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The metabolic health of New Zealand vegans
- L. Hill, C. Conlon, H. Mazahery, K.L. Beck, K. Mumme, R. Batty, P. von Hurst
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E179
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The popularity of a vegan diet is growing worldwide. Data analysed from the 2018 NZ Attitudes and Values study showed that 1.1% of New Zealanders followed a vegan diet(1). Though there are potential nutrient deficiencies in a vegan diet, it is generally accepted that a vegan diet, with its emphasis on a variety of vegetables, fruit, grains, legumes, and pulses, has greater metabolic benefits than a Western-style diet high in red meat and processed foods and lower in plants(2). This observational cross-sectional study aimed to explore the dietary intake (4-day food diary) and metabolic health status (including anthropometry, blood pressure, lipids, body fat percentage, omega-3 index and glycaemic control) of adults who had been consuming a vegan diet for 2+ years. Participants (N = 212) were predominantly female (N = 155) with a mean (SD) age of 39.5 (12.4) years. Mean cardiometabolic markers of systolic and diastolic blood pressure, BMI, waist circumference, HbA1c, total cholesterol, LDL-cholesterol, HDL-cholesterol, Chol:HDL ratio and triglycerides were all below the thresholds for disease risk. Omega-3 index results <4% placed most participants (86.3%) in the high-risk category for heart disease. Many female participants (71%) had >30% body fat, compared to 5.3% of males. With reference to the AMDR (total fat 20-35%, carbohydrate 45-65% and protein 15-25%), the intake of total fat was at the upper end (males 34.4%, females 35.9%), carbohydrate was at the lower end (males 46.2%, females 44.7%), and protein was below the lower end (males 14.9%, females 14.2%). Saturated fat intakes ranged from 4.0-65.9 g/d, with a mean (SD) of 24.9 (10.5) g/d for males and 20.2 (9.9) g/d for females. The mean (SD) dietary fibre intake was much higher than the AI set by the Ministry of Health of 25g/d for females and 30g/d for males, at 55.0 (17.8) g/d for males and 43.4 (12.8) g/d for females, ranging from 10.9-133.9g/d. This is the first New Zealand study to examine the metabolic health and dietary intake of adult vegans. The results of cardiometabolic health markers indicate that the vegan diet confers cardioprotective benefits. However, the low Omega-3 index of most participants is concerning, which warrants longitudinal research to assess the level of risk conferred by a low Omega-3 index result in a population with no other cardiometabolic risk factors. The findings of the present study may help guide the growing New Zealand vegan community towards a nutritionally optimal vegan diet.
The effect of motivation type on intake and nutritional status of vitamin B12, omega-3 fatty acids, iron and nutrition knowledge in individuals following a vegan diet
- R. Pearce, C. Conlon, K. Beck, K. Mumme, H. Mazahery, R. Batty, P. von Hurst
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E136
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The fundamental principle of veganism is to avoid all possible animal exploitation and therefore, animal ethics has always been a primary motivator. Nowadays, the environment and health are also common motivators. Omission of all animal products leads to dietary exclusion of vitamin B12, limited intake of omega-3 fatty acids, specifically EPA and DHA, and intake of low bioavailable iron sources1. Obtaining the knowledge to appropriately plan and replace nutrients through food or supplementation is key to avoiding deficiencies and subsequent consequences. This study aimed to determine the effect of motivation for being vegan on intake of key nutrients and nutritional knowledge. This cross-sectional, observational study recruited participants, who had followed a vegan diet for minimum 2 years. Demographics and nutrition knowledge were obtained from questionnaires. Motivation type was determined using the validated vegetarian eating motives inventory (VEMI) – participants scored the importance of animal ethic, environment and health. Intakes of vitamin B12 and iron, were collected using a 4-day food diary and assessed against Estimated Average Requirement (EAR). Blood samples were taken to determine status of vitamin B12, haemoglobin, serum ferritin, and omega-3 index. Omega-3 index score ≤4 indicates increased risk of coronary heart disease. Animal ethics was the greatest motivator to become vegan, with 83.5% of participants scoring it as very important, compared to 71.7% of people stating the environment, and 53.3% stating health. No association was found between all motivation types and intake of vitamin B12 and iron, nor omega-3 index. Mean vitamin B12 intake (supplements excluded) of 2.11ug/day ± 3.43 exceeded the EAR of 2.0ug/day for both men and women, however intakes ranged between 0.00 and 37.63ug/day. Mean intake of iron (18.77mg/day) exceeded the EAR for both men and women. Overall mean omega-3 index was 3.16%. Both men (162.24g/L) and women (151.44g/L) had adequate mean Hb serum concentrations. Mean serum ferritin was within normal range for both men (64.86ug/L ± 43.48) and women (32.55ug/L ± 26.04). Overall mean serum vitamin B12 was within normal range (316.54pmol/L ± 146.18), however a large range was observed from 72.00pmol/L to 1,015pmol/L. Males and females had similar knowledge, with only one question regarding fibre content in cornflakes found to be significantly different (P = 0.012). Knowledge was varied e.g., 100% of participants could identify that pasta was a carbohydrate source, yet could not identify which fats are most important to reduce. Mean vitamin B12 intake exceeding EAR and normal status despite limited vegan sources, indicates high consumption of high bioavailable fortified foods, and supplementation. Iron status shows large consumption of iron rich foods to overcome bioavailability issues, reflected by adequate iron intake, after increasing EAR by 80% to meet recommendations. The mean omega-3 index shows a low cardioprotective omega-3 fatty acid intake.
Evaluation of the potential implications of following a vegan diet on bone health
- A. Clark, M.C. Kruger, H. Mazahery, C. Conlon, K.L. Beck, K. Mumme, R. Batty, P.R. von Hurst
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E180
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Cow’s milk is the primary source of calcium in the NZ diet(1). The absence of dietary planning in a vegan diet can result in the individual unknowingly obtaining low intakes of calcium. Prolonged low calcium intakes can result in negative implications on bone mineral density by increasing the risk of osteoporosis later in life. The measurement of bone health parameters in NZ vegan adults have not been investigated. Therefore, we measured bone mineral density, markers of calcium homeostasis and assessed intake of essential nutrients for optimal bone health in vegans. This cross-sectional study included adults (>18yrs), who followed a vegan diet for 2 years minimum. Demographic and lifestyle information was obtained from questionnaires including previous history of bone fractures and background of familial osteoporosis. A 4-day food record was completed for analysis of calcium, zinc, protein, magnesium, phosphorus and vitamin C intake and compared to the Estimated Average Requirement (EAR)(2). Weight, height and BMI were obtained, bone mineral density was measured at the hip and spine via dual x-ray absorptiometry (DXA) and reported as Z and T scores. Plasma calcium concentrations were corrected for albumin. All values are presented as mean and standard deviation. The study included 212 participants, aged 39 ± 12.38 years, 71% female. T scores at the lumbar spine and femoral neck were −0.63 ± 1.22 (Z score: −0.29 ± 1.12) and −0.66 ± 1.00 (Z score: −0.24 ± 0.89), respectively. Nine participants had a Z-score of <-2.0 at the lumbar spine, and three at the femoral neck. Corrected calcium concentrations were 2.21 ± 0.33 mmol/L. Calcium intake was 917 ± 347.23 (range 195 to 2,429 mg/day) in all participants, which exceeded the EAR of 840 mg/day for adults aged 19-50 years. Men had higher intakes of calcium than women, 1,051 ± 363.7 mg/day (range 382 to 2,267 mg/day) vs. 867 ± 328.04 mg/day (range 194 to 2,428 mg/day), P-value <0.001. The main source of calcium in the vegan diet was tofu. The intake of protein (77 ± 27.80) g/day, magnesium (569 ± 181.05) mg/day, and vitamin C (145 ± 96.94) mg/day met the EAR, excluding vitamin and mineral supplements. However, the intake of phosphorus (1,472 ± 459.98) mg/day and zinc (10.6 ± 4.01) mg/day were below the EAR. The findings of this study suggest that bone health of vegans are not negatively affected by the exclusion of dairy in the diet, provided that appropriate dietary planning is included to avoid nutrient deficiencies associated with poor bone health. Despite mean intake of calcium exceeding the EAR, very low intakes demonstrated significant variations between participants.
Performance anxiety in professional musicians: a systematic review on prevalence, risk factors and clinical treatment effects
- I. Fernholz, J. L. M. Mumm, J. Plag, K. Noeres, G. Rotter, S. N. Willich, A. Ströhle, A. Berghöfer, A. Schmidt
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- Journal:
- Psychological Medicine / Volume 49 / Issue 14 / October 2019
- Published online by Cambridge University Press:
- 02 September 2019, pp. 2287-2306
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Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case–control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from −11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and −4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45–50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and β-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.