Medical bulletin 11/ April/ 2024

A recent study published in The American Journal of Clinical Nutrition analyzed the effects of animal-based meat diets (ABMD) relative to Plant-based meat analogs diets (PBMD) on cardiometabolic health.

Plant-based diets (PBDs) have been shown to positively impact cardiometabolic health due to the presence of a wide range of bioactive constituents, e.g., vitamins, dietary fibres, carotenoids, and so on. The plant-based diets, developed from sustainable plant-based sources, aim to mimic the taste and texture attributes of their animal-based counterparts. With their growing popularity, it is important to critically evaluate their health effects relative to a typical omnivorous diet.

The study examined the effects of plant-based and animal-based diets on heart and metabolic health in people at risk of type 2 diabetes. Researchers hypothesized that switching to plant-based meat alternatives (PBMA) would improve health and lower disease risks. It was an 8-week trial with 89 participants. 44 were given PBMA, while the rest continued with animal-based meats. LDL-cholesterol was the main focus, with other risk factors like glucose levels also assessed. Some participants also monitored blood pressure and glucose continuously for 14 days.

The results revealed no significant effects on the lipid-lipoprotein profile; however, both dietary regimes were associated with lower fructosamine and higher HOMA-β over time. No apparent differences were noted between the ABMD and the PBMD groups. No clear benefits of PBMD on cardiometabolic health relative to ABMD was observed. Furthermore, the subpopulation that underwent glucose monitoring reported more effective glycemic management in the ABMD group.

These findings suggested that incorporating PBMAs into the diet could affect nutritional intake and potentially compromise glycemic management. This implied that the health benefits of PBDs should not be conflated with PBMD because PBMDs are distinct from PBDs in terms of their nutrition and impact on cardiometabolic health.

Reference: Darel Wee Kiat Toh, Amanda Simin Fu, Kervyn Ajay Mehta, Nicole Yi Lin Lam, Sumanto Haldar, Christiani Jeyakumar Henry; Plant-based meat analogues (PBMAs) and their effects on cardiometabolic health: An 8-week randomized controlled trial comparing PBMAs with their corresponding animal-based foods; Journal: Journal: American Journal of Clinical Nutrition; https://doi.org/10.1016/j.ajcnut.2024.04.006

A study published in the journal Nature Mental Health explored how dietary patterns impacted a number of areas of brain health, including mental health, cognitive function, metabolic biomarkers, and brain structure as measured using MRI.

People can develop preferences for certain foods, which can impact overall dietary patterns over time. Recently, growing evidence has highlighted the profound impact of dietary patterns on health, including chronic medical diseases, such as cardiovascular disease, type 2 diabetes, metabolic syndrome and cancer, as well as mental health and/or cognitive impairments such as major depression disorders and anxiety.

Previous research has confirmed the significant connection between diet and mental health, particularly cognitive functions. For instance, a systematic review found that a higher intake of simple carbohydrates is linked to lower cognitive performance. Saturated fatty acids are associated with impaired memory and learning and protein intake may improve executive function and working memory.

In the study, researchers analyzed UK Biobank data on food preferences across categories like dairy, fruits, alcohol, and vegetables. They studied how these preferences related to various brain-related outcomes, including mental health indicators like anxiety and depression symptoms, cognitive function, blood biochemistry, brain structure via MRI, and genetic risk scores for mental disorders.

The researchers found that the balanced dietary group had the most positive outcomes, with lower scores for mental health issues and higher well-being. They also had better reaction times and cognitive performance compared to other groups. Additionally, they exhibited higher levels of gray matter in certain brain areas. However, the vegetarian group had a higher genetic risk for various mental disorders, while the high-protein, low-fiber group had a higher genetic risk for ischemic stroke.

“This study found that a ‘healthier’ diet with balanced preferences in various food categories — fruit, vegetables, starches, protein, and snack foods, are associated with better mental health status, higher levels of cognitive functions and fewer risks of mental disorders,” said Molly Rapozo, RDN, registered dietician nutritionist, and senior nutrition and health educator at Pacific Neuroscience Institute in Santa Monica, CA

Reference: Ruohan Zhang, Bei Zhang, Chun Shen, Barbara J. Sahakian, Zeyu Li, Wei Zhang, Yujie Zhao, Yuzhu Li, Jianfeng Feng & Wei Cheng; Associations of dietary patterns with brain health from behavioral, neuroimaging, biochemical and genetic analyses; Journal: Nature Mental Health; https://doi.org/10.1038/s44220-024-00226-0

A study published in the journal JAMA Network Open found that acetaminophen use during pregnancy was not associated with children’s risk of autism, attention-deficit/hyperactivity disorder (ADHD), or intellectual disability.

Acetaminophen is commonly used for pain and fever during pregnancy, considered low risk by FDA and EMA. Previous studies linking it to neurodevelopmental disorders may be influenced by biases, like confounding by indication, where reasons for use (e.g., fever, pain) could also be risk factors for these disorders. Confounding by parental health and genetics is likely because neurodevelopmental disorders are highly heritable and those who used acetaminophen during pregnancy reported higher prevalence of multiple health conditions associated with neurodevelopmental disorders compared with nonusers.

This study included all singleton liveborn children from 1995 to 2019. Early drug exposure information was prospectively collected during the 8-10 weeks gestation period. Later medication use in pregnancy was also prospectively documented. Children were followed up from birth, using the age of the child as the time scale, until the earliest date of diagnosis of a neurodevelopmental disorder, death, emigration, or end of follow-up.

The results found no evidence that acetaminophen use during pregnancy was associated with children’s risk of autism, ADHD, or intellectual disability. This suggested that the small increase in children’s risk of neurodevelopmental disorders associated with acetaminophen use observed in statistical models may have been due to unmeasured confounding. Further, the findings indicated that the association between acetaminophen use during pregnancy and neurodevelopmental disorders is a noncausal association.

Reference: Viktor H. Ahlqvist, PhD; Hugo Sjöqvist, MSc; Christina Dalman, MD, PhD; et al; Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability; Journal: JAMA Network Open; doi:10.1001/jama.2024.3172