Vegetarian diets are associated with several health benefits, but whether a vegetarian or vegan diet is beneficial for athletic performance has not yet been defined. Based on the evidence in the literature that diets high in unrefined plant foods are associated with beneficial effects on overall health, lifespan, immune function, and cardiovascular health, such diets likely would promote improved athletic performance as well. In this article, we review the state of the literature on vegetarian diets and athletic performance, discuss prevention of potential micronutrient deficiencies that may occur in the vegan athlete, and provide strategies on meeting the enhanced caloric and protein needs of an athlete with a plant-based diet.

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BackgroundPeople overeat because their hunger directs them to consume more calories than they require. The purpose of this study was to analyze the changes in experience and perception of hunger before and after participants shifted from their previous usual diet to a high nutrient density diet.MethodsThis was a descriptive study conducted with 768 participants primarily living in the United States who had changed their dietary habits from a low micronutrient to a high micronutrient diet. Participants completed a survey rating various dimensions of hunger (physical symptoms, emotional symptoms, and location) when on their previous usual diet versus the high micronutrient density diet. Statistical analysis was conducted using non-parametric tests.ResultsHighly significant differences were found between the two diets in relation to all physical and emotional symptoms as well as the location of hunger. Hunger was not an unpleasant experience while on the high nutrient density diet, was well tolerated and occurred with less frequency even when meals were skipped. Nearly 80% of respondents reported that their experience of hunger had changed since starting the high nutrient density diet, with 51% reporting a dramatic or complete change in their experience of hunger.ConclusionsA high micronutrient density diet mitigates the unpleasant aspects of the experience of hunger even though it is lower in calories. Hunger is one of the major impediments to successful weight loss. Our findings suggest that it is not simply the caloric content, but more importantly, the micronutrient density of a diet that influences the experience of hunger. It appears that a high nutrient density diet, after an initial phase of adjustment during which a person experiences "toxic hunger" due to withdrawal from pro-inflammatory foods, can result in a sustainable eating pattern that leads to weight loss and improved health. A high nutrient density diet provides benefits for long-term health as well as weight loss. Because our findings have important implications in the global effort to control rates of obesity and related chronic diseases, further studies are needed to confirm these preliminary results.

Objective: The purpose of this study was to provide an initial assessment of the effectiveness of the high nutrient density (HND) diet on glycemic control and cardiovascular risk factors in participants with type 2 diabetes. Design: This was a retrospective case series study. Participants were 13 adult type 2 diabetic U.S. women and men between the ages of 30 -80 years old. Glycosylated hemoglobin (HbA1C), lipid profile, blood pressure, BMI, and medication requirements before and after commencement of the HND diet were compared. Results: After a median length on the HND diet of 7 months, the mean HbA1C dropped from 8.2% to 5.8% (p = 0.002), with sixty-two percent of participants reaching normoglycemic levels (HbA1C < 6.0%). There was a substantial reduction in mean blood pressure for hypertensive participants (n=10) from a pre-intervention level of 148/87 mmHg to 121/74 mmHg (p = 0.0004 for systolic blood pressure, p = 0.01 for diastolic blood pressure). Triglycerides significantly decreased from a mean of 171 mg/dl to a mean of 103 mg/dl (p = 0.02). The mean HDL increased significantly from 48.3 mg/dl to 54.6 mg/dl (p = 0.03). The mean number of medications dropped from 4 to 1 (p = 0.0006). Conclusions: The HND diet was very effective in controlling glycemic levels and cardiovascular risk factors in 13 participants with type 2 diabetes. Therefore, there is a well-justified need for further study with the HND diet.

Background Worksite dietary interventions show substantial potential for improving employee health and well-being. The aim of this pilot study was to determine the effect of a worksite nutrition intervention on improving well-being. Methods Thirty-five university employees participated in a 6-week nutrition intervention. The dietary protocol emphasized the daily consumption of greens, beans/legumes, a variety of other vegetables, fruits, nuts, seeds, and whole grains, referred to as a micronutrient-dense, plant-rich diet. Participants were encouraged to minimize the consumption of refined foods and animal products. Results Significant improvements in sleep quality, quality of life, and depressive symptoms were found. Conclusions Findings reveal that a worksite nutrition intervention is effective at improving sleep quality, quality of life, and depressive symptoms with a projected improvement in work productivity and attendance.

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This study is a qualitative case series of lifestyle medicine practitioners’ protocols for medication de-escalation in the context of reduced need for glucose-lowering medications due to lifestyle modifications. Increasing numbers of lifestyle medicine practitioners report achieving reductions in medications among patients with type 2 diabetes, and in some cases remission, but limited data exist on the clinical decision-making process used to determine when and how medications are deprescribed. Practitioners interviewed here provide accounts of their deprescribing protocols. This information can serve as pilot data for other practitioners seeking examples of how deprescribing in the context of lifestyle medicine treatment is conducted.

. The results presented from a practice survey include cases of interest, demonstrating improvements in cardiometabolic risk factors utilizing a Nutrient-Dense, Plant-Rich (NDPR) diet. It includes changes in weight, blood pressure, and lipids parameters derived from the survey and retrospective chart review. . Practice records and interviews were used for case history descriptions. Participants' data were collected via an online survey.. Adherence to a NDPR dietary protocol resulted in reduced low-density lipoprotein cholesterol and serum triglycerides. Compliance of greater than 80% with the target diet resulted in an average sustained weight loss of over 50 pounds in 75 obese subjects. There was a corresponding average reduction of 27.8 mm Hg in systolic blood pressure for the 127 survey responders with untreated hypertension at baseline, and a 42.2 mg/dL average decrease in low-density lipoprotein cholesterol for the 328 survey responders, not on cholesterol reducing medications. . The outcomes from both the survey responders and cases demonstrate the potential for the NDPR dietary intervention to improve weight, blood pressure, lipids, and even reverse severe cardiovascular disease. Though this is a report of cases and self-reported benefits, it adds evidence to support the need for further studies investigating the potential of this dietary intervention.