As the number of subjects choosing vegan diets increases, healthcare providers must be prepared to give the best advice to vegan patients during all stages of life. A completely plant-based diet is suitable during pregnancy, lactation, infancy, and childhood, provided that it is well-planned. Balanced vegan diets meet energy requirements on a wide variety of plant foods and pay attention to some nutrients that may be critical, such as protein, fiber, omega-3 fatty acids, iron, zinc, iodine, calcium, vitamin D, and vitamin B12. This paper contains recommendations made by a panel of experts from the Scientific Society for Vegetarian Nutrition (SSNV) after examining the available literature concerning vegan diets during pregnancy, breastfeeding, infancy, and childhood. All healthcare professionals should follow an approach based on the available evidence in regard to the issue of vegan diets, as failing to do so may compromise the nutritional status of vegan patients in these delicate periods of life.

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A growing number of Italian families are adopting a vegan diet (VD) for their offspring from infancy for various reasons, with health benefits and ethics being the most common reasons. Barriers to effective communication with primary care pediatricians (PCPs) are perceived by many parents and, depending on the actors involved and the environment, a VD may affect social interactions in everyday life. A national cross-sectional survey was conducted between July and September 2020. Parents of children following a VD completed an online questionnaire. Data from 176 Italian parents were collected. About 72% (71.8%) of the children included in this study had been on a VD since weaning. Parents did not inform their primary care pediatricians (PCP) about the VD in 36.2% of the cases. In 70.8% of the cases, PCPs were perceived as skeptical or against a VD. About 70% (71.2%) of the parents relied on medical dietitians, and 28.2% on nutritionists/dietitians for dietary counseling. Parents administered an individual B12 supplement in 87.2% of the cases. To the best of our knowledge, this survey is the first which explores the relationship between vegan parents and their PCPs, the parental management of their children’s diet and problems regarding the implementation of a VD in everyday life.

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A growing number of people are paying more attention to the concept of environmental sustainability, implementing sustainable eating practices to minimize the waste of resources, and the production of waste products related to the food production process. The careful application of sustainable eating practices makes it possible to help the environment, public health, and society by increasing the availability of food and farmland to feed every inhabitant on Earth. Individuals impact the environment through their eating because of three factors: food, energy used in the home, and transport. The most powerful of these factors is food. Animal food production involves a greater use of resources (raw materials, land, water, energy) and produces more pollutants (chemical residues from agriculture, greenhouse gases, manure) than plant-based food. Thus, a lifestyle based on eating plant foods is not only beneficial for the environment, but also protective of a consumer’s health. Alternative practices, such as using renewable energy sources or alternative fuels, however desirable they may be in combination with limiting the consumption of animal foods, are more difficult to implement across society. To change one’s eating habits is, on the other hand, a simple, fast, and inexpensive approach.

We studied the effect of soluble fiber-enriched products on anthropometric and biochemical variables in 30 healthy non-obese, non-diabetic subjects. This was a randomized, controlled crossover, single-blind, dietary intervention study performed for 8 weeks. Subjects received an isocaloric diet with fiber-enriched products for the first 4 weeks and with regular flour products for the following 4 weeks, or vice versa. Weight, height, measures of fat distribution (waist, hip circumference), glucose, insulin and triglycerides were measured at baseline, after 4 and 8 weeks of intervention. BMI and insulin sensitivity indices were calculated. Weight and BMI decreased in the first period of isocaloric diet in both groups, regardless of the type of flour consumed (weight p<0.01, p<0.001 respectively; BMI p = 0.01, p<0.001 respectively). At the end of the 8 weeks, weight and BMI further decreased in the group consuming the fiber-enriched diet (p<0.01). Insulin resistance, estimated with the Homeostasis Model Assessment index and the Lipid Accumulation Product index, improved in all subjects after the fiber-enriched flour diet (p = 0.03, p = 0.02, respectively). In conclusion, an isocaloric diet supplemented with fiber-enriched products may improve measures of fatness and insulin sensitivity in healthy non-obese non-diabetic subjects. We might hypothesize a similar effect also in subjects with metabolic abnormalities.

In recent years, the link between obesity, inflammation and atherosclerosis has attracted increasing interest. Recently, besides the classical inflammatory markers, the competitive nitric oxide synthase antagonist asymmetric dimethylarginine (ADMA) has been shown to be involved in the pathogenesis of atherosclerosis and cardiovascular diseases. Since obese people present a condition of chronic lowgrade inflammation and endothelial dysfunction, in the present study we quantified ADMA levels in uncomplicated obese women (with no clinical, cardiac or metabolic complications) and normal-weight control subjects. We investigated the relationship of ADMA with some anthropometric measurements, abdominal visceral and subcutaneous adipose tissue accumulation, and biochemical and proinflammatory factors of the subjects [interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), IL6-R/IL-6 ratio, tumor necrosis factor alpha (TNFa), homocysteine (Hcy) and plasminogen activator inhibitor-l (PAl-I)]. ADMA and all the other pro-inflammatory parameters resulted.higher in obese patients than in healthy subjects. ADMA significantly correlated with Hey, PAl-I, TNFa and with sIL-6R/IL-6 ratio but not with other anthropometric and biochemical parameters. In a stepwise regression analysis ADMA correlated most closely with Hcy and TNFa. In conclusion, in our obese uncomplicated patients TNFa and Hcy emerged as strong predictors of ADMA which might be a potential mediator of the effects of different risk factors affecting the cardiovascular system.It is now well established that obesity is one of the most important independent risk factors for the development of atherosclerosis and cardiovascular diseases (CD) (1). Chronic immune-mediated inflammation, which involves adipokines, chemokines, cytokines and their receptors, and vascular endothelial cell dysfunction, characterized by a reduced bioavailability ofthe signaling molecule nitric oxide (NO), are both critically involved in the onset and progression of atherosclerosis (1-2).