Plant-Based Nutrition Flashcards
1
Q
Any eating pattern that excludes animal-derived foods to some degree
Increasing in popularity among all age groups for various reasons
A
Plant-Based Diet
2
Q
Reasons for Choosing a Plant-Based Diet
A
- Religious or Cultural Beliefs: Hinduism, Jainism, Buddhism
- Health Reasons: CVD, HLD, DM, CKD, chronic acidosis, inflammatory disorders
- Animal welfare
- Environmental concerns
- Any combination of the above
3
Q
Major Categories of Plant-Based Diets
A
- Vegetarian - Umbrella term; diet focused on plant-based foods
- Generally avoid meat, poultry, and seafood - Vegan - excludes all animal-derived foods
- Including meat, poultry, fish/seafood, eggs, dairy, and honey - Ovo-vegetarian - Permits consumption of eggs
- Otherwise avoids animal-derived food products - Lacto-vegetarian - Permits consumption of dairy products
- Otherwise avoids animal-derived food products - Ovo-lacto vegetarian - Permits consumption of both eggs and dairy products
- Otherwise avoids animal-derived food products - Pescetarianism (Pesco-vegetarianism) - Permits consumption of fish and other seafood, and often eggs and dairy
- Otherwise avoids animal-derived food products - Pollotarianism (Pollo-vegetarianism) - Permits consumption of chicken (+/- other poultry), and often eggs and dairy
- Otherwise avoids animal-derived food products - Plant-Based (“Flexitarian”) - Dietary pattern that is predominantly, but not exclusively, based on plant foods
- May consume meat, but encouraged to minimize
- No universal limit; some sources say 85-90% plant-based foods
4
Q
how to Assess Plant-Based Diets
A
- Food Diary - retrospective or prospective
- Allows assessment of variety of foods ingested
- Allows assessment of processed food intake - Dietary Calculators - numerous tools to use
- Basic nutrient intake calculator
- Nutrients per food item calculator
- Recipe nutrition calculator
- Numerous food tracker apps
5
Q
Allows classification of whether a plant-based food is healthy or unhealthy
A
Plant-Based Dietary Index
6
Q
what are some Healthy Plant-Based Foods
A
vegetables, fruits, legumes, whole grains, nuts, seeds
7
Q
what are some Unhealthy Plant-Based Foods
A
sugar, refined grains, juices, potatoes, desserts, highly processed foods
8
Q
Traditional Plant-Based Meat Alternatives
A
historically made from tofu, tempeh, or “veggie blends” like legumes, grains, and vegetables
9
Q
Newer Plant-Based Meat Alternatives
A
- more varied ingredients and generally found to be closer to meat products with regard to texture and taste
- Seitan - made from vital wheat gluten
- Beyond Meats - made from pea protein, rice protein, cocoa butter, coconut oil, yeast
- Impossible Meats - made from potato and soy proteins, yeast; contain vegan heme iron
- Jackfruit - naturally occurring fruit; often used in recipes to replace pulled beef or pork
- Soy-based foods - tofu, tempeh, edamame still often used
- Not enough clinical data to say if these products are healthier than meat!
10
Q
what vitamin is found to be highest amounts in animal-based foods
A
vit B12 (cobalamin)
Meats, eggs, dairy, and seafood products
11
Q
Vegetarian-Friendly Sources for vit B12
A
- fortified cereals, fortified plant-based milks, dairy, eggs
- Not usually enough to meet dietary needs alone
12
Q
Most vegetarian patients should be on what vitamin supplement
A
B12 supplement
13
Q
GI absorption declines after what age
A
50
14
Q
Supplement forms of vit B12
A
- Cyanocobalamin - most common, synthetic, more stable
- Methylcobalamin - naturally occurring
15
Q
what type of vitamin can only found in animal-based foods
A
preformed vit A
Meats, eggs, dairy, and seafood products
16
Q
what type of vit A is found in many fruits and vegetables
A
Provitamin A carotenoids
Alpha-carotene, beta-carotene, beta-cryptoxanthin
Converted to retinol in the body
17
Q
most abundant provitamin A found in plant-based foods
A
Beta-Carotene
Spinach, broccoli, carrots, sweet potatoes, tomatoes, red peppers, mango, apricots, papaya, cantaloupe
Genetically modified foods - golden rice
18
Q
what vitamin is Found in orange, yellow, red, and green vegetables and fruits
A
Beta-Carotene
19
Q
Most vegetarians should be able to achieve what vitamin sufficiency
A
vit A
20
Q
widely distributed in ocean and soil, but usually not high concentrations in agricultural soil
A
iodine
21
Q
Most Iodine in Diet is prevalent in what foods
A
- iodized salt, fish, dairy produced by cows given supplements
- Also highly prevalent in sea vegetables (kelp, nori, etc.)
- Non-dairy milks now often fortified with iodine
22
Q
what plant based diet is higher at risk bc of using non-iodized salt
A
vegan
23
Q
widely distributed in plant foods, but absorption and bioavailability are limited by the presence of oxalates
A
calcium
24
Q
___ is a significant source of dietary calcium for most people
A
dairy
25
Plant-based calcium-rich foods
- low-oxalate vegetables (cabbage, chives, cauliflower, cucumbers, water chestnuts); legumes, nuts, seeds
- Non-dairy milks now often fortified with calcium
26
what occurs naturally in both plant-based and animal-derived foods
iron, zinc, protein
27
how much heme iron is absorbed
40% of iron in animal-derived foods - 10-20% absorbed
28
how much non-heme iron is absorbed
- 60% of iron in animal-derived foods; 100% of naturally occurring iron in plant-based foods - 1-5% absorbed
29
what impacts non-heme iron absorption
absorption inhibitors (phytates and polyphenols)
enhancers (vitamin C, citric acids) that naturally occur in the plant foods
30
why do vegetarians have a much higher risk of iron deficiency
Similar iron intake between vegetarians and omnivores, but because vegetarians primarily consume non-heme iron
31
Dietary modifications or supplementation often indicated for plant-based diets of what mineral
iron
- Consuming “Impossible Meats,” with heme iron, may help - no real studies
- Consuming iron-rich foods (whole grain, nuts, legumes, seeds) with foods rich in vitamin C (fruit, vegetables) to enhance iron absorption
32
zinc deficiency is usually only seen in what type of plant-based diet
very restricted plant-based diets
33
Zinc-rich foods
- nuts, seeds, legumes, whole grains
34
what can limit zinc absorption
Naturally occurring phytates
35
Methods to reduce phytates include
soaking/sprouting of cereals and beans and fermentation methods
(used for tempeh, fermented tofu, miso, sourdough bread)
36
Consider ordering zinc labs if signs of deficiency:
hair loss, diarrhea, anorexia, suppressed immune function, hypogonadism
37
key omega-3 fatty acids include ?
alpha linolenic acid (ALA)
docosahexaenoic acid (DHA)
eicosapentaenoic acid (EPA)
38
which Omega-3 Fatty Acid is found in plant-derived foods
ALA
39
which Omega-3 Fatty Acids are typically found in fish/seafood
DHA and EPA
can be converted (in small amounts) from ALA
40
what diet relies on ALA conversion to DHA/EPA, requiring higher amounts of ALA intake
Plant-Based Diet
Supplementation often recommended for vegans OR little/no DHA/EPA diet intake
Higher levels of supplementation needed if patient is trying to conceive, pregnant, or breastfeeding
41
which protein is more easily digestible (90%), more closely align with all 9 essential amino acids needed to meet human requirements
animal
42
which protein is less digestible (80%) due to fiber-rich matrix, and often “incomplete” due to lower or absent levels of 1+ of the 9 essential amino acids
plant
43
Complete plant protein sources
soybeans, quinoa, chia seeds, buckwheat
44
Nutrients essential to bone health
calcium, potassium, magnesium, folate, vitamin K, vitamin D
Higher risk of deficiency in plant-derived foods
pay attention to BMI, other risk factors (like smoking or + family hx of bone disease), and intake of protein, calcium, and vitamin D
45
what specific nutrients are especially deficient fir bone health
calcium and vitamin D
46
Systematic review and meta-analysis with over 37,000 total participants found what in regards about bone health
lower bone mineral density and increased risk of fracture
47
what type of plant-based diet is at highest risk about their bone health
vegans
48
how does plant-based diets and anemia relate?
lower in absorbable vitamin B12 and iron
- Highest risk among vegan
- sx of B12 or iron deficiency can manifest before ever become anemic on their CBC
- special attention to sx of iron and B12 deficiency, educate on well-balanced dietary intake or vegetarian-friendly supplements, and consider annual screening labs
49
how does plant-based diets and pregnancy/lactation relate
1. increased nutritional demands, especially for calcium, vitamin D, vitamin B12, iodine, and iron
- Highest risk of deficiency is in vegans
- If nutrition is well-balanced…similar health outcomes to omnivore mothers
- encourage supplementation with several nutrients, including vitamin B12, vitamin D, iodine (if not using iodized salt), EPA/DHA Omega-3 fatty acids, iron, and calcium
- If mother is unable to breastfeed and reluctant to use dairy-based formula = soy-based formulas
50
Encourage increased protein-rich food intake during pregnancy, especially when?
third trimester
51
how do Plant-Based Diets and Childhood Nutrition relate
1. overall higher metabolic rates and increased nutritional demands
- Difficult to obtain accurate studies due to small sample sizes, bias towards patients of higher socioeconomic status
- Limited data available suggests no major negative effects on height, weight, daily energy intake…as long as diet is well-balanced
52
how does plant-based diets and Long-Term Outcomes and Overall Mortality relate?
1. Overall Disease Risk - weak suggestion of reduced risk of several chronic diseases
- Inconsistent data - varies by country of study and study controlling for confounding factors
2. All-Cause Mortality Risk - weak suggestion of reduced risk of all-cause mortality
- Depended heavily on quality of foods consumed, which varied a lot based on geography
53
Several Favorable Effects of plant-based diets for CV disease
1. lower body mass index (BMI), lower serum lipid levels, lower fasting glucose, lower blood pressure
- Higher intake of unsaturated fats
- Healthier sources of protein
- High fiber and plant sterol intake reduces absorption of dietary fat and cholesterol
- May have an inflammation-reducing effect as well
54
how does Gut Microbiome help with CV disease
Gut Microbiome like plant-based diets apparently
55
how does plant-based diets help T2DM
1. benefit to all types of plant-based diet, with stepwise reduction in T2DM risk as more meat was removed from diet
- Up to 45-50% reduced risk of diabetes compared to regular omnivore diet
- Greatest benefit in patients who are overweight or obese
- Several animal-derived foods contain compounds that promote insulin resistance
- Plant-derived polyphenols thought to inhibit glucose absorption, stimulate insulin secretion, reduce hepatic glucose output, and enhance glucose uptake
56
how does plant-based diets affect cancer risk
1. lower for pt consuming a plant-based diet, with variations in risk by site of cancer
- Specific cancer types:
- Reduced - stomach, bladder, lymphatic, hematopoietic
- Inconsistent data - prostate, breast, colorectal
Overall: increased consumption of plant-based
foods generally is helpful or at the least not harmful
