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In the past five decades, global food systems have undergone a notable transition, moving from predominantly rural settings to increasingly urban and industrialized environments, largely driven by processes of globalization and supply chain integration. However, this evolution has not adequately addressed equitable access to nutritious diets and food environments, resulting in adverse health outcomes. This study delves into the spatial and non-spatial barriers that impede the adoption of healthy diets in the Noreste of Mexico, particularly focusing on the challenges associated with accessing and cultivating plant-based foods. Through an examination of suitable areas for urban agriculture and an exploration of the socio-cultural factors influencing the adoption of plant-based diets, the research focuses on interventions aimed at promoting healthier and more sustainable eating practices in Monterrey. The findings of the study reveal significant disparities in food access across the Monterrey metropolitan area, with central urban zones exhibiting superior access to fresh foods compared to suburban and peripheral regions. This inequality disproportionately affects marginalized areas characterized by higher poverty rates, exacerbating issues of food insecurity. Nevertheless, traditional dietary practices could offer promising avenues for creating culturally significant and healthier dietary transitions, even amidst the ongoing process of urbanization.

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PURPOSE OF REVIEW: Bone fractures can have a devastating effect on health, especially in the elderly, undermining their independence for daily activities, and increasing the risk of comorbidities and mortality. Nutrition is a key factor in maintaining an optimal bone health across the lifespan. The number of people that choose to avoid meat or even all animal products is increasing globally, for a diversity of reasons. Properly planned vegetarian and vegan diets are widely recognized as a healthy dietary pattern, but the long-term impact of these diets on bone health and more specifically risk of bone fractures is less clear. Classic studies have observed a slightly lower bone mineral density in vegetarians but have many limitations, including inadequate adjusting for relevant confounding factors, and cross-sectional design. The aim of this review is to summarize and put into context the current evidence on the effect of vegetarian and vegan diets on bone health, with a focus on fracture risk. RECENT FINDINGS: In recent years, results from many large prospective studies have emerged, which allowed us to assess the risk of incident bone fractures in vegetarians. In these studies, vegetarian and especially vegan diets were associated with an increased risk of bone fractures. In many recent prospective cohort studies, vegetarian and especially vegan diets were associated with an increased risk of bone fractures. At least part of this risk could be due to a lower body mass index and a lower intake of nutrients such as calcium, vitamin D, and protein. Some evidence suggests that combined vitamin D and calcium supplementation and other factors such as consumption of protein-rich foods may attenuate this risk. The eventual deleterious effect of vegetarian diets on bone health should be contextualized and balanced with its benefits, such as lower risk of cardiovascular disease and cancer.

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Resumen Introducción: la alimentación es uno de los factores modificables más importantes que participa en la salud ósea. Contribuye a ésta, una adecuada ingesta de calcio, vitamina D y proteínas, como así también otros nutrientes. A la alimentación basada en plantas (ABP) se le ha atribuido importantes beneficios para la salud en general, pero mal planificada podría tener efectos deletéreos sobre la salud ósea. Materiales y método: revisión narrativa con búsqueda en el sistema digital de recopilación de información biomédica PubMed cuyo objetivo fue analizar la evidencia científica disponible en la actualidad sobre el efecto de la ABP sobre la salud ósea. Resultados: dentro de los patrones de consumo de la ABP, los veganos que exhiben un consumo de calcio inferior a 525 mg/día presentan mayor riesgo de fractura por fragilidad ósea [incidencia de fractura: 1.37 (IC95%: 1,07; 1,74)]. En cambio, el papel de la hiperhomocisteinemia (HHcy) secundaria al déficit de vitamina B12 y riesgo de fractura continúa siendo controvertido en esta población. Si bien, in vitro la HHcy puede incrementar la actividad de los osteoclastos, en estudios clínicos no se observaron diferencias estadísticamente significativas en los niveles de crosslaps sérico (marcador de resorción ósea) en los consumidores de ABP (vegetarianos) comparados con los omnívoros. Conclusión: una ABP bien planificada, óptima y adecuada, que cubra los requerimientos diarios de calcio, vitamina D, vitamina B12 y proteínas aportará importantes beneficios para la salud general sin afectar la salud ósea en particular, aunque se requiere de futuros estudios para una mejor comprensión de su efecto sobre aspectos específicos del sistema musculo esquelético.

Abstract Introduction: diet is one of the most significant and modifiable factors involved in bone health, as an appropriate intake of calcium, vitamin D and proteins, as well as other nutrients, contributes to this. Significant overall health benefits have been attributed to plant-based diets (PBD); however, poorly planned PBD could have detrimental effects on bone health. Materials and Method: a narrative review through a search in the digital biomedical data collection system PubMed whose objective was to analyze currently available scientific evidence about the effects of PBD on bone health. Results: within the PBD intake patterns, vegans exhibiting calcium intakes below 525mg/day are at a higher risk of fracture due to bone fragility [incidence of fracture: 1.37 (95% CI: 1.07; 1.74)]. In contrast, the role of hyperhomocysteinemia (HHcy) secondary to vitamin B12 deficiency and fracture risk remains controversial in this population. While in vitro HHcy osteoclast activity may increase, in clinical studies no statistically significant differences in serum crosslaps levels (bone resorption marker) were observed in PBD consumers (vegetarians) when compared to omnivores. Conclusion: a well-planned, optimal and adequate PBD, covering daily calcium, vitamin D, vitamin B12 and proteins requirements, will provide significant benefits to the overall health condition without affecting bone health in particular, although future studies are required in order to better understand its effects on specific aspects of the musculoskeletal system.

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There has been an increase in vegetarianism and veganism in human populations. This trend also appears to be occurring in companion animals, with guardians preferring to feed their animals in accordance with their own dietary values and choices. However, there has been controversy amongst vets and online commentators about the safety of feeding vegan diets to carnivorous species, such as cats and dogs. In spite of this controversy, to date there has been no systematic evaluation of the evidence on this topic. A systematic search of Medline, Scopus, and Web of Science was performed, identifying 16 studies on the impact of vegan diets on cat and dog health. Studies were appraised for quality using established critical appraisal tools or reporting guidelines. There was considerable heterogeneity in the outcomes measured, and study designs employed, with few studies evaluating key outcomes of interest. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was utilized for assessment of certainty in the evidence, with the evidence for most outcomes being assessed as low or very low. Whilst the quality and amount of evidence needs to be considered in formulating recommendations, there was no overwhelming evidence of adverse effects arising from use of these diets and there was some evidence of benefits. It is, however, recommended that future high-quality studies, with standardized outcome measures and large sample sizes, be conducted. At the current time, if guardians wish to feed their companion animals vegan diets, a cautious approach should be taken using commercially produced diets which have been formulated considering the nutritional needs of the target species.

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Interest in plant-based diets and vegetarianism is increasing worldwide, however, a concern for total vegetarians is vitamin B12 (B12) deficiency. We conducted a systematic review to investigate non-animal food sources of B12. Databases were PubMed, LILACS, Cochrane, Embase and Google Scholar, up to September 9, 2020. Quality of the eligible studies were assessed. We identified 25 studies which assessed B12 content in seaweeds, mushrooms, plants and fermented foods. Initial studies were microbiological bioassay, ELISA and HPLC. In the last decade, more sensitive method for real B12 determination was used, the liquid chromatography-electrospray ionization tandem mass spectrometry chromatograms. Real B12 content varied from mean (SD) mcg/portion size of seaweed hijiki 3 × 10-3/7 g to nori 1.03 - 2.68/sheet; mushroom white button cap 2 × 10-3(7 × 10-4)/20 g dry weight (dw) to shiitake 0.79(0.67)-1.12 (0.78)/20 g dw; and fermented foods from soy yogurt 20/cup. It is possible that daily recommendations for B12 can be met by a varied diet containing non-animal B12 food sources. Future research should consider different methods of storage, preparation, fermented foods and standardization of the production of certain foods.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2053057.

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Aimed at improving the quality of school meals, the Sustainable School Program (SSP) implemented low-carbon meals, twice a week, in 155 schools of 4 municipalities, reaching more than 32,000 students. This study evaluated the environmental impact and nutritional viability of this intervention for this population. The 15 most repeated meals from the conventional and sustainable menus were selected, and we considered the school age group and number of meals served per student/day. Nutritional information was calculated using validated food composition tables, nutritional adequacy was assessed using National School Feeding Program (PNAE) requirements, the level of processing was considered using NOVA classification, and greenhouse gas emissions (GHGE) were estimated using food life cycle assessment (LCA) validated data. We found both conventional and sustainable food menus are equivalent, in terms of nutrients, except for calcium, iron, and magnesium. Sustainable food menus were cholesterol-free. However, there was a reduction of up to 17% in GHGE, depending on the school age group analysed. Considering the greater energy efficiency and lower environmental impact of these food menus, the SSP, therefore, demonstrates that a substantial reduction in climate impact is feasible, successful, and can be an inspiration to other regions globally.

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Diets rich in plant foods are increasingly recommended to lower the risk of cardiometabolic diseases because of strong evidence that fruit, vegetables, legumes, whole grains, nuts, and seeds are protective. Although some animal products, such as unprocessed lean red meat, poultry, eggs, and dairy products, are recommended in dietary patterns to prevent cardiometabolic diseases, many health professionals advocate for exclusively plant-based dietary patterns. The aim of this article was to review recent evidence on the relative contributions of plant-based foods and animal products to a healthy dietary pattern. Secondary aims were to discuss current consumption patterns and adherence to dietary recommendations. Epidemiologic evidence suggests that a higher intake of plant-based foods is associated with a lower risk of cardiometabolic disease, whereas a higher meat intake increases the risk of cardiometabolic disease and the replacement of small quantities of animal protein with plant protein is associated with lower risk. Randomized controlled studies show that nutrient-dense diets containing animal protein, including some unprocessed lean meats, improve cardiovascular disease risk factors. Therefore, it is likely that the consumption of animal products, at recommended amounts, in the context of a dietary pattern that meets recommendations for fruit, vegetables, whole grains, nuts, seeds, and legumes, and does not exceed recommendations for added sugar, sodium, and saturated fat, may not increase cardiometabolic risk. Currently, adherence to these recommendations is suboptimal. Therefore, rather than debating the merits of healthy dietary patterns that are exclusively plant-based or that include animal sources in recommended amounts, the focus should be on improving overall eating patterns to align with dietary guidelines. Registered Dietitian/Nutritionists (RDNs) have the requisite nutrition expertise to facilitate change at the individual and population levels to promote adherence to healthy dietary patterns. Importantly, advocacy activities are urgently needed to create a healthier food environment, and all health professionals, including RDNs, must play a role.