: The Adventist Health Study-2 AHS-2). Int J Epidemiol 2008; 37(2): 260–265.
  16. Carpenter CE, Mahoney AW. Contributions of heme and nonheme iron to human nutrition. Crit Rev Food Sci Nutr 1992; 31(4): 333–367.
  17. Casas R, Castro-Barquero S, Estruch R, Sacanella E. Nutrition and Cardiovascular Health. IJMS 2018; 19(12): 3988.
  18. Craig WJ. Health effects of vegan diets. Am J Clin Nutr 2009; 89(5): 1627S–1633S.
  19. Craig WJ. Nutrition Concerns and Health Effects of Vegetarian Diets. Nutr Clin Pract 2010; 25(6): 613–620.
  20. Davey GK, Spencer EA, Appleby PN, et al. EPIC-Oxford: lifestyle characteristics and nutrient intakes in a kohort of 33 883 meat–eaters and 31 546 non meat-eaters in the UK. Public Health Nutr 2003; 6(3): 259–268.
  21. Davis B, Melina V. Becoming Vegan: Comprehensive Edition. Summertown Tennessee, USA: Book publishing company 2014.
  22. de Jager J, Kooy A, Lehert P, et al. Long term treatment with metformin in patiens with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ 2010; 340: c2181–c2181.
  23. Dod HS, Bhardwaj R, Sajja V, et al. Effect of Intensive Lifestyle Changes on Endothelial Function and on Inflammatory Markers of Atherosclerosis. Am J Cardiol 2010; 105(3): 362–367.
  24. European Food Safety Authority. DRV Finder online) (2021-01-14). Dostupné na: https://www.efsa.europa.eu/en/interactive-pages/drvs
  25. European Food Safety Authority. Scientific Opinion on Dietary Reference Values for protein. EFSA Journal 2012; 10(2): 2557.
  26. Evert AB, Boucher JL, Cypress M, et al. Nutrition Therapy Recommendations for the Management of Adults With Diabetes. Diabetes Care 2013; 36(11): 3821–3842.
  27. Fakultní nemocnice Královské Vinohrady. Laboratorní příručka CL FNKV (online) 2020 (cit. 2021-02-15). Dostupné na: https://www.fnkv.cz/lab/lp_uld/HVEZDACADF.htm
  28. Food and Agriculture Organization of the United Nations. Livestock’s Long Shadow: Environmental Issues and Options (online) 2006 (cit. 2020-10-22). Dostupné na: http://www.fao.org/3/a0701e/a0701e00.htm
  29. Food and Agriculture Organization of the United Nations & World Health Organization. Diet, Nutrition, and the Prevention of Chronic Diseases (online) 2003 (cit. 2020-11-25). Dostupné na: https://www.who.int/dietphysicalactivity/publications/trs916/en/
  30. Food and Agriculture Organization of the United Nations, World Health Organization & United Nations University. Protein and Amino Acid Requirements in Human Nutrition (online) 2007 (cit. 2020–11–01). Dostupné na: https://apps.who.int/iris/handle/10665/43411
  31. Fraser GE, Cosgrove CM, Mashchak AD, et al. Lower rates of cancer and all‐cause mortality in an Adventist kohort compared with a US Census population. Cancer 2020; 126(5): 1102–1111.
  32. Green R. Indicators for assessing folate and vitamin B-12 status and for monitoring the efficacy of intervention strategies. Am J Clin Nutr 2011; 94(2): 666S–672S.
  33. Greenpeace. Eating Less Meat, More Plants Helps the Environment (online) 2020 (cit. 2020-12-04). Dostupné z: https://www.greenpeace.org/usa/sustainable-agriculture/eco-farming/eat-more-plants/
  34. Grofová Z. Mastné kyseliny. Med Pro Praxi 2010; 7(10): 388–390.
  35. Herrmann W, Obeid R, Schorr H, Geisel J. Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk. Clin Chem Lab Med 2003; 41(11): 478–488.
  36. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency. BMJ 2014; 349: g5226–g5226.
  37. Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr 2010; 91(5): 1461S–1467S.
  38. Chiu Y-F, Hsu C-C, Chiu THT, et al. Cross-sectional and longitudinal comparisons of metabolit profiles between vegetarian and non-vegetarian subjects: a matched cohort study. Br J Nutr 2015; 114(8): 1313–1320.
  39. Cholewski M, Tomczykowa M, Tomczyk M. A Comprehensive Review of Chemistry, Sources and Bioavailability of Omega-3 Fatty Acids. Nutrients 2018; 10 (11): 1662.
  40. Ipsos. Bezmasou stravu preferuje desetina mladých (online) 2019 (cit. 2020-12-04). Dostupné na: https://www.ipsos.com/cs-cz/bezmasou-stravu-preferuje-desetina-mladych
  41. Jančeková K, Kapounová Z, Hašová M. Vitamin B12 u těhotných a kojících žen s veganským způsobem stravování. Výživa a potraviny 2019; č. 1.
  42. Knurick J, Johnston C, Wherry S, Aguayo I. Comparison of Correlates of Bone Mineral Density in Individuals Adhering to Lacto–Ovo, Vegan, or Omnivore Diets: A Cross–Sectional Investigation. Nutrients 2015; 7(5): 3416–3426.
  43. Lane DJR, Ayton S, Bush AI. Iron and Alzheimer’s Disease: An Update on Emerging Mechanisms. JAD 2018; 64(Suppl 1): S379–S395.
  44. Langan RC, Goodbred AJ. Vitamin B12 Deficiency: Recognition and Management. Am Fam Physician 2017; 96(6): 384–389.
  45. Mangels AR. Bone nutrients for vegetarians. Am J Clin Nutr 2014; 100(Suppl 1): 469S–475S.
  46. Mariotti F, Gardner CD. Dietary Protein and Amino Acids in Vegetarian Diets – A Review. Nutrients 2019; 11(11): 2661.
  47. Marsh KA, Munn EA, Baines SK. Protein and vegetarian diets. Med J Aust 2013; 199(S4): S7–S10.
  48. Martinka E, Lejavová J, Mokáň M, a kol. „Plant-based diet“ podľa NFI-protokolu u pacientov s diabetes mellitus 2. typu: pilotná štúdia. Forum Diab 2020; 9(1): 54–60.
  49. Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet 2016; 116(12): 1970–1980.
  50. Messina V, Mangels AR. Considerations in Planning Vegan Diets: Children. J Am Diet Assoc 2001; 101(6): 661–669.
  51. Messina V, Melina V, Mangels AR. A new food guide for North American vegetarians. J Am Diet Assoc 2003; 103 (6): 771–775.
  52. Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother 2012; 3(2): 118–126.
  53. National Health and Medical Research Council Australia), Australia, Department of Health and Ageing. Eat for Health: Australian Dietary Guidelines  online) 2013 (cit. 2020-11-24). Dostupné na: file:///C:/Users/HP/AppData/Local/Temp/australian-dietary-guidelines-2013.pdf
  54. Office of Dietary Supplements (ODS). Vitamin B12 – Health Professional Fact Sheet online) 2020 (cit. 2021-01-13). Dostupné na: https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  55. Oh R, Brown DL. Vitamin B12 deficiency. Am Fam Physician 2003, 67(5): 979–986.
  56. Olfert MD, Wattick RA. Vegetarian Diets and the Risk of Diabetes. Curr Diab Rep 2018; 18(11), 101.
  57. Orlich MJ, Fraser GE. Vegetarian diets in the Adventist Health Study 2: a review of initial Publisher findings. Am J Clin Nutr 2014; 100(Suppl 1): 353S–358S.
  58. Oseeva M, Paluchova V, Zacek P, et al. Omega-3 index in the Czech Republic: No diference between urban and rural populations. Chem Phys Lipids 2019; 220: 23–27.
  59. Phillips F. Vegetarian nutrition. Nutr Bulletin 2005; 30(2): 132–167.
  60. Poore J, Nemecek T. Reducing food’s environmental impacts through producers and consumers. Science 2018; 360(6392): 987–992.
  61. Richter M, Boeing H, Grünewald-Funk D, et al. Vegan diet. Position of the German Nutrition Society (DGE). Ernahrungs Umschau 2016; 63: 92–102.
  62. Ripple WJ, Wolf C, Newsome TM, et al. World Scientists’ Warning of a Climate Emergency. Bio Science 2020; 70(1): 8–12.
  63. Rizzo G, Laganà A, Rapisarda A, et al. Vitamin B12 among Vegetarians: Status, Assessment and Supplementation. Nutrients 2016, 8(12): 767.
  64. Rogerson D. Vegan diets: practical advice for athletes and exercisers. J Int Soc Sports Nutr 2017; 14(1): 36.
  65. Saraff V, Shaw N. Sunshine and vitamin D. Arch Dis Child 2016; 101(2): 190–192.
  66. Scolamiero E, Villani GRD, Ingenito L, et al. Maternal vitamin B12 deficiency detected in expanded newborn screening. Clin Biochem 2014; 47(18): 312–317.
  67. Selinger E, Kühn T, Procházková M, Anděl M, Gojda J. Vitamin B12 Deficiency Is Prevalent Among Czech Vegans Who Do Not Use Vitamin B12 Supplements. Nutrients 2019; 11(12): 3019.
  68. Shah B, Newman JD, Woolf K, et al. Anti‐Inflammatory Effects of a Vegan Diet Versus the American Heart Association–Recommended Diet in Coronary Artery Disease Trial. J Am Heart Assoc 2018; 7(23).
  69. Shah R, Davis B. Nourish: TheDefinitive Plant–Based Nutrition Guide for Families. Boca Raton, Florida USA: Health Communications, Inc. 2020.
  70. Shahidi F, Ambigaipalan P. Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits. Annu Rev Food Sci Technol 2018; 9(1): 345–381.
  71. Simopoulos AP. Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nutr 1991; 54(3): 438–463.
  72. Simopoulos AP. The Importance of the Omega-6/Omega-3 Fatty Acid Ratio in Cardiovascular Disease and Other Chronic Diseases. Exp Biol Med (Maywood) 2008; 233(6): 674–688.
  73. Śliwińska A, Luty J, Aleksandrowicz-Wrona E, Małgorzewicz S. Iron status and dietary iron intake in vegetarians. AdvClin Exp Med 2018; 27(10): 1383–1389.
  74. Snow CF. Laboratory Diagnosis of Vitamin B12 and Folate Deficiency: A Guide for the Primary Care Physician. Arch Intern Med 1999; 159(12), 1289.
  75. Společnost pro výživu, z.s., Česká republika, Vyzivaspol.cz (internetová stránka) 2020 (cit. 2020-06-08). Dostupné na: https://www.vyzivaspol.cz/veganska-dietshina/
  76. Stabler SP. Vitamin B12 Deficiency. N Engl J Med 2013; 368(2): 149–160.
  77. Stark KD, van Elswyk ME, Higgins MR, et al. Global surfy of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults. Prog Lipid Res 2016; 63: 132–152.
  78. Státní zdravotní ústav, Méně než 1 % osob má dostatek vitaminu D z obvyklé české stravy – v zimě to zakládá na problémy (online) 2007 (cit. 2020-10-01). Dostupné na: http://www.szu.cz/tema/bezpecnost-potravin/mene-nez-1-osob-ma-dostatek-vitaminu-d-z-obvykle-ceske
  79. Státní zdravotní ústav. Systém monitorování zdravotního stavu obyvatelstva ve vztahu k životnímu prostředí, Subsystém 6, Hodnocení zdravotního stavu, Studie HELEN, Demografické stárnutí. Odborná zpráva za rok 2010 (online) 2011 (cit. 2021-02-24). Dostupné na: http://www.szu.cz/uploads/documents/chzp/zdrav_stav/OZ_zdravi_2010.pdf
  80. Štruncová D, Dymáčková R. Diet and its effect on prostate cancer, with a focus on plant-based diet. Klin Onkol 2020; 33(Suppl 1): 51–59.
  81. Trapp CB, Barnard ND. Usefulness of Vegetarian and Vegan Diets for Treating Type 2 Diabetes. Curr Diab Rep 2010; 10(2): 152–158.
  82. Watanabe F. Vitamin B12 Sources and Bioavailability. Exp Biol Med (Maywood), 2007; 232(10): 1266–1274.
  83. Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary kalcium with a vegetarian diet. Am J Clin Nutr 1999; 70(3): 543s–548s.
  84. World Health Organization. A healthy diet sustainably produced online) 2018 (cit. 2020–02–09). Dostupné na: https://www.who.int/publications/i/item/WHO-NMH-NHD-18.12
  85. World Health Organization. Healthy diet (online) 2020 (cit. 2020-11-27). Dostupné na: https://www.who.int/news-room/fact-sheets/detail/healthy-diet
  86. World Health Organization. Noncommunicable diseases online) 2020 (cit. 2020-11-18). Dostupné na: https://www.who.int/data/gho/data/themes/noncommunicable-diseases
  87. World Health Organization. The top 10 causes of death| (online) 2020 (cit. 2020-11-18). Dostupné na: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
  88. Young VR, Pellett PL. Plant proteins in relation to human protein and amino acid nutrition. Am J Clin Nutr 1994; 59(5): 1203S–1212S.
  89. Zacharski LR, Shamayeva G, Chow BK, DePalma RG. Ferritin and Percent Transferrin Saturation Levels Predict Type 2 Diabetes Risk and Cardiovascular Disease Outcomes. CDR 2017; 13(4).
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