Abstract

This review examines the impact of plant-based diets on health, focusing on preventing cardiovascular disease (CVD), obesity, type 2 diabetes mellitus (T2DM), and certain cancers. Various plant-based dietary models are assessed, including vegetarian, vegan, flexitarian, Mediterranean, and DASH, considering their nutritional composition and health benefits. Transitioning to plant-based nutrition is crucial not only for individual health but also for environmental sustainability due to its lower ecological footprint compared to animal-based diets. However, ensuring nutritional adequacy, especially for key nutrients like calcium, vitamin D, and B12, requires careful planning. Patient-centered approaches and gradual transitions to plant-based diets are emphasized in clinical practice. Integrating plant-based nutrition into healthcare settings involves patient assessment, dietary counseling, and menu planning to empower patients towards sustainable dietary habits. Overall, evidence strongly supports the health and sustainability benefits of plant-based diets. By incorporating plant-based nutrition into clinical practice, healthcare practitioners can significantly impact healthier dietary choices and improve patient outcomes.

Keywords: plant-based nutrition, clinical practice, dietary patterns, chronic diseases, environmental health

Copyright and license

Copyright © 2024 The author(s). This is an open-access article under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Arslan S, Aydın A, Gerboğa R, et al. Innovative approaches to integrating plant-based nutrition in clinical care: a path to better patient outcomes. Clin Sci Nutr. 2024;Early View:1-16. doi:10.62210/ClinSciNutr.2024.93

References

  1. World Health Organization (WHO). Healthy diet. 2020. Available at: https://www.who.int/news-room/fact-sheets/detail/healthy-diet (Accessed on April 10, 2024).
  2. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;393:1958-1972. https://doi.org/10.1016/S0140-6736(19)30041-8
  3. Cena H, Calder PC. Defining a Healthy Diet: Evidence for The Role of Contemporary Dietary Patterns in Health and Disease. Nutrients. 2020;12:334. https://doi.org/10.3390/nu12020334
  4. Joshi S, McMacken M, Kalantar-Zadeh K. Plant-Based Diets for Kidney Disease: A Guide for Clinicians. Am J Kidney Dis. 2021;77:287-296. https://doi.org/10.1053/j.ajkd.2020.10.003
  5. Shanmugam N. Plant-based nutrition and cardiovascular disease. In: Kassam S, Kassam Z, Simon L, editors. Plant-based nutrition in clinical practice. London, UK: Hammersmith Health Books; 2022.
  6. English LK, Ard JD, Bailey RL, et al. Evaluation of Dietary Patterns and All-Cause Mortality: A Systematic Review. JAMA Netw Open. 2021;4:e2122277. https://doi.org/10.1001/jamanetworkopen.2021.22277
  7. World Health Organization (WHO). Cardiovascular diseases (CVD's). 2021. Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (Accessed on April 10, 2024).
  8. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41:111-188. https://doi.org/10.1093/eurheartj/ehz455
  9. Quek J, Lim G, Lim WH, et al. The Association of Plant-Based Diet With Cardiovascular Disease and Mortality: A Meta-Analysis and Systematic Review of Prospect Cohort Studies. Front Cardiovasc Med. 2021;8:756810. https://doi.org/10.3389/fcvm.2021.756810
  10. Shi W, Huang X, Schooling CM, Zhao JV. Red meat consumption, cardiovascular diseases, and diabetes: a systematic review and meta-analysis. Eur Heart J. 2023;44:2626-2635. https://doi.org/10.1093/eurheartj/ehad336
  11. Peña-Jorquera H, Cid-Jofré V, Landaeta-Díaz L, et al. Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review. Nutrients. 2023;15:3244. https://doi.org/10.3390/nu15143244
  12. Lamberg-Allardt C, Bärebring L, Arnesen EK, et al. Animal versus plant-based protein and risk of cardiovascular disease and type 2 diabetes: a systematic review of randomized controlled trials and prospective cohort studies. Food Nutr Res. 2023;67:10.29219/fnr.v67.9003. https://doi.org/10.29219/fnr.v67.9003
  13. Satija A, Hu FB. Plant-based diets and cardiovascular health. Trends Cardiovasc Med. 2018;28:437-441. https://doi.org/10.1016/j.tcm.2018.02.004
  14. Lotfi M, Nouri M, Turki Jalil A, et al. Plant-based diets could ameliorate the risk factors of cardiovascular diseases in adults with chronic diseases. Food Sci Nutr. 2022;11:1297-1308. https://doi.org/10.1002/fsn3.3164
  15. Yokoyama Y, Levin SM, Barnard ND. Association between plant-based diets and plasma lipids: a systematic review and meta-analysis. Nutr Rev. 2017;75:683-698. https://doi.org/10.1093/nutrit/nux030
  16. Lee K, Kim H, Rebholz CM, Kim J. Association between Different Types of Plant-Based Diets and Risk of Dyslipidemia: A Prospective Cohort Study. Nutrients. 2021;13:220. https://doi.org/10.3390/nu13010220
  17. Budhathoki S, Sawada N, Iwasaki M, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality in a Japanese Cohort. JAMA Intern Med. 2019;179:1509-1518. https://doi.org/10.1001/jamainternmed.2019.2806
  18. Landry MJ, Ward CP, Cunanan KM, et al. Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial. JAMA Netw Open. 2023;6:e2344457. https://doi.org/10.1001/jamanetworkopen.2023.44457
  19. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e563-e595. https://doi.org/10.1161/CIR.0000000000000677
  20. Wild CP, Weiderpass E, Stewart BW, editors. World Cancer Report: Cancer Research for Cancer Prevention. Lyon: International Agency for Research on Cancer; 2020.
  21. Vineis P, Wild CP. Global cancer patterns: causes and prevention. Lancet. 2014;383:549-557. https://doi.org/10.1016/S0140-6736(13)62224-2
  22. Molina-Montes E, Salamanca-Fernández E, Garcia-Villanova B, Sánchez MJ. The Impact of Plant-Based Dietary Patterns on Cancer-Related Outcomes: A Rapid Review and Meta-Analysis. Nutrients. 2020;12:2010. https://doi.org/10.3390/nu12072010
  23. Brown JC, Zhang S, Niedzwiecki D, et al. Grain Intake and Clinical Outcome in Stage III Colon Cancer: Results From CALGB 89803 (Alliance). JNCI Cancer Spectr. 2018;2:pky017. https://doi.org/10.1093/jncics/pky017
  24. Anyene IC, Ergas IJ, Kwan ML, et al. Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study. Nutrients. 2021;13:3374. https://doi.org/10.3390/nu13103374
  25. Ratjen I, Enderle J, Burmeister G, et al. Post-diagnostic reliance on plant-compared with animal-based foods and all-cause mortality in omnivorous long-term colorectal cancer survivors. Am J Clin Nutr. 2021;114:441-449. https://doi.org/10.1093/ajcn/nqab061
  26. Song M, Wu K, Meyerhardt JA, et al. Fiber Intake and Survival After Colorectal Cancer Diagnosis. JAMA Oncol. 2018;4:71-79. https://doi.org/10.1001/jamaoncol.2017.3684
  27. Wang YB, Shivappa N, Hébert JR, Page AJ, Gill TK, Melaku YA. Association between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index and the Risk of Obesity. Nutrients. 2021;13:1536. https://doi.org/10.3390/nu13051536
  28. Mousavi SM, Rigi S, Shayanfar M, Mohammad-Shirazi M, Sharifi G, Esmaillzadeh A. Refined grains consumption is associated with a greater odds of glioma. Nutr Neurosci. 2022;25:432-440. https://doi.org/10.1080/1028415X.2020.1758889
  29. Tang NP, Zhou B, Wang B, Yu RB, Ma J. Flavonoids intake and risk of lung cancer: a meta-analysis. Jpn J Clin Oncol. 2009;39:352-359. https://doi.org/10.1093/jjco/hyp028
  30. Watling CZ, Schmidt JA, Dunneram Y, et al. Risk of cancer in regular and low meat-eaters, fish-eaters, and vegetarians: a prospective analysis of UK Biobank participants. BMC Med. 2022;20:73. https://doi.org/10.1186/s12916-022-02256-w
  31. Wolk A. Potential health hazards of eating red meat. J Intern Med. 2017;281:106-122. https://doi.org/10.1111/joim.12543
  32. Malli F, Koutsioukis T, Pounis G, Gourgoulianis KI. Diet and Lung Health. Analysis in Nutrition Research. 2019:355–382. https://doi.org/10.1016/B978-0-12-814556-2.00014-2
  33. Rodrigues M, de Castro Mendes F, Padrão P, et al. Mediterranean Diet and Airway Inflammation in School-Aged Children. Children (Basel). 2023;10:1305. https://doi.org/10.3390/children10081305
  34. Varraso R, Dumas O, Tabung FK, et al. Healthful and Unhealthful Plant-Based Diets and Chronic Obstructive Pulmonary Disease in U.S. Adults: Prospective Study. Nutrients. 2023;15:765. https://doi.org/10.3390/nu15030765
  35. Fekete M, Csípő T, Fazekas-Pongor V, et al. The Possible Role of Food and Diet in the Quality of Life in Patients with COPD-A State-of-the-Art Review. Nutrients. 2023;15:3902. https://doi.org/10.3390/nu15183902
  36. Scoditti E, Massaro M, Garbarino S, Toraldo DM. Role of Diet in Chronic Obstructive Pulmonary Disease Prevention and Treatment. Nutrients. 2019;11:1357. https://doi.org/10.3390/nu11061357
  37. Varraso R, Willett WC, Camargo CA. Prospective study of dietary fiber and risk of chronic obstructive pulmonary disease among US women and men. Am J Epidemiol. 2010;171:776-784. https://doi.org/10.1093/aje/kwp455
  38. Alwarith J, Kahleova H, Crosby L, et al. The role of nutrition in asthma prevention and treatment. Nutr Rev. 2020;78:928-938. https://doi.org/10.1093/nutrit/nuaa005
  39. Guilleminault L, Williams EJ, Scott HA, Berthon BS, Jensen M, Wood LG. Diet and Asthma: Is It Time to Adapt Our Message? Nutrients. 2017;9:1227. https://doi.org/10.3390/nu9111227
  40. St-Onge MP, Crawford A, Aggarwal B. Plant-based diets: Reducing cardiovascular risk by improving sleep quality? Curr Sleep Med Rep. 2018;4:74-78.
  41. Kim H, Rebholz CM, Hegde S, et al. Plant-based diets, pescatarian diets and COVID-19 severity: a population-based case-control study in six countries. BMJ Nutr Prev Health. 2021;4:257-266. https://doi.org/10.1136/bmjnph-2021-000272
  42. Merino J, Joshi AD, Nguyen LH, et al. Diet quality and risk and severity of COVID-19: a prospective cohort study. Gut. 2021;70:2096-2104. https://doi.org/10.1136/gutjnl-2021-325353
  43. Tarasov AV, Rakhmanov RS, Bogomolova ES, Perminova LA, Malakhova ZL. The Role of Plant-Based Protein Functional Food in Preventing Acute Respiratory Disease: A Case Study. Nutrients. 2021;13:2116. https://doi.org/10.3390/nu13062116
  44. Türkiye Endokrinoloji ve Metabolizma Derneği. Obezite Tanı ve Tedavi Kılavuzu 2019. 8th ed. İstanbul: Türkiye Endokrinoloji ve Metabolizma Derneği; 2019.
  45. Freire R. Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition. 2020;69:110549. https://doi.org/10.1016/j.nut.2019.07.001
  46. Herpich C, Müller-Werdan U, Norman K. Role of plant-based diets in promoting health and longevity. Maturitas. 2022;165:47-51. https://doi.org/10.1016/j.maturitas.2022.07.003
  47. Ivanova S, Delattre C, Karcheva-Bahchevanska D, Benbasat N, Nalbantova V, Ivanov K. Plant-Based Diet as a Strategy for Weight Control. Foods. 2021;10:3052. https://doi.org/10.3390/foods10123052
  48. Sevim Y, Derli G. Vejetaryen diyetlerde besin tüketimleri ve beden kütle indeksi farklılıkları. Samsun Sağlık Bilimleri Dergisi. 2022;7:965-986. https://doi.org/10.47115/jshs.1101095
  49. Kahleova H, McCann J, Alwarith J, et al. A plant-based diet in overweight adults in a 16-week randomized clinical trial: The role of dietary acid load. Clin Nutr ESPEN. 2021;44:150-158. https://doi.org/10.1016/j.clnesp.2021.05.015
  50. Wright N, Wilson L, Smith M, Duncan B, McHugh P. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr Diabetes. 2017;7:e256. https://doi.org/10.1038/nutd.2017.3
  51. Asoudeh F, Mousavi SM, Keshteli AH, et al. The association of plant-based dietary pattern with general and abdominal obesity: a large cross-sectional study. J Diabetes Metab Disord. 2023;22:469-477. https://doi.org/10.1007/s40200-022-01166-1
  52. Wang YB, Page AJ, Gill TK, Melaku YA. The association between diet quality, plant-based diets, systemic inflammation, and mortality risk: findings from NHANES. Eur J Nutr. 2023;62:2723-2737. https://doi.org/10.1007/s00394-023-03191-z
  53. Kenneally S. Plant-based nutrition and weight management. In: Kassam S, Kassam Z, Simon L, editors. Plant-based nutrition in clinical practice. London, UK: Hammersmith Health Books; 2022.
  54. Shahavandi M, Djafari F, Shahinfar H, et al. The association of plant-based dietary patterns with visceral adiposity, lipid accumulation product, and triglyceride-glucose index in Iranian adults. Complement Ther Med. 2020;53:102531. https://doi.org/10.1016/j.ctim.2020.102531
  55. Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia. 2001;44(Suppl 2):S14-S21. https://doi.org/10.1007/pl00002934
  56. Kumar A, Gangwar R, Zargar AA, Kumar R, Sharma A. Prevalence of Diabetes in India: A Review of IDF Diabetes Atlas 10th Edition. Curr Diabetes Rev. 2024;20:e130423215752. https://doi.org/10.2174/1573399819666230413094200
  57. Hu FB, Satija A, Manson JE. Curbing the Diabetes Pandemic: The Need for Global Policy Solutions. JAMA. 2015;313:2319-2320. https://doi.org/10.1001/jama.2015.5287
  58. Uusitupa M, Khan TA, Viguiliouk E, et al. Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients. 2019;11:2611. https://doi.org/10.3390/nu11112611
  59. Papier K, Appleby PN, Fensom GK, et al. Vegetarian diets and risk of hospitalisation or death with diabetes in British adults: results from the EPIC-Oxford study. Nutr Diabetes. 2019;9:7. https://doi.org/10.1038/s41387-019-0074-0
  60. Schoenaker DA, Mishra GD, Callaway LK, Soedamah-Muthu SS. The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. Diabetes Care. 2016;39:16-23. https://doi.org/10.2337/dc15-0540
  61. Pollakova D, Andreadi A, Pacifici F, Della-Morte D, Lauro D, Tubili C. The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review. Nutrients. 2021;13:2123. https://doi.org/10.3390/nu13062123
  62. Ye J, Yu Q, Mai W, Liang P, Liu X, Wang Y. Dietary protein intake and subsequent risk of type 2 diabetes: a dose-response meta-analysis of prospective cohort studies. Acta Diabetol. 2019;56:851-870. https://doi.org/10.1007/s00592-019-01320-x
  63. Viguiliouk E, Stewart SE, Jayalath VH, et al. Effect of Replacing Animal Protein with Plant Protein on Glycemic Control in Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2015;7:9804-9824. https://doi.org/10.3390/nu7125509
  64. Jardine MA, Kahleova H, Levin SM, Ali Z, Trapp CB, Barnard ND. Perspective: Plant-Based Eating Pattern for Type 2 Diabetes Prevention and Treatment: Efficacy, Mechanisms, and Practical Considerations. Adv Nutr. 2021;12:2045-2055. https://doi.org/10.1093/advances/nmab063
  65. Barnard ND, Katcher HI, Jenkins DJA, Cohen J, Turner-McGrievy G. Vegetarian and vegan diets in type 2 diabetes management. Nutr Rev. 2009;67:255-263. https://doi.org/10.1111/j.1753-4887.2009.00198.x
  66. Chanson-Rolle A, Meynier A, Aubin F, et al. Systematic Review and Meta-Analysis of Human Studies to Support a Quantitative Recommendation for Whole Grain Intake in Relation to Type 2 Diabetes. PLoS One. 2015;10:e0131377. https://doi.org/10.1371/journal.pone.0131377
  67. Zheng JS, Sharp SJ, Imamura F, et al. Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries. BMJ. 2020;370:m2194. https://doi.org/10.1136/bmj.m2194
  68. Kara B. Herkes için böbrek sağlığı. Journal of Nephrology Nursing. 2015;10:10-12.
  69. Carrero JJ, González-Ortiz A, Avesani CM, et al. Plant-based diets to manage the risks and complications of chronic kidney disease. Nat Rev Nephrol. 2020;16:525-542. https://doi.org/10.1038/s41581-020-0297-2
  70. Ikizler TA, Burrowes JD, Byham-Gray LD, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76:S1-S107. https://doi.org/10.1053/j.ajkd.2020.05.006
  71. González-Ortiz A, Xu H, Avesani CM, et al. Plant-based diets, insulin sensitivity and inflammation in elderly men with chronic kidney disease. J Nephrol. 2020;33:1091-1101. https://doi.org/10.1007/s40620-020-00765-6
  72. Goraya N, Simoni J, Jo CH, Wesson DE. A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clin J Am Soc Nephrol. 2013;8:371-381. https://doi.org/10.2215/CJN.02430312
  73. Noori N, Sims JJ, Kopple JD, et al. Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iran J Kidney Dis. 2010;4:89-100.
  74. Moe SM, Zidehsarai MP, Chambers MA, et al. Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clin J Am Soc Nephrol. 2011;6:257-264. https://doi.org/10.2215/CJN.05040610
  75. Schaffner F, Thaler H. Nonalcoholic fatty liver disease. Prog Liver Dis. 1986;8:283-298.
  76. Huang TD, Behary J, Zekry A. Non-alcoholic fatty liver disease: a review of epidemiology, risk factors, diagnosis and management. Intern Med J. 2020;50:1038-1047. https://doi.org/10.1111/imj.14709
  77. Petroni ML, Brodosi L, Bugianesi E, Marchesini G. Management of non-alcoholic fatty liver disease. BMJ. 2021;372:m4747. https://doi.org/10.1136/bmj.m4747
  78. Zelber-Sagi S, Salomone F, Mlynarsky L. The Mediterranean dietary pattern as the diet of choice for non-alcoholic fatty liver disease: Evidence and plausible mechanisms. Liver Int. 2017;37:936-949. https://doi.org/10.1111/liv.13435
  79. Barnard ND, Levin SM, Yokoyama Y. A systematic review and meta-analysis of changes in body weight in clinical trials of vegetarian diets. J Acad Nutr Diet. 2015;115:954-969. https://doi.org/10.1016/j.jand.2014.11.016
  80. Li X, Peng Z, Li M, et al. A Healthful Plant-Based Diet Is Associated with Lower Odds of Nonalcoholic Fatty Liver Disease. Nutrients. 2022;14:4099. https://doi.org/10.3390/nu14194099
  81. Lv Y, Rong S, Deng Y, Bao W, Xia Y, Chen L. Plant-based diets, genetic predisposition and risk of non-alcoholic fatty liver disease. BMC Med. 2023;21:351. https://doi.org/10.1186/s12916-023-03028-w
  82. Zelber-Sagi S, Ivancovsky-Wajcman D, Fliss Isakov N, et al. High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance. J Hepatol. 2018;68:1239-1246. https://doi.org/10.1016/j.jhep.2018.01.015
  83. Peate I. The gastrointestinal system. British Journal of Healthcare Assistants. 2021;15:132–137. https://doi.org/10.12968/bjha.2021.15.3.132
  84. Fenneman AC, Weidner M, Chen LA, Nieuwdorp M, Blaser MJ. Antibiotics in the pathogenesis of diabetes and inflammatory diseases of the gastrointestinal tract. Nat Rev Gastroenterol Hepatol. 2023;20:81-100. https://doi.org/10.1038/s41575-022-00685-9
  85. Corsello A, Pugliese D, Gasbarrini A, Armuzzi A. Diet and Nutrients in Gastrointestinal Chronic Diseases. Nutrients. 2020;12:2693. https://doi.org/10.3390/nu12092693
  86. Limketkai BN, Hamideh M, Shah R, Sauk JS, Jaffe N. Dietary Patterns and Their Association With Symptoms Activity in Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2022;28:1627-1636. https://doi.org/10.1093/ibd/izab335
  87. Mazzocchi S, Visaggi P, Baroni L. Plant-based diets in gastrointestinal diseases: Which evidence? Best Pract Res Clin Gastroenterol. 2023;62-63:101829. https://doi.org/10.1016/j.bpg.2023.101829
  88. Tomova A, Bukovsky I, Rembert E, et al. The Effects of Vegetarian and Vegan Diets on Gut Microbiota. Front Nutr. 2019;6:47. https://doi.org/10.3389/fnut.2019.00047
  89. Sidhu SRK, Kok CW, Kunasegaran T, Ramadas A. Effect of Plant-Based Diets on Gut Microbiota: A Systematic Review of Interventional Studies. Nutrients. 2023;15:1510. https://doi.org/10.3390/nu15061510
  90. Sun C, Li A, Xu C, et al. Comparative Analysis of Fecal Microbiota in Vegetarians and Omnivores. Nutrients. 2023;15:2358. https://doi.org/10.3390/nu15102358
  91. Jain R, Larsuphrom P, Degremont A, Latunde-Dada GO, Philippou E. Association between vegetarian and vegan diets and depression: A systematic review. Nutr Bull. 2022;47:27-49. https://doi.org/10.1111/nbu.12540
  92. Küçük E. Nöropsikiyatrik bozukluklarda beslenme. In: Ertem DH, editor. Nörolojik Hastalıklarda Nutrisyona Multidisipliner Yaklaşım. Ankara: Nobel Tıp Kitabevleri; 2023: 169-184.
  93. Mörkl S, Wagner-Skacel J, Lahousen T, et al. The Role of Nutrition and the Gut-Brain Axis in Psychiatry: A Review of the Literature. Neuropsychobiology. 2020;79:80-88. https://doi.org/10.1159/000492834
  94. Noble EE, Hsu TM, Kanoski SE. Gut to Brain Dysbiosis: Mechanisms Linking Western Diet Consumption, the Microbiome, and Cognitive Impairment. Front Behav Neurosci. 2017;11:9. https://doi.org/10.3389/fnbeh.2017.00009
  95. Jiang HY, Zhang X, Yu ZH, et al. Altered gut microbiota profile in patients with generalized anxiety disorder. J Psychiatr Res. 2018;104:130-136. https://doi.org/10.1016/j.jpsychires.2018.07.007
  96. Carlson JL, Erickson JM, Lloyd BB, Slavin JL. Health Effects and Sources of Prebiotic Dietary Fiber. Curr Dev Nutr. 2018;2:nzy005. https://doi.org/10.1093/cdn/nzy005
  97. Jovandaric MZ, editor. Veganism - a Fashion Trend or Food as a Medicine. IntechOpen; 2021. https://doi.org/10.5772/intechopen.78107
  98. Sarris J, Murphy J, Mischoulon D, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. Am J Psychiatry. 2016;173:575-587. https://doi.org/10.1176/appi.ajp.2016.15091228
  99. Haghighatdoost F, Bellissimo N, Totosy de Zepetnek JO, Rouhani MH. Association of vegetarian diet with inflammatory biomarkers: a systematic review and meta-analysis of observational studies. Public Health Nutr. 2017;20:2713-2721. https://doi.org/10.1017/S1368980017001768
  100. Beezhold B, Radnitz C, Rinne A, DiMatteo J. Vegans report less stress and anxiety than omnivores. Nutr Neurosci. 2015;18:289-296. https://doi.org/10.1179/1476830514Y.0000000164
  101. World Health Organization (WHO). ICD-10: international statistical classification of diseases and related health problems. 10th ed. Geneva: WHO; 2019. Available at: https://icd.who.int/browse10/2019/en
  102. Kudesia R, Alexander M, Gulati M, Kennard A, Tollefson M. Dietary Approaches to Women's Sexual and Reproductive Health. Am J Lifestyle Med. 2021;15:414-424. https://doi.org/10.1177/15598276211007113
  103. Aoun A, Khoury VE, Malakieh R. Can Nutrition Help in the Treatment of Infertility? Prev Nutr Food Sci. 2021;26:109-120. https://doi.org/10.3746/pnf.2021.26.2.109
  104. Skoracka K, Eder P, Łykowska-Szuber L, Dobrowolska A, Krela-Kaźmierczak I. Diet and Nutritional Factors in Male (In)fertility-Underestimated Factors. J Clin Med. 2020;9:1400. https://doi.org/10.3390/jcm9051400
  105. Bergh CM, Moore M, Gundell C. Evidence-Based Management of Infertility in Women With Polycystic Ovary Syndrome. J Obstet Gynecol Neonatal Nurs. 2016;45:111-122. https://doi.org/10.1016/j.jogn.2015.10.001
  106. Soave I, Occhiali T, Wenger J-M, Pluchino N, Caserta D, Marci R. Endometriosis and food habits: Can diet make the difference? Journal of Endometriosis and Pelvic Pain Disorders. 2018;10:59–71. https://doi.org/10.1177/2284026518773212
  107. Wong WY, Merkus HM, Thomas CMG, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Fertil Steril. 2002;77:491-498. https://doi.org/10.1016/s0015-0282(01)03229-0
  108. Montezano AC, Touyz RM. Reactive oxygen species and endothelial function-role of nitric oxide synthase uncoupling and Nox family nicotinamide adenine dinucleotide phosphate oxidases. Basic Clin Pharmacol Toxicol. 2012;110:87-94. https://doi.org/10.1111/j.1742-7843.2011.00785.x
  109. Katonova A, Sheardova K, Amlerova J, Angelucci F, Hort J. Effect of a Vegan Diet on Alzheimer's Disease. Int J Mol Sci. 2022;23:14924. https://doi.org/10.3390/ijms232314924
  110. Bakaloudi DR, Halloran A, Rippin HL, et al. Intake and adequacy of the vegan diet. A systematic review of the evidence. Clin Nutr. 2021;40(5):3503-3521. https://doi.org/10.1016/j.clnu.2020.11.035
  111. Neufingerl N, Eilander A. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients. 2021;14:29. https://doi.org/10.3390/nu14010029
  112. Jiang X, Huang J, Song D, Deng R, Wei J, Zhang Z. Increased Consumption of Fruit and Vegetables Is Related to a Reduced Risk of Cognitive Impairment and Dementia: Meta-Analysis. Front Aging Neurosci. 2017;9:18. https://doi.org/10.3389/fnagi.2017.00018
  113. World Health Organization (WHO). Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: WHO; 2019: 96. Available at: https://www.who.int/publications/i/item/9789241550543
  114. Morris MC. The role of nutrition in Alzheimer's disease: epidemiological evidence. Eur J Neurol. 2009;16(Suppl 1):1-7. https://doi.org/10.1111/j.1468-1331.2009.02735.x
  115. Shah R. The role of nutrition and diet in Alzheimer disease: a systematic review. J Am Med Dir Assoc. 2013;14:398-402. https://doi.org/10.1016/j.jamda.2013.01.014
  116. Smith AD, Smith SM, de Jager CA, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010;5:e12244. https://doi.org/10.1371/journal.pone.0012244
  117. Selinger E, Neuenschwander M, Koller A, et al. Evidence of a vegan diet for health benefits and risks - an umbrella review of meta-analyses of observational and clinical studies. Crit Rev Food Sci Nutr. 2023;63:9926-9936. https://doi.org/10.1080/10408398.2022.2075311
  118. Lombardo M, Aulisa G, Marcon D, Rizzo G. The Influence of Animal- or Plant-Based Diets on Blood and Urine Trimethylamine-N-Oxide (TMAO) Levels in Humans. Curr Nutr Rep. 2022;11:56-68. https://doi.org/10.1007/s13668-021-00387-9
  119. Abbas AK, Lichtman AH. Temel immünoloji: immün sistemin işlev ve bozuklukları. Camcıoğlu Y, Deniz G, translators. İstanbul: İstanbul Tıp Kitabevleri; 2015: 1-23.
  120. Tamer A, Nalbant A. Nutrition and Immune System. Sakarya Medical Journal 2021;11:458-466.
  121. Venter C, Eyerich S, Sarin T, Klatt KC. Nutrition and the Immune System: A Complicated Tango. Nutrients. 2020;12:818. https://doi.org/10.3390/nu12030818
  122. Clark JS, Dyer KA, Davis CR, et al. Adherence to a Mediterranean Diet for 6 Months Improves the Dietary Inflammatory Index in a Western Population: Results from the MedLey Study. Nutrients. 2023;15:366. https://doi.org/10.3390/nu15020366
  123. Thomas MS, Calle M, Fernandez ML. Healthy plant-based diets improve dyslipidemias, insulin resistance, and inflammation in metabolic syndrome. A narrative review. Adv Nutr. 2023;14:44-54. https://doi.org/10.1016/j.advnut.2022.10.002
  124. Nikiphorou E, Philippou E. Nutrition and its role in prevention and management of rheumatoid arthritis. Autoimmun Rev. 2023;22:103333. https://doi.org/10.1016/j.autrev.2023.103333
  125. Craddock JC, Neale EP, Peoples GE, Probst YC. Vegetarian-Based Dietary Patterns and their Relation with Inflammatory and Immune Biomarkers: A Systematic Review and Meta-Analysis. Adv Nutr. 2019;10:433-451. https://doi.org/10.1093/advances/nmy103
  126. Park S, Zhang T. A Positive Association of Overactivated Immunity with Metabolic Syndrome Risk and Mitigation of Its Association by a Plant-Based Diet and Physical Activity in a Large Cohort Study. Nutrients. 2021;13:2308. https://doi.org/10.3390/nu13072308
  127. Soycan G. Vegetarian nutrition. In: Baygut H, editor. Health & Science 2023: Nutrition-I. 2023: 21.
  128. Li T, Li Y, Wu S. Comparison of human bone mineral densities in subjects on plant-based and omnivorous diets: a systematic review and meta-analysis. Arch Osteoporos. 2021;16:95. https://doi.org/10.1007/s11657-021-00955-0
  129. Iguacel I, Miguel-Berges ML, Gómez-Bruton A, Moreno LA, Julián C. Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis. Nutr Rev. 2019;77:1-18. https://doi.org/10.1093/nutrit/nuy045
  130. Bajekal R, Simon L. Plant-based nutrition and bone health. In: Kassam S, Kassam Z, Simon L, editors. Plant-based nutrition in clinical practice. London, UK: Hammersmith Health Books; 2022.
  131. Qiu R, Cao WT, Tian HY, He J, Chen GD, Chen YM. Greater Intake of Fruit and Vegetables Is Associated with Greater Bone Mineral Density and Lower Osteoporosis Risk in Middle-Aged and Elderly Adults. PLoS One. 2017;12:e0168906. https://doi.org/10.1371/journal.pone.0168906
  132. Flores-Balderas X, Peña-Peña M, Rada KM, et al. Beneficial Effects of Plant-Based Diets on Skin Health and Inflammatory Skin Diseases. Nutrients. 2023;15:2842. https://doi.org/10.3390/nu15132842
  133. Gürtler A, Laurenz S. The impact of clinical nutrition on inflammatory skin diseases. J Dtsch Dermatol Ges. 2022;20:185-202. https://doi.org/10.1111/ddg.14683
  134. Baldwin H, Tan J. Effects of Diet on Acne and Its Response to Treatment. Am J Clin Dermatol. 2021;22:55-65. https://doi.org/10.1007/s40257-020-00542-y
  135. Fusano M. Veganism in acne, atopic dermatitis, and psoriasis: Benefits of a plant-based diet. Clin Dermatol. 2023;41:122-126. https://doi.org/10.1016/j.clindermatol.2022.09.008
  136. Lee H, Sim N, Fotouhi A, Daveluy S. Vegan Diet in Dermatology: A Review. J Clin Med. 2023;12:5800. https://doi.org/10.3390/jcm12185800
  137. Bowe WP, Joshi SS, Shalita AR. Diet and acne. J Am Acad Dermatol. 2010;63:124-141. https://doi.org/10.1016/j.jaad.2009.07.043
  138. Sharma N. Plant-based nutrition and dermatological conditions. In: Kassam S, Kassam Z, Simon L, editors. Plant-based nutrition in clinical practice. London, UK: Hammersmith Health Books; 2022.
  139. Meixiong J, Ricco C, Vasavda C, Ho BK. Diet and acne: A systematic review. JAAD Int. 2022;7:95-112. https://doi.org/10.1016/j.jdin.2022.02.012
  140. Khan A, Adalsteinsson J, Whitaker-Worth DL. Atopic dermatitis and nutrition. Clin Dermatol. 2022;40:135-144. https://doi.org/10.1016/j.clindermatol.2021.10.006
  141. Guasch-Ferré M, Salas-Salvadó J, Ros E, et al. The PREDIMED trial, Mediterranean diet and health outcomes: How strong is the evidence? Nutr Metab Cardiovasc Dis. 2017;27:624-632. https://doi.org/10.1016/j.numecd.2017.05.004
  142. Livingstone KM, Brayner B, Celis-Morales C, et al. Associations between dietary patterns, FTO genotype and obesity in adults from seven European countries. Eur J Nutr. 2022;61:2953-2965. https://doi.org/10.1007/s00394-022-02858-3