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Type 2 Diabetes Mellitus (T2DM) is a chronic condition with growing worldwide prevalence. Besides genetic factors, a sedentary lifestyle, excess weight, and inadequate eating habits, characterized by an excess intake of refined carbohydrates and ultra-processed foods, are contributing factors for the development of the disease. In this scenario, promoting a plant-based diet, and limiting animal product consumption while increasing the intake of vegetables, concurrently with healthy lifestyle habits, is a promising strategy to prevent T2DM. This scoping review, carried out between 2017 and 2022, aimed to gather evidence substantiating the benefits of a plant-based diet in T2DM prevention, considering different eating patterns, such as vegetarian, vegan, Mediterranean, and DASH diets. Several studies demonstrate a significant reduction in T2DM incidence among individuals adopting plant-based eating patterns or emphasizing healthy plant-based food alongside decreased intake or exclusion of animal-based foods. There are still no robust data regarding plant-based diets and the prevention of diabetes without loss in body weight. Hence, prospective studies in plant-based diets with weight control are needed. Nevertheless, adopting plant-based diets appears to induce significant weight loss, which is crucial in an obesity-endemic context. Thus, embracing plant-based diets, along with healthy habits, emerges as a relevant strategy in obesity and T2DM prevention.

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En la actualidad cada vez más familias optan por seguir una alimentación basada en plantas (ABP). Es fundamental que pediatras y agentes de salud conozcan estos tipos de patrones alimentarios para asesorar adecuadamente a sus pacientes y derivarlos oportunamente a especialistas capacitados con el objetivo de garantizar un adecuado crecimiento y desarrollo principalmente en la edad pediátrica, evitando posibles consecuencias negativas sobre la salud. La mayoría de las sociedades científicas del mundo considera a las dietas vegetarianas apropiadas para todas las etapas de la vida si están correctamente planificadas, suplementadas y con un seguimiento adecuado por especialistas capacitados. Con respecto a las dietas veganas existen controversias por parte de las distintas sociedades con respecto a si son adecuadas o no en pediatría. Recientemente se han revisado las descripciones respecto a las tipificaciones de una ABP y se ha propuesto una definición estándar de estos tipos de dieta. Los riesgos más significativos asociados a la mala planificación de estas dietas son las deficiencias de calcio, vitamina D y vitamina B12, aunque también se debe tener en cuenta el estado del zinc, selenio, yodo y los ácidos grasos Omega 3. Es importante la planificación diaria de un plato nutricionalmente completo y es incuestionable que quienes siguen estos patrones alimentarios reciban suplementos con vitamina B12 adecuados para cada etapa de la vida. Se requieren más estudios en pediatría para evaluar los efectos de las distintas ABP sobre la ingesta de nutrientes, el estado nutricional, el crecimiento, desarrollo y la prevención de enfermedades no transmisibles (AU)

Currently, an increasing number of families are choosing to follow a plant-based diet (PBD). It is essential that pediatricians and healthcare agents know these types of dietary patterns in order to properly advise their patients and refer them to trained specialists to ensure adequate growth and development, especially in the pediatric age, avoiding possible negative health consequences. Most of the world's scientific societies consider vegetarian diets appropriate for all stages of life if they are adequately planned, supplemented and monitored by trained specialists. However, there is controversy among different societies regarding the appropriateness of vegan diets for children. Recently, there has been a review of descriptions concerning the characteristics of a plant-based diet, leading to a proposed standard definition for these types of diets. The most significant risks associated with poorly planned diets are calcium, vitamin D, and vitamin B12 deficiencies, although zinc, selenium, iodine and omega-3 fatty acid status should also be considered. The daily planning of a nutritionally complete meal is important and it is imperative that those who follow these dietary patterns receive vitamin B12 supplementation appropriate for each stage of life. Further studies in children are needed to evaluate the effects of different PBDs on nutrient intake, nutritional status, growth, development, and prevention of noncommunicable diseases (AU)

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El calcio es uno de los nutrientes esenciales para la salud ósea. Objetivos: evaluar la ingesta de calcio en un grupo de mujeres pre-menopáusicas consumidoras de alimentación basada en plantas (ABP). Materiales y métodos: un grupo de mujeres premenopáusicas entre 30 y 45 años consumidoras de ABP fueron invitadas a participar. Para la evaluación de ingesta se empleó un recordatorio alimentario de 24 horas. Se utilizó la Encuesta Nacional de Nutrición y Salud (ENNyS, 2007) como información relevada disponible de ingesta de calcio en nuestra población. En un subgrupo de participantes se evaluó la densidad mineral ósea (DMO) de columna lumbar (L1-L4) por el método de absorciometría de rayos X (DXA), mientras que la microarquitectura fue estudiada a través del trabecular bone score (TBS). Resultados: se incluyeron 30 mujeres con un tiempo de adherencia promedio (X±DS) a la ABP 5,6±4 años, edad de 35,6±4 años, y un índice de masa corporal (IMC) de 23.,7±3 kg/m2. Una ingesta diaria de calcio promedio (IC al 95%) de 980 mg (639 mg-1320 mg) fue observada en las mujeres vegetarianas, mientras que en las veganas fue de 772 mg (460 mg-1085 mg), lo que resulta superior a la de la población general (406 mg). Una correlación positiva fue observada entre DMO e IMC (r=0,990; p=0,01) pero no entre DMO e ingesta de calcio. Conclusiones: en esta cohorte de mujeres premenopáusicas consumidoras de ABP, las vegetarianas y el 96,5% de las veganas cubrieron el requerimiento promedio estimado. La adecuada planificación de la ABP permite evitar deficiencias nutricionales que afecten la salud ósea. (AU)

Calcium is one of the essential nutrients intervening in bone health. Objective: To assess calcium intake in a group of premenopausal women consumers of a plant-based diet (PBD). Materials and methods: Premenopausal women between 30 and 45 y/o consumers of a PBD were invited to participate. A 24-hour food reminder was provided for the intake evaluation. Argentina's National Nutrition and Health Survey (ENNyS, 2007) was used as available information on calcium intake in our population. In a participants' subset, the bone mineral density (BMD) of the lumbar spine (L1-L4) was evaluated by dual-energy X-ray absorptiometry (DXA), while the trabecular bone score (TBS) was used to study the microarchitecture. Results: The study included 30 women with an average adherence time (X±DS) to PBD of 5.6±4 years, of 35.6±4 years and a body mass index (BMI) of 23.7±3kg/m2. An average daily calcium intake (95% CI) of 980mg (639 mg-1.320mg) was observed in vegetarian women, while in vegan women it was 772 mg (460mg-1.085mg), higher than the general population (406 mg). A positive correlation was observed between BMD and BMI (r=0.990; p=0.01), though not between BMD and calcium intake. Conclusions: In this cohort of premenopausal women consuming a PBD, the vegetarians and 96.5% of vegans met the estimated average requirement. An appropriate planning of the PBD prevents nutritional deficiencies that may affect bone health. (AU)

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Resumen Introducción: la enfermedad renal crónica (ERC) se asocia a complicaciones como la hiperpotasemia, que pueden afectar la calidad de vida de los niños que la padecen. Así la alimentación basada en plantas (ABP) cobra relevancia ya que muchos de los alimentos incluidos son fuentes de potasio (K) entre ellos: vegetales, frutas y legumbres. Sin embargo, realizar restricciones severas en estos grupos, podría asociarse a déficits nutricionales que pongan en riesgo el crecimiento y desarrollo de niños con ERC. Objetivos: describir el rol de la ABP y su aporte de K en el abordaje nutricional de pacientes pediátricos con ERC. Materiales y método: se realizó una revisión narrativa de artículos científicos publicados desde el año 2013 a 2023, utilizando las bases de datos: PUBMED, Scielo y el buscador Google Académico. Resultados: la ABP se asocia a beneficios como disminuir la progresión de la ERC, ser precursora de compuestos alcalinos, mejorar el tránsito y la microbiota intestinal. La ingesta de K a través de la ABP no tendría una relación directa con su concentración sérica. Sin embargo, se sugiere disminuir el consumo de productos ultraprocesados y considerar los factores no alimentarios que inciden en la potasemia, como primera medida. Clasificar los alimentos según la relación k/fibra permitiría incluir una mayor variedad. Los resultados referidos a las pérdidas de K por lixiviación no son concluyentes. Conclusiones: el abordaje nutricional de la ERC a través de una ABP tendría un impacto positivo que permitiría mejorar el control de la patología y disminuir la aparición de sus complicaciones. Se destaca el rol del Lic. en Nutrición en el asesoramiento respecto a la incorporación de alimentos según el perfil de nutrientes aportados, las características de sus componentes y su impacto en el metabolismo.

Abstract Introduction: chronic kidney disease (CKD) is associated with complications such as hyperkalemia, which can affect the quality of life of children who suffer from it. Thus, the plant-based diet (PBD) becomes relevant since many of the foods included are sources of potassium (K) such as vegetables, fruits and legumes. However, severe restrictions in these groups could be associated with nutritional deficits that jeopardize the growth and development of children with CKD. Objectives: to describe the role of PBD and its contribution of K in the dietary management of pediatric patients with CKD. Materials and method: a narrative review of scientific articles published from 2013 to 2023 was carried out, using the databases: PUBMED, Scielo and the Google Scholar search engine. Results: PBD is associated with benefits such as slowing the progression of CKD, being a precursor of alkaline compounds, improving transit and intestinal microbiota. The intake of K through PBD would not have a direct relationship with its serum concentration. However, it is suggested to reduce the consumption of ultra-processed products and consider the non-food factors that affect potassium, as a first measure. Classifying foods according to the k/fiber ratio would allow for greater variety. The results regarding K leaching losses are inconclusive. Conclusions: the nutritional approach to CKD through a PBD would have a positive impact that would improve the control of the pathology and reduce the appearance of its complications. The role of the nutritionist in advising on the incorporation of foods according to the profile of nutrients provided, the characteristics of their components and their impact on metabolism is highlighted.

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The human skin is a crucial organ that protects the organism from the outer environment. Skin integrity and health depend on both extrinsic and intrinsic factors. Intrinsic factors such as aging and genetic background contribute to weakened skin and disease susceptibility. Meanwhile, extrinsic factors including UV radiation, pollution, smoking, humidity, and poor diet also affect skin health and disease. On the other hand, healthy dietary patterns such as plant-based diets have gained popularity as a complementary therapy for skin health. A plant-based diet is defined as all diets based on plant foods, including an abundance of vegetables, fruits, beans, lentils, legumes, nuts, seeds, fungi, and whole grains, with limited or no animal products or processed foods. However, some authors also exclude or limit processed foods in the definition. Recent research has shown that these diets have beneficial effects on inflammatory skin diseases. This review explored the beneficial effects of plant-based diets on inflammatory skin diseases and plant-based functional foods on healthy skin. In conclusion, plant-based diets and plant-based functional foods may have beneficial effects on skin health through the gut microbiome.

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Dietary acid load (DAL) is an important determinant of the acid-base balance in humans and has been associated with several chronic non-communicable diseases. Plant-based diets, including vegetarian and vegan diets, decrease DAL-although their alkalizing potential varies substantially. Their net effect on common DAL scores, including potential renal acid load and net endogenous acid production, has been insufficiently quantified and is poorly understood-particularly in populations outside of Europe and North America. We assessed the associations between three plant-based dietary patterns (flexitarian vs. lacto-ovo-vegetarian vs. vegan diet) and DAL scores in a healthy Venezuelan population in the metropolitan area of Puerto La Cruz, Venezuela. Substantial differences in DAL scores were observed, whereby the vegan diet yielded the highest alkalizing potential, followed by the lacto-ovo-vegetarian and the flexitarian diet. DAL scores were substantially lower in comparison to European and North American plant-based populations, probably due to the higher potassium intake (exceeding 4000 mg/d in vegans), the higher magnesium intake (390.31 ± 1.79 mg/d in vegans) and the lower intake of protein in vegans and lacto-ovo-vegetarians. Additional studies in other non-industrialized populations are warranted to allow for a better understanding of the (numeric) impact of plant-based dietary patterns on DAL scores, potentially allowing for an establishment of reference ranges in the near future.

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Healthy eating habits are one of the requirements for the health of society. In particular, in natura foods are increasingly encouraged, since they have a high concentration of nutrients. However, these foods are often grown in the presence of agrochemicals, such as fertilizers and pesticides. To increase crop productivity and achieve high vigor standards in less time, farmers make excessive use of agrochemicals that generate various economic, environmental, and clinical problems. In this way, bionanotechnology appears as an ally in developing technologies to improve planting conditions, ranging from the health of farmers and consumers to the production of new foods and functional foods. All these improvements are based on the better use of land use in synergy with the lowest generation of environmental impacts and the health of living beings, with a view to the study and production of technologies that take into account the concept of One Health in its processes and products. In this review article, we will address how caring for agriculture can directly influence the quality of the most desired foods in contemporary society, and how new alternatives based on nanotechnology can point to efficient and safe solutions for living beings on our planet.

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PURPOSE: This paper aims to present an overview of the definitions of "plant-based and "vegetarian diets" adopted by different organizations worldwide, proposing new standard definitions and discussing the notion of vegetarianism as a restrictive dietary pattern. METHODS: An extensive literature review on the different definitions of vegetarian and plant-based diets was conducted. Definitions of different international vegetarian and vegan organizations were also taken into account. Objective definitions for vegetarian and plant-based diets, as well as for their subcategories, were proposed. Other aspects related to how vegetarian diets are viewed and defined were also discussed. RESULTS: We proposed that a vegetarian diet should be defined as "a dietary pattern that excludes meat, meat-derived foods, and, to different extents, other animal products". This definition would include, among others, ovolactovegetarian and vegan diets. The proposed definition for a plant-based diet was "a dietary pattern in which foods of animal origin are totally or mostly excluded". Other types of diets, such as flexitarian and pescetarian diets, could be considered plant-based. A vegetarian diet should not be considered restrictive. Instead, terms such as alternative or non-conventional could be used to define it and to distinguish it from the conventional diet adopted by most of the Western population. CONCLUSION: This paper was able to elaborate objective definitions of vegetarian and plant-based diets. Standardizing nomenclatures may reduce misinterpretation and confusion in this field of study.

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Chia (Salvia hispanica L.) is a seed native to northern Mexico and southern Guatemala that has started to be consumed in recent years in other regions of the world owing to its nutritional and functional properties. Germination of chia seeds seems to be able to further improve these properties, and it has been the subject of some studies. In general, germination has proven to be a simple and inexpensive process capable of improving the content of phenolic compounds and the antioxidant capacity of foods, as well as reducing antinutritional factors that interfere with nutrient absorption. A particular characteristic of chia seeds is that they produce mucilage when they are hydrated. For this reason, the germination conditions of the seed need to be adapted. The nutritional guidelines of some countries, such as Brazil, Germany and Sweden, recommend that the diet of the population should be more plant-based, thus encouraging the consumption of foods with a high content of bioactive compounds and nutrients, e.g., germinated seeds. This review briefly explored the germination conditions of chia seeds as well as the changes in phytonutrient content and antinutritional factors after their germination process. The main information available in the literature is that germination of chia seeds can increase the contents of protein, fiber, and total phenolic compounds. As a conclusion, germination of chia seeds is favorable for increasing their health benefits and nutritional value. However, chia germination parameters should be adjusted and microbiological risks should be properly evaluated.

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We hypothesized that a plant-based diet, without excluding any specific animal food, may be beneficial for body composition. This study aims to evaluate if the consumption of a plant-based diet affects body composition of adults, through a systematic review of the literature. The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The literature search was conducted in EMBASE, PubMed, Scopus, and Web of Science in February 2021. Cross-sectionals, interventional trials, and cohort studies were included if changes in the body composition were associated with plant-based index (PDI). Meta-analyses were performed using DerSimonian and Laird random effects model with 95% confidence intervals (CIs) even in the absence of statistical heterogeneity. A total of 6680 citations were found in the systematic search, and after the screening process, 12 studies were included. Of the 11 studies evaluating body mass index, 8 provided data of body mass index (BMI) from a total of 134,128 participants among the quantiles of PDI. A meta-analysis was performed (standardized mean difference [SMD] = 0.17 kg/m²; 95% CI, 0.02-0.32). Of the 7 studies that evaluated waist circumference (WC), 4 provided data of WC among the quantiles of PDI from a total of 12,968 participants. As with BMI, the pooled analysis indicated an increase (SMD = 0.50 kg/m²; 95% CI, 0.01-1.00) of WC as greater was the PDI. Both analyses were influenced by a large study, and in the sensitive analysis the significance was lost. Our findings did not reflect an association between a higher PDI and body composition. Also, most studies evaluating total and central adiposity did not find any association with the PDI. Probably, PDI must be considered in the context of food processing, considering that not all vegetable foods are healthy.

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When it comes to food choices, high levels of trait compassion should decrease a person's likelihood to choose meat compared to a plant-based alternative [1], [2], [3], [4]. Because meat advertising often threatens masculinity, for men, this effect is expected to be moderated by gender identity threat. The data provided with this article were collected online from 1,350 participants to conduct a replication of study 1 in "The taste of compassion: Influencing meat attitudes with interhuman and interspecies moral appeals" [5]. The original study reports that men with high trait compassion [6] are significantly less likely to choose a vegetarian jerky-and more likely to choose a meat jerky instead-if masculinity is threatened. The replication is successful if the age range of participants between the two studies is matched. The size and direction of the effect tested in the replication study is comparable to that in the original study. This outcome suggests that the formation and the processing of meat attitudes depend on life stage, and it points to additional avenues for research in the fields of nutrition, social psychology, marketing, and consumer behavior. Additional variables in the dataset (e.g., items of the composite trait compassion variable, meat avoidance intent, social identity based on diet, and dietary pattern adherence [7], [8], [9], [10], [11]) may be used to develop and/or test hypotheses relating to meat attitudes and food-related choice behaviors. A print-out of the survey instrument, the dataset including scale items, and a script to perform the analysis are provided.

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BACKGROUND: Homemade diets are a worldwide trend, and many recipes are currently available on websites but may not be considered balanced. This study aimed to evaluate if the number of ingredients, supplement, or vegetarian/vegan-only ingredients included in a recipe influence the nutrient content of homemade diets for dogs and cats. Chemical analyses were performed on 75 diets for dogs and 25 for cats prepared according to websites' recipes, and minerals were analyzed by inductively coupled plasma optical emission spectrometry (ICP-OES). RESULTS: Canine diets that met fat requirements had more ingredients than those below recommendations. None of the cat diets met iron requirements, and feline diets that met requirements of manganese had fewer ingredients and those that supplied requirements of protein and sodium had more ingredients than the diets below recommendations (p < 0.05). Non-supplemented canine and feline diets had calcium and calcium:phosphorus ratio below recommendations (p < 0.05). Non-supplemented feline diets had lower sodium and iron, and zinc levels were below recommendation in diets for both species. Diets with animal products for dogs had higher levels of protein and zinc, although zinc was deficient in both groups, and there were higher amounts of crude fiber, magnesium, and manganese in vegetarian/vegan diets (p < 0.05). Diets with animal products for cats had higher levels of protein (p = 0.003), but there was a higher amount of crude fiber (p = 0.014) in vegetarian/vegan diets. CONCLUSION: The number of ingredients and vegetarian/vegan preparation did not guarantee nutritional adequacy of diets, and the presence of supplement did not ensure a balanced diet.

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Women are more affected by obesity than men which increases their risk of cancer and cardiovascular disease (CVD). Therefore, it is important to understand the effectiveness of different types of diet in the context of women's health. This review aims to summarize the scientific evidence on the effects of different types of diet for women with obesity and their impact on CVD and cancer risk. This review included epidemiological and clinical studies on adult women and different types of diets, such as the Mediterranean (MED) diet, the Traditional Brazilian Diet, the Dietary Approach to Stop Hypertension (DASH), intermittent fasting (IF), calorie (energy) restriction, food re-education, low-carbohydrate diet (LCD) and a very low-carbohydrate diet (VLCD). Our main findings showed that although LCDs, VLCD and IF are difficult to adhere to over an extended period, they can be good options for achieving improvements in body weight and cardiometabolic parameters. MED, DASH and the Traditional Brazilian Diet are based on natural foods and reduced processed foods. These diets have been associated with better women's health outcomes, including lower risk of CVD and cancer and the prevention and treatment of obesity.

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The objective of this study was to evaluate the serum levels of ferritin and the prevalence of iron deficiency in vegan and omnivorous individuals by taking into account the presence of elements that cause an elevation of ferritin levels, such as increased homeostatic model assessment of insulin resistance (HOMA-IR), body mass index (BMI), and high-sensitivity C-reactive protein (hs-CRP) values. The parameters were evaluated in 1340 individuals, i.e., 422 men and 225 women who do not menstruate and 693 women who do menstruate, based on omnivorous or vegetarian eating habits. The progressive increase in BMI, HOMA-IR, and inflammation caused an elevation in ferritin concentration, regardless of the eating habits in the groups studied. In the overall sample, omnivores had a higher prevalence of obesity, higher ferritin levels, and a lower prevalence of iron deficiency (ferritin < 30 ng/mL). However, after the exclusion of individuals with inflammation (with overweight/obesity and elevated hs-CRP levels), the actual iron deficiency was assessed and was not higher among vegetarians, except in women with regular menstrual cycles. Our data show that nutritional status and inflammation levels affect ferritin levels and may interfere with the correct diagnosis of iron deficiency in both vegetarian and omnivorous individuals. Compared to vegetarians, women who do not menstruate and men had the same prevalence of iron deficiency when following an omnivorous diet.

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The dataset provided with this article is related to "Lowering Barriers to Plant-based Diets: The Effect of Human and Non-Human Animal Self-Similarity on Meat Avoidance Intent and Sensory Food Satisfaction" [1]. The connection between compassion and adherence to plant-based diets is intuitive. The first dataset is a sample of 372 participants in the United States that was collected online. Trait compassion, measured using the Santa Clara Brief Compassion Scale [2], is positively associated with intent to avoid dietary meat consumption. The second set of data, collected online from 131 participants in the United States, provides evidence for the underlying psychological process: the relationship between trait compassion and meat avoidance intent is serially mediated by perceived similarity to other human animals and non-human animals. Similarity scores were measured inversely as perceived distance using heat-map type questionnaire items based on inclusion-of-other-in-the-self (IOS, [3]) and relational closeness scales [4]. Demographic information, physical characteristics, and measurement of athletic identity are provided [5]. These data can be used in psychology research on food studies specifically and to glean more insight on human's connection with other animals in general [6], [7]. The supplementary data on participants' physical characteristics such as BMI, combined with measurement of athletic identity, can inform sports and nutrition science. Survey print-outs, two datasets including scale items, and scripts for analysis are provided.

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Medicina del Estilo de Vida (MEV), se define como la práctica basada en la evidencia, de asistir a individuos y familias en la adopción y mantención de conductas que mejoran la salud y calidad de vida, tales como alimentación saludable, realización de actividad física periódica, sueño reparador, manejo del estrés, cese del uso de sustancias tóxicas y una sólida red de apoyo social. Esta disciplina de la medicina, ha demostrado ser efectiva en la prevención, manejo y a veces reversión de las patologías que conllevan la mayor morbimortalidad global, tales como hipertensión arterial, diabetes mellitus tipo 2, enfermedad coronaria y obesidad. Es más, se estima que el 80% de las enfermedades crónicas no transmisibles podrían prevenirse llevando un estilo de vida más saludable. Ciertas barreras estructurales han hecho que la incorporación de la MEV en las mallas curriculares universitarias y establecimientos de salud sea más lenta de lo esperado, sin embargo, cada vez son más las instituciones académicas y prestadoras de salud que adoptan los principios de la MEV, y la aparición de sociedades médicas relacionadas a esta disciplina en casi todos los continentes, están acelerando el paso hacia una medicina más focalizada en tratar las causas de la enfermedad, en lugar de centrarse en lo sintomático

Lifestyle Medicine (LM) is the evidence based practice of assisting individuals and families to adopt and sustain behaviors that can improve health and quality of life. These include healthy diet, participating in regular physical activity, having good quality sleep, managing stress, avoiding risky substance abuse and building strong social connections. LM has demonstrated its effectiveness at preventing, managing and sometimes reversing the diseases that globally carry the biggest morbidity and mortality burden, such as hypertension, type 2 diabetes mellitus, coronary artery disease and obesity. More so, it is estimated that 80% of non-communicable chronic diseases could be avoided by living a healthier lifestyle. Certain structural barriers have made LM's incorporation into the medical curriculum and clinical practice slower than expected, however, more and more academic institutions and healthcare providers are adopting LM's principles. The appearance of medical associations related to this discipline in almost every continent is accelerating the pace towards a medicine that is more centered on the root-causes of disease, rather than focusing on symptoms

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Latin America is experiencing a significant epidemiological and nutritional transition, with a trend toward higher incidence of food-related chronic diseases. In this context, Lifestyle Medicine (LM) is a growing field focused on assisting individuals in adopting healthy behaviors for the prevention and treatment of these chronic diseases, including, among other pillars, a great emphasis on healthy eating. There is also a growing interest worldwide in environmental sustainability of dietary patterns, with increasing concern about their effects on planetary health. In this context, whole-food, plant-based diets -such as the Mediterranean diet (MD)- have emerged as a solution for both healthier eating and lowering environmental impact. Yet in order to be effective at these goals and achieve a high adherence to any nutritional prescription, the sociocultural reality of the community or population where we aim to practice must also be taken into account. In this review, we specifically highlight the plant-based MD as a LM-contextualized dietary pattern that is adaptable, applicable, and sustainable within the Chilean context and has the potential to address the current trend of chronic diseases in our country.

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RESUMEN Las dietas basadas en plantas (DBP) se caracterizan por una alta ingesta de alimentos de origen vegetal y evitan parcial o totalmente los productos animales. El objetivo de esta revisión fue recopilar evidencia sobre DBP, sus tipos y su efecto en principales factores de riesgo cardio-metabólicos (FRCM) modificables. Se encontró que existen DBP saludables y no saludables. Algunas DBP saludables son: vegetariana, mediterránea y DASH (sigla en inglés de la dieta Enfoques Alimenticios para Detener la Hipertensión). Estas promueven la ingesta de alimentos de origen vegetal "saludables" (frutas, verduras, legumbres, semillas, frutos secos, cereales integrales, palta, aceite de oliva y/o canola) y, una reducción gradual de todos los alimentos de origen animal, especialmente carnes rojas y procesadas; evitando alimentos de origen vegetal "menos saludables" (cereales refinados, fritos, productos de pastelería, alimentos con azúcar añadido). Las DBP no saludables, se caracterizan por una alta ingesta de estos alimentos "menos saludables", y se asocian con mayor riesgo cardiovascular, por el bajo aporte de antioxidantes, micronutrientes, fibra dietética y grasas insaturadas. DBP saludables pueden disminuir el riesgo de diabetes tipo 2, hipertensión arterial, sobrepeso y obesidad. Han mostrado mayores beneficios cardiovasculares en comparación con dietas tradicionales, reduciendo significativamente: HbA1c y glicemia en ayunas en diabéticos; presión arterial sistólica y diastólica en hipertensos y prehipertensos; índice de masa corporal en sujetos con sobrepeso/obesidad y mejorando el perfil lipídico en sujetos con dislipidemia. Patrones de DBP saludables, como el tipo vegetariano, mediterráneo y DASH son recomendadas para prevenir y tratar los FRCM.

ABSTRACT Plant-based diets (PBD) are characterized by a high intake of foods of plant origin and the partial or total avoidance of animal products. The objective of the current study was to compile the evidence on types of PBD and its effect on the main modifiable cardio-metabolic risk factors (CMRF). Healthy and unhealthy PBD were found to exist. Some healthy PBDs were: vegetarian, mediterranean and DASH (Dietary Approaches to Stop Hypertension). These promote the intake of "healthy" plant-based foods (fruits, vegetables, legumes, seeds, nuts, whole grains, avocado, olive oil and / or canola) and a gradual reduction of all foods of animal origin, especially red and processed meats; avoiding "less healthy" plant-based foods (refined, fried cereals, pastry products, foods with added sugar). Unhealthy PBDs were characterized by a high intake of these "less healthy" foods, and are associated with greater cardiovascular risk, due to the low contribution of antioxidants, micronutrients, dietary fiber and unsaturated fats. Healthy PBDs can lower the risk of type 2 diabetes, high blood pressure, being overweight, and obesity. They have shown greater cardiovascular benefits compared to traditional diets, significantly reducing: HbA1c and fasting glycemia in diabetics; systolic and diastolic blood pressure in hypertensive and prehypertensive patients; body mass index in overweight / obese subjects and improves lipid profile in subjects with dyslipidemia. Healthy PBD patterns, such as vegetarian, Mediterranean, and DASH are recommended to prevent and treat CMRF.

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RESUMEN Introducción: la popularidad de las dietas vegetarianas y veganas está aumentando en países occidentales y son adoptadas por niños, niñas y adolescentes (NNyA). Las principales asociaciones de nutrición y dietética del mundo avalan este tipo de práctica alimentaria en estos grupos etáreos si son supervisados y acompañados por profesionales idóneos. Objetivo: tomar posicionamiento como Asociación Argentina de Dietistas y Nutricionistas Dietistas acerca de la implementación de dietas vegetarianas en edad pediátrica y adolescencia, considerando recomendaciones basadas en evidencias científicas. Materiales y método: revisión y actualización bibliográfica, no sistemática con búsquedas en Google Scholar, PudMed y Medline entre diciembre 2018 y marzo 2019. Resultados: la valoración nutricional, evaluando ingesta alimentaria utilizando recordatorio de 24 horas y frecuencia de consumo, orientará sobre cuáles son las potenciales deficiencias nutricionales que puede presentar para adecuar la dieta y/o suplementación de nutrientes específicos. La alimentación vegetariana tiene una densidad energética más baja que la no vegetariana, pero se logran alcanzar las recomendaciones. Las necesidades proteicas se satisfacen fácilmente cuando la dieta incluye variedad de alimentos y las calorías son adecuadas. Algunos autores sugieren aumentar un 10 a 15% la recomendación proteica. Además, considerar el aporte de ácidos grasos omega 3 (EPA y DHA) para lograr el equilibrio óptimo entre los ácidos grasos poliinsaturados omega3/omega6. Los requerimientos nutricionales de calcio no varían con respecto a los omnívoros. Es imprescindible suplementar vitamina B12 oral a todos los NNyA vegetarianos, incluso en ovolactovegetarianos o en NNyA que consuman habitualmente alimentos fortificados. La suplementación adecuada es la mejor forma de garantizar unos niveles óptimos de esta vitamina. Se recomienda evaluar el estado de la vitamina D suplementando según edad. Conclusiones: La Asociación Argentina de Dietistas y Nutricionistas Dietistas (AADYND) plantea que la alimentación vegetariana y/o vegana planificada, supervisada y suplementada por un profesional de la nutrición idóneo, son saludables en la niñez y adolescencia. Los profesionales de la alimentación y nutrición pueden desempeñar un papel clave en la educación y acompañamiento de las personas vegetarianas acerca de fuentes específicas de nutrientes, preparación de alimentos, y modificaciones dietéticas necesarias para satisfacer sus necesidades(AU)

ABSTRACT Introduction: the popularity of vegetarian and vegan diets is increasing in western countries and are adopted by children and adolescents (Ch&A). The main nutrition and dietetic associations in the world approve this type of dietary practice in these age groups if they are supervised and accompanied by qualified professionals. Objective: take a position as the Argentine Association of Dietitians and Dietitian Nutritionists about the implementation of vegetarian diets in pediatric and adolescent age, considering recommendations based on scientific evidence. Materials and Method: review and bibliographic update, non-systematic, with searches on Google Scholar, PudMed and Medline between December 2018 and March 2019. Results: The nutritional assessment, evaluating food intake using a 24-hour reminder and frequency of consumption, will provide guidance on what are the potential nutritional deficiencies that may come up, adapt the diet and/or supplementation of specific nutrients. The vegetarian diet has a lower energy density than the non-vegetarian diet but manages to meet the recommendations. Protein needs are easily met when the diet includes a variety of foods and calories are adequate. Some authors suggest increasing the protein recommendation by 10 to 15%. Considering the contribution of omega 3 fatty acids (EPA and DHA) to achieve the optimal balance between omega3/omega6 polyunsaturated fatty acids. The nutritional requirements of calcium do not vary with respect to omnivores. It is essential to supplement oral vitamin B12 to all vegetarian Ch&A, even in ovolactovegetarians or in Ch&A that habitually consume fortified foods. Proper supplementation is the best way to ensure optimal levels of this vitamin. It is recommended to evaluate the status of vitamin D by supplementing according to age. Conclusions: Argentine Association of Dietitians and Dietitian Nutritionists states that vegetarian and/or vegan food, planned, supervised and supplemented by a suitable nutrition professional, are healthy in childhood and adolescence. Food and nutrition professionals can play a key role in educating and mentoring vegetarians about specific sources of nutrients, food preparation, and dietary modifications necessary to meet their needs(AU)

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