Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.

Introduction: The prevalence of obesity is high and increasing worldwide. Obesity is generally associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a lifestyle intervention on body weight and other chronic disease risk markers. Methods: A non-randomized controlled trial was conducted, including mostly middle-aged and elderly participants recruited from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme, focussing on four key areas: a largely plant-based diet (strongest emphasis), physical activity, stress management, and community support. Parameters were assessed at baseline, 10 weeks, 6 months, and 1 year. The control group received no intervention. Results: Compared to the control, in the intervention group, significantly lower 1-year trajectories were observed for body weight, body mass index (BMI), waist circumference (WC), total cholesterol, calculated LDL cholesterol, non-HDL cholesterol, remnant cholesterol (REM-C), glucose, HbA1c, and resting heart rate (RHR). However, between-group differences at 1 year were small for glucose, HbA1c, and cholesterol (apart from REM-C). No significant between-group differences were found for 1-year trajectories of measured LDL cholesterol, HDL cholesterol, triglycerides, insulin, blood pressure, and pulse pressure. Conclusion: The intervention successfully reduced body weight, BMI, WC, REM-C, and RHR. However, at 1 year, effectiveness of the intervention regarding other risk markers was either very modest or could not be shown.

Brazil nuts are well known for their extraordinarily high selenium content. For this reason, they are frequently recommended as a kind of natural selenium ‘supplement’, particularly for certain population groups such as vegetarians and vegans in regions with low soil selenium levels. Typically, an intake of one or two Brazil nuts per day is recommended. Brazil nuts, however, also stand out from other nuts in terms of their high (albeit highly variable) radium content. The radium isotopes Ra‐226 and Ra‐228 emit alpha‐ and beta‐radiation, with this type of radiation being particularly harmful when ingested. Consequently, it is important to consider radium levels in Brazil nuts before formulating recommendations for a long‐term, daily intake of these nuts. To date, however, no comprehensive overview of radium levels in Brazil nuts has been published. Therefore, a literature review without time or language restrictions was conducted, including unpublished original data from Germany. The literature review (including the German data) indicated mean Ra‐226 and Ra‐228 levels of 49 (range: 17–205) mBq/g and 67 (range: 12–235) mBq/g, respectively. Assuming a consistent daily intake of one or two Brazil nuts, this would result in an effective dose of ~88–220 μSv/year. This level of exposure appears to be neither clearly harmful nor clearly harmless. As increased radioactivity exposure (at least at higher doses) is associated with increased cancer risk, randomised controlled trials assessing the effect of Brazil nuts on cancer risk biomarkers are needed.

Previously published recommendations for vegetarian (including vegan) diets for children have highlighted the need for vitamin B12 supplementation. Increased attention to several other key nutrients (including iodine, vitamin D, calcium, and iron) has also been recommended. However, an overview focusing on supplementation guidelines, specifically for vegan infants, has not been published, and a potential requirement for iodine and/or selenium supplementation in (some) vegan infants has not been discussed. Vegan complementary feeding should be supplemented (particularly with 5 μg/day of vitamin B12 and 10 μg/day of vitamin D). Iodine should be supplemented (up to 110 μg/day) if the intake of breast milk and infant formula is low, and selenium supplementation (5 μg/day) should be considered in regions with low soil selenium levels. Caution is required to avoid excessive intakes of iodine and particularly selenium. Supplements for vegan infants are on the market, and observational studies are urgently needed to assess the nutrient intake (including supplements) and status in vegan infants.

Objectives The intima-media thickness of the common carotid artery (ccIMT) is an established risk marker for cardiovascular disease (CVD). However, it is unclear whether lifestyle interventions can easily demonstrate an improvement in ccIMT. The objective was to test if our intervention would beneficially affect ccIMT (among other CVD markers). Design Non-randomized controlled trial Setting Rural northwest Germany Participants Middle-aged and elderly participants from the general population (intervention: n = 114; control: n = 87) Intervention A community-based, 6-month controlled lifestyle intervention focusing on four areas of lifestyle change: a plant-based diet, physical activity, stress management, and an improved social life. A strong emphasis was on dietary change. Measurements We tested whether ccIMT change from baseline to 6 months was different between groups. Results With all participants included, no significant difference in mean ccIMT change between groups was observed (p = 0.708). However, in a subgroup analysis with participants with high baseline mean ccIMT (≥0.800 mm) a significant difference in mean ccIMT change between intervention (−0.023 [95% CI −0.052, 0.007] mm; n = 22; baseline mean ccIMT: 0.884 ± 0.015 mm) and control (0.041 [95% CI 0.009, 0.073] mm; n = 13; baseline mean ccIMT: 0.881 ± 0.022 mm) was observed (p = 0.004). Adjusting for potential confounders did not substantially alter the results. Conclusion The results indicate that healthy lifestyle changes can beneficially affect ccIMT within 6 months and that such a beneficial effect may be more easily demonstrated if participants with high baseline ccIMT are recruited. The observed effect is of relevance for the prevention of CVD events, including myocardial infarction and stroke.

In regions with low selenium soil concentrations, selenium can be considered a critical nutrient for vegetarians and vegans. While the number of vegetarians and vegans is increasing in many countries, a large research gap remains in this field. For example, to date, no study seems to have assessed selenium intake in vegetarian and vegan children. Therefore, the selenium intake of 1- to 3-year-old vegetarian, vegan, and omnivorous children who participated in the cross-sectional VeChi Diet study was determined. Selenium intake was assessed based on 3-day food diaries (not including supplements) and food selenium concentrations provided by the European Food Safety Authority (EFSA). Between-group differences were assessed with analysis of covariance (ANCOVA). The median daily selenium intake was 17 µg, 19 µg, and 22 µg in vegetarian, vegan, and omnivorous children, respectively. However, only the difference between the vegan and omnivorous children was statistically significant. On average, all three groups met the harmonized average requirement (H-AR) for selenium of 17 µg/day. Nevertheless, the hypothesis that vegetarian and vegan children generally consume less selenium than omnivorous children could be confirmed, and 39% of vegetarians, 36% of vegans, and 16% of omnivores fell below the adequate intake for selenium (provided by EFSA) of 15 µg/day.