Vegetarian diets are often characterized as having beneficial health effects due to their higher nutritional quality. However, not all vegetarian diets are alike in terms of foods choice. In general, there are three categories of vegetarian diets: pesco-vegetarians, vegetarians, and vegans. Pesco-vegetarians avoid meat but eat fish, seafood, eggs, and dairy foods. Vegetarians avoid meat, fish, and seafood but eat eggs and dairy foods. Vegans avoid all foods from animals.
Recent developments in the food industry have introduced a variety of new plant-based meat and dairy substitutes, some of which can be classified as ultra-processed foods. These includes foods with some additives (texturizers, dyes, emulsifiers, etc.) made from textured soy protein foods, quinoa, corn, and other cereals, legumes or pulses, and plant-based drinks made from soy, almond, or rice. Although the plethora of plant-based food alternatives for vegetarians may help make dietary planning easier, very little is known about the contribution of these ultra-processed foods to their diet, in relation to the nutritional quality.
To better understand the contribution of ultra-processed plant-based meat and dairy substitutes across different types of vegetarian and meat-based diets, Drs. Benjamin Allès, Joséphine Gehring and colleagues from the Nutritional Epidemiology Research Team (EREN-CRESS, Inserm, INRAE, Cnam, Université Sorbonne Paris Nord) analyzed daily food intakes in a study population from the NutriNet-Santé cohort divided into 4 groups: 19,812 meat eaters, 646 pesco-vegetarians, 500 vegetarians, and 254 vegans. Dietary nutritional quality of these four diets was assessed by describing ultra-processed foods intake but also using healthy and unhealthy plant-based indices. Additional analyses evaluated determinants of ultra-processed food consumption including duration and age at vegetarian diet initiation.
Compared to the other categories, vegetarians tended to be younger, had higher educational attainment, but lower monthly household incomes, and were more likely to be single at the time of data collection. Higher avoidance of animal-based foods was associated with higher consumption of ultra-processed foods supplying 33.0%, 32.5%, 37.0%, and 39.5% of energy intakes for meat eaters, pesco-vegetarians, vegetarians, and vegans. Nutritional quality was associated with the level of animal-based food avoidance, with healthy plant-based indices at 53.5, 60.6, 61.3. and 67.9 for meat-eaters, pesco-vegetarians, vegetarians, and vegans.
The finding that vegans, vegetarians, and pesco-vegetarians consumed more of both healthy and unhealthy plant-based products and ultra-processed food products than meat-eaters is noteworthy. This highlights the heterogeneity in vegetarian diets and that those consuming a higher intake of the processed form of plant-based foods may not reap the health benefits often attributed to plant-based diets.
Two corresponding editorials provide further insights regarding the contribution of plant-based ultra-processed foods. Neha Khandpur and colleagues (University of São Paulo) stress the need to better understand the range of plant-based foods, their degree of processing, their nutrient profile, and the nutritional adequacy of the meal patterns that incorporate them. Michael Gibney (University of Dublin) points out that we live in a society that seeks ever-increasing convenience in all aspects of our lives, which leaves us with a difficult choice – either we embrace food technology and conveniences as a solution, or we partly dismantle our present manner of living.
Gehring J, Touvier M, Baudry J, Julia C, Buscail C et al. Consumption of Ultra-Processed Foods by Pesco-Vegetarians, Vegetarians, and Vegans: Associations with Duration and Age at Diet Initiation. The Journal of Nutrition, Volume 151, Issue 1, January 2021, Pages 120–131, https://doi.org/10.1093/jn/nxaa196
Gibney MJ. Food Technology and Plant-Based Diets. The Journal of Nutrition, Volume 151, Issue 1, January 2021, Pages 1–2, https://doi.org/10.1093/jn/nxaa301.
Khandpur K, Martinez-Steele E, Sun Marine Q. Plant-Based Meat and Dairy Substitutes as Appropriate Alternatives to Animal-Based Products? The Journal of Nutrition, Volume 151, Issue 1, January 2021, Pages 3–4, https://doi.org/10.1093/jn/nxaa351.
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