Faba beans CREDIT Suvi Itkonen

A study conducted at the University of Helsinki demonstrated that the partial substitution of red and processed meat with pea- and faba bean–based food products ensured sufficient intake of amino acids in the diet and did not negatively affect bone metabolism.

“Decreasing the consumption of red and processed meat in the diet to the upper limit of the Planetary Health Diet while increasing the consumption of legumes cultivated in Finland, such as peas and faba beans, is safe from the perspective of protein nutrition. Similarly, bone health is not compromised by such a dietary change either,” says Docent Suvi Itkonen from the Faculty of Agriculture and Forestry.

In the BeanMan study, 102 Finnish men followed a study diet for six weeks.

• One group consumed 760 grams of red and processed meat per week, which accounted for 25% of the total protein intake. The amount corresponds to the average protein consumption of Finnish men.
• The other group consumed food products based on legumes, mainly peas and faba beans, corresponding to 20% of the total protein intake. In addition, the amount of red and processed meat consumed per week in this group amounted to the upper limit of the Planetary Health Diet (200 g or 5% of the total protein intake).

Otherwise, the study subjects followed their habitual diet but were not allowed to eat other red or processed meat or legumes than those provided by the study.

The researchers did not find any differences between the dietary groups in markers of bone formation or resorption. Neither did the intake of calcium or vitamin D differ between the groups. Calcium intake was in line with the current dietary recommendations, and the intake of vitamin D was very close to the recommendations. Mean essential amino acid and protein intakes met the recommendations in both groups.

“Reducing read meat consumption is extremely important in terms of environmental impact,” Itkonen notes.

Increasingly plant-based diets are becoming more and more popular, and the recently updated Nordic Nutrition Recommendations also emphasise the restriction of meat consumption and the moderation of dairy consumption.

“In this study, the subjects consumed dairy products as in their habitual diets, thus their calcium and vitamin D intakes were unchanged. However, in terms of bone health, it is important to bear in mind that if one reduces the amount of dairy in the diet, it is necessary to ensure the intake of calcium and vitamin D from other sources. These sources can be plant-based beverages and yoghurt-like products fortified with those nutrients or, when necessary, dietary supplements,” Itkonen points out.

Snacking is becoming increasingly popular, with more than 70% of people reporting they snack at least twice a day. In a new study involving more than 1,000 people, researchers examined whether snacking affects health and if the quality of snack foods matters.

“Our study showed that the quality of snacking is more important than the quantity or frequency of snacking, thus choosing high quality snacks over highly processed snacks is likely beneficial,” said Kate Bermingham, PhD, a postdoctoral fellow at King’s College London. “Timing is also important, with late night snacking being unfavorable for health.”

Bermingham will present the findings at NUTRITION 2023, the annual flagship meeting of the American Society for Nutrition held July 22-25 in Boston.

The work is part of the ZOE PREDICT project, a group of large in-depth nutritional research studies designed to uncover how and why people respond differently to the same foods.

“Surprisingly little has been published on snacking, despite the fact that it accounts for 20-25% of energy intake,” said Bermingham. “PREDICT followed a large number of people and captured detailed information on their snacking behaviors, allowing this in-depth exploration of snacking on health.”

Using data from just over 1,000 people in the United Kingdom who participated in the ZOE PREDICT 1 study, the researchers examined the relationship between snacking quantity, quality, and timing with blood fats and insulin levels, which are both indicators of cardiometabolic health.

The analysis showed that snacking on higher quality foods — foods that contain significant amounts of nutrients relative to the calories they provide — was associated with better blood fat and insulin responses. The researchers also observed that late-evening snacking, which lengthens eating windows and shortens the overnight fasting period, was associated with unfavorable blood glucose and lipid levels. There was no association between snacking frequency, calories consumed, and food quantity with any of the health measures analyzed.

“We observed only weak relationships between snack quality and the remainder of the diet, which highlights snacking as an independent modifiable dietary feature that could be targeted to improve health,” said Bermingham.

A study led by McMaster University and Hamilton Health Sciences researchers at the Population Research Health Institute (PHRI) has found that not eating enough of six key foods in combination is associated with a higher risk of cardiovascular disease (CVD) in adults.

Consuming fruits, vegetables, legumes, nuts, fish and whole-fat dairy products is key to lowering the risk of CVD, including heart attacks and strokes. The study also found that a healthy diet can be achieved in various ways, such as including moderate amounts of whole grains or unprocessed meats.

Previous and similar research has focused on Western countries and diets that combined harmful, ultra-processed foods with nutrient-dense foods. This research was global in scope and focused on foods commonly considered to be healthy.

The World Health Organization estimates nearly 18 million people died from CVD in 2019, representing 32 per cent of all global deaths. Of these deaths, 85 per cent were due to heart attacks and strokes. PHRI researchers and their global collaborators analyzed data from 245,000 people in 80 countries from multiple studies. The results were published in the European Heart Journal on July 6.

Researchers derived a diet score from PHRI’s ongoing, large-scale global Prospective Urban and Rural Epidemiological (PURE) study, then replicated that in five independent studies to measure health outcomes in different world regions and in people with and without prior CVD.

“Previous diet scores – including the EAT-Lancet Planetary Diet and the Mediterranean Diet tested the relationship of diet to CVD and death mainly in Western countries. The PURE Healthy Diet Score included a good representation of high, middle, and low-income countries,” said Salim Yusuf, senior author and principal investigator of PURE.

As well as being truly global, the PURE Healthy Diet Score focused on exclusively protective, or natural, foods.

“We were unique in that focus. The other diet scores combined foods considered to be harmful – such as processed and ultra-processed foods – with foods and nutrients believed to be protective of one’s health,” said first author Andrew Mente, PHRI scientist and assistant professor at McMaster’s Department of Health Research Methods, Evidence, and Impact.

“There is a recent increased focus on higher consumption of protective foods for disease prevention. Outside of larger amounts of fruits, vegetables, nuts and legumes, the researchers showed that moderation is key in the consumption of natural foods,” he said.

“Moderate amounts of fish and whole-fat dairy are associated with a lower risk of CVD and mortality. The same health outcomes can be achieved with moderate consumption of grains and meats – as long as they are unrefined whole grains and unprocessed meats.”

The PURE Healthy Diet Score recommends an average daily intake of: Fruits at two to three servings; vegetables at two to three servings; nuts at one serving; and dairy at two servings. The score also includes three to four weekly servings of legumes and two to three weekly servings of fish. Possible substitutes included whole grains at one serving daily, and unprocessed red meat or poultry at one serving daily.

There was no specific funding for this analysis, although each study that contributed data was funded separately and conducted over a 25-year period.

Unprocessed red meat and whole grains can be included or left out of a healthy diet, according to a study conducted in 80 countries across all inhabited continents and published today in European Heart Journal, a journal of the European Society of Cardiology (ESC).¹ Diets emphasising fruit, vegetables, dairy (mainly whole-fat), nuts, legumes and fish were linked with a lower risk of cardiovascular disease (CVD) and premature death in all world regions. The addition of unprocessed red meat or whole grains had little impact on outcomes.

“Low-fat foods have taken centre stage with the public, food industry and policymakers, with nutrition labels focused on reducing fat and saturated fat,” said study author Dr. Andrew Mente of the Population Health Research Institute, McMaster University, Hamilton, Canada. “Our findings suggest that the priority should be increasing protective foods such as nuts (often avoided as too energy dense), fish and dairy, rather than restricting dairy (especially whole-fat) to very low amounts. Our results show that up to two servings a day of dairy, mainly whole-fat, can be included in a healthy diet. This is in keeping with modern nutrition science showing that dairy, particularly whole-fat, may protect against high blood pressure and metabolic syndrome.”

The study examined the relationships between a new diet score and health outcomes in a global population. A healthy diet score was created based on six foods that have each been linked with longevity. The PURE diet included 2-3 servings of fruit per day, 2-3 servings of vegetables per day, 3-4 servings of legumes per week, 7 servings of nuts per week, 2-3 servings of fish per week, and 14 servings of dairy products (mainly whole fat but not including butter or whipped cream) per week. A score of 1 (healthy) was assigned for intake above the median in the group and a score of 0 (unhealthy) for intake at or below the median, for a total of 0 to 6. Dr. Mente explained: “Participants in the top 50% of the population – an achievable level – on each of the six food components attained the maximum diet score of six.”

Associations of the score with mortality, myocardial infarction, stroke and total CVD (including fatal CVD and non-fatal myocardial infarction, stroke and heart failure) were tested in the PURE study which included 147,642 people from the general population in 21 countries. The analyses were adjusted for factors that could influence the relationships such as age, sex, waist-to-hip ratio, education level, income, urban or rural location, physical activity, smoking status, diabetes, use of statins or high blood pressure medications, and total energy intake.

The average diet score was 2.95. During a median follow-up of 9.3 years, there were 15,707 deaths and 40,764 cardiovascular events. Compared with the least healthy diet (score of 1 or less), the healthiest diet (score of 5 or more) was linked with a 30% lower risk of death, 18% lower likelihood of CVD, 14% lower risk of myocardial infarction and 19% lower risk of stroke. Associations between the healthy diet score and outcomes were confirmed in five independent studies including a total of 96,955 patients with CVD in 70 countries.

Dr. Mente said: “This was by far the most diverse study of nutrition and health outcomes in the world and the only one with sufficient representation from high-, middle- and low-income countries. The connection between the PURE diet and health outcomes was found in generally healthy people, patients with CVD, patients with diabetes, and across economies.”

“The associations were strongest in areas with the poorest quality diet, including South Asia, China and Africa, where calorie intake was low and dominated by refined carbohydrates. This suggests that a large proportion of deaths and CVD in adults around the world may be due to undernutrition, that is, low intakes of energy and protective foods, rather than overnutrition. This challenges current beliefs,” said Professor Salim Yusuf, senior author and principal investigator of PURE.

In an accompanying editorial, Dr. Dariush Mozaffarian of the Friedman School of Nutrition Science and Policy, Tufts University, Boston, US stated: “The new results in PURE, in combination with prior reports, call for a re-evaluation of unrelenting guidelines to avoid whole-fat dairy products. Investigations such as the one by Mente and colleagues remind us of the continuing and devastating rise in diet-related chronic diseases globally, and of the power of protective foods to help address these burdens. It is time for national nutrition guidelines, private sector innovations, government tax policy and agricultural incentives, food procurement policies, labelling and other regulatory priorities, and food-based healthcare interventions to catch up to the science. Millions of lives depend on it.”