Helsefordeler ved plantebaserte kosttyper

Helsefordeler ved plantebaserte kosthold versus et sunt vestlig kosthold

Plantebasert kosthold, altså kostholdstyper med betydelig mindre kjøtt, egg og melk enn det er i et vanlig norsk kosthold, har fler edokumenterte helsefordeler:

  • Det er konkludert med overbevisende dokumentasjon (evidens grad en) for at vegetarisk kosthold reduserer risiko for å dø av hjerteinfarkt,
  • Plantebaserte kostholdsmønstre kan redusere risiko for livsstilssykdommer som diabetes type 2,
  • Hjerteinfarkt
  • Hjerneslag
  • Hjertesvikt- og karsykdommer,
  • Overvekt og fedme,
  • Flere typer kreft.
  • Mange studier tyder på at plantebasert kost bidrar til økt livslengde og reduserer risikoen for tidlig død fra flere sykdommer.
  • På kort sikt vil plantebasert kosthold gi bedre fordøyelse og bedre restitusjon etter trening

Dette gjelder også hvis man justerer studieresultatene for såkalte konfunderende faktorer, eller forvirrende faktorer som fysisk aktivitet, røyk, overvekt o.a. faktorer som kan påvirke helse. Det er altså ikke slik at vegetarianere har lavere forekomst va diabetes type to, overvekt, hjerteinfarkt, høyt blodtrykk, høyt kolesterol o.a. bare fordi de ellers lever sunnere og spiser sunnere. Et godt eksempel er AHS-2, der man sammenlignet en sunn befolkningsgruppe (syvende dags adventister) som er vegetarianere eller veganere med sunn befolkningsgruppe som ikke er vegetarianere eller veganere.

Verdens største organisasjon for ernæringsfysiologer konkluderte i 2016 med følgende:

Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: vegetarian diets.  J Acad Nutr Diet. 2016;116:1970-1980

It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases.
These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes.
Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage. Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity.

Low intake of saturated fat and high intakes of vegetables, fruits, whole grains, legumes, soy products, nuts, and seeds (all rich in fiber and phytochemicals) are characteristics of vegetarian and vegan diets that produce lower total and low-density lipoprotein cholesterol levels and better serum glucose control. These factors contribute to reduction of chronic disease.

Vegans need reliable sources of vitamin B-12, such as fortified foods or supplements.

Les også: Ulemper ved animalske matvarer – kjøtt, egg, meieriprodukter

Nordiske oppsummeringsartikler

Sara Ask, dietist, Åsa Strindlund, nutritionist. Vegetarisk mat är bra – även för små barn. Läkartidningen. 2014;111:CMEA  Läkartidningen 11/2014 Lakartidningen.se 2014-03-11 (uppdaterad 2014-09-22) http://www.lakartidningen.se/EditorialFiles/EA/%5BCMEA%5D/CMEAny.pdf

«Egentligen borde alla barn äta en stor andel vegetabilier. Helvegetarisk mat är ett bra kostalternativ – även för små barn – och kan ge långsiktiga hälsovinster. Kosten måste dock vara väl sammansatt, med extra observans på vissa näringsämnen.»

Baljit Kaur, klinisk ernæringsfysiolog, M.Sc. Helsefordeler og utfordringer ved vegankoster. Norsk tidsskrift for ernæring http://www.ntfe.no/utgaver/18-nr-1-2014/114-helsefordeler-og-utfordringer-ved-vegankoster

Oppsummeringsartikler

Verdens største forening for ernæringsfysiologer, standpunkt om vegetariske kostholdstyper. Craig WJ, Mangels AR. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc 2009, 109(7):1266-1282; http://www.vrg.org/nutrition/2009_ADA_position_paper.pdf

«The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk ofdeath from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates.»

Kanadisk ernæringsfysiologforening, Eating Guidelines for Vegans, http://www.dietitians.ca/Nutrition-Resources-A-Z/Factsheets/Vegetarian/Eating-Guidelines-for-Vegans.aspx:

«A healthy vegan diet has many health benefits including lower rates of obesity, heart disease, high blood pressure, high blood cholesterol, type 2 diabetes and certain types of cancer.

It may take planning to get enough protein, iron, zinc, calcium, vitamins D and B12 and omega-3 fats from foods or supplements.  A healthy vegan diet can meet all your nutrient needs at any stage of life including when you are pregnant, breastfeeding or for older adults.»

Nordiske myndigheter om vegetarisk kosthold

Vegetarisk kosthold. Helsedirektoratet  https://helsenorge.no/kosthold-og-ernaring/vegetarisk-kosthold/naringsrik-vegetarkost

«Godt sammensatt vegetarkost er ernæringsmessig fullverdig og kan ha positive helseeffekter med tanke på forebygging og behandling av flere sykdommer.
Vegetarkost er forbundet med lavere risiko for blant annet overvekt, hjerte- og karsykdommer, diabetes og kreft. En balansert og variert vegetarkost egner seg for individer i alle livsfaser, inkludert under svangerskap, ved amming, i spedbarnsperioden, for barn og unge og for idrettsutøvere.»
«Godt sammensatt vegetarkost inneholder korn og fullkornsprodukter, bønner, linser, erter, soyaprodukter, grønnsaker, frukt, bær, nøtter, frø og planteoljer. Et slikt kosthold gir mye fiber, vitaminer, mineraler og sporstoffer.»

Vegetarisk mat till barn. Livsmedelverket http://www.livsmedelsverket.se/matvanor-halsa–miljo/kostrad-och-matvanor/barn-och-ungdomar/vegetarisk-mat-till-barn/

«En kost med mycket grönsaker, rotfrukter, baljväxter och fullkorn är bra både för hälsan och miljön. Därför är det bra om barn lär sig tycka om sådan mat i unga år, det ökar chansen för att de ska fortsätta med de vanorna även senare i livet. En helt vegetarisk kost till barn kräver, precis som till vuxna, goda kunskaper om mat och näringsämnen och noggrann planering. Om den vegetariska kosten är väl sammansatt, innehåller berikade produkter och ger tillräckligt med energi kan även barn äta helt vegetarisk mat – veganmat.»

Vegetarisk mat. Livsmedelverket   http://www.livsmedelsverket.se/matvanor-halsa–miljo/kostrad-och-matvanor/vegetarisk-mat-for-vuxna/

«Det finns stora hälsovinster med att äta mycket grönsaker, frukt, baljväxter och annan mat från växtriket. Vegetarianer löper till exempel mindre risk att drabbas av en rad olika sjukdomar, som högt blodtryck, hjärt- och kärlsjukdom och vissa cancerformer.»

Alt Om Kost, Fødevarestyrelsen  http://altomkost.dk/raad-og-anbefalinger/personer-med-saerlige-behov/vegetarer/vegetarmad-og-sundhed/

«Videnskabelige undersøgelser tyder på, at vegetarmad nedsætter risikoen for kroniske sygdomme som fedme, hjerte-kar-sygdomme, forhøjet blodtryk, diabetes, visse former for kræft og nyrelidelser.»

Forskning om vegetarisk/plantebasert kosthold og hjerte- og karsykdommer, kardiometabolske risikofaktorer, noen typer kreft og for tidlig dødelighet

Craig WJ. Health effects of vegan diets. Am J Clin Nutr 2009, 89(5):1627S-1633S; http://ajcn.nutrition.org/content/89/5/1627S.abstract

«Compared with other vegetarian diets, vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease.»

Le LT, Sabaté J. Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients. 2014 May 27;6(6):2131-47. doi: 10.3390/nu6062131. Review. PubMed PMID: 24871675; PubMed Central PMCID: PMC4073139.  http://www.ncbi.nlm.nih.gov/pubmed/24871675

«Vegetarians, those who avoid meat, and vegans, additionally avoiding dairy and eggs, represent 5% and 2%, respectively, of the US population. The aim of this review is to assess the effects of vegetarian diets, particularly strict vegetarian diets (i.e., vegans) on health and disease outcomes. We summarized available evidence from three prospective cohorts of Adventists in North America: Adventist Mortality Study, Adventist Health Study, and Adventist Health Study-2. Non-vegetarian diets were compared to vegetarian dietary patterns (i.e., vegan and lacto-ovo-vegetarian) on selected health outcomes. Vegetarian diets confer protection against cardiovascular diseases, cardiometabolic risk factors, some cancers and total mortality. Compared to lacto-ovo-vegetarian diets, vegan diets seem to offer additional protection for obesity, hypertension, type-2 diabetes, and cardiovascular mortality. Males experience greater health benefits than females.»

Fraser GE. Vegetarian diets: What do we know of their effects on common chronic diseases? Am J Clin Nutr. 2009;89(5):1607S-12S. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677008/

«There is convincing evidence that vegetarians have lower rates of coronary heart disease, largely explained by low LDL cholesterol, probable lower rates of hypertension and diabetes mellitus, and lower prevalence of obesity. Overall, their cancer rates appear to be moderately lower than others living in the same communities, and life expectancy appears to be greater.»

Key TJ, Appleby PN, Rosell MS. Health effects of vegetarian and vegan diets. Proc Nutr Soc. 2006;65:35-41. http://ajcn.nutrition.org/content/89/5/1627S.full

«Recently, vegetarian diets have experienced an increase in popularity. A vegetarian diet is associated with many health benefits because of its higher content of fiber, folic acid, vitamins C and E, potassium, magnesium, and many phytochemicals and a fat content that is more unsaturated. Compared with other vegetarian diets, vegan diets tend to contain less saturated fat and cholesterol and more dietary fiber. Vegans tend to be thinner, have lower serum cholesterol, and lower blood pressure, reducing their risk of heart disease.»

Phillip J Tuso, MD; Mohamed H Ismail, MD; Benjamin P Ha, MD; Carole Bartolotto, MA, RD: Nutritional Update for Physicians: Plant-Based Diets. Perm J 2013 Spring; 17(2):61-66  http://www.thepermanentejournal.org/issues/2013/spring/5117-nutrition.html

«Physicians should consider recommending a plant-based diet to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.»

Appleby PN, Thorogood M, Mann JI, Key TJ. The Oxford Vegetarian Study: an overview. Am J Clin Nutr. 1999;70:525S–531S.

Bradbury KE, Crowe FL, Appleby PN, Schmidt J a, Travis RC, Key TJ. Serum concentrations of cholesterol, apolipoprotein A-I and apolipoprotein B in a total of 1694 meat-eaters, fish-eaters, vegetarians and vegans. Eur J Clin Nutr. Nature Publishing Group; 2013;(April):1–6.

Vegetarisk/plantebasert kosthold og kreft

•Yessenia Tantamango-Bartley, Karen Jaceldo-Siegl,Jing Fan, and Gary Fraser: Vegetarian Diets and the Incidence of Cancer in a Low-risk Population 2013. Cancer Epidemiol Biomarkers Prev; 22(2); 286–94. ©2012 AACR. http://cebp.aacrjournals.org/content/22/2/286.abstract    http://cebp.aacrjournals.org/content/22/2/286.long
•Key TJ, Appleby PN, Crowe FL, Bradbury KE, Schmidt JA, Travis RC. Cancer in British vegetarians: updated analyses of 4998 incident cancers in a cohort of 32,491 meat eaters, 8612 fish eaters, 18,298 vegetarians, and 2246 vegans.  Am J Clin Nutr. 2014 Jul;100 Suppl 1:378S-85S.   doi: 10.3945/ajcn.113.071266. Epub 2014 Jun 4.    http://ajcn.nutrition.org/content/100/Supplement_1/378S.long

Vegetarisk/plantebasert kosthold og hjerte- og karsykdommer

•Academy og Nutrition and Dietetics har konkludert med overbevisende sammenheng mellom vegetarisk kosthold og redusert risiko for å dø av iskemisk hjertesykdom (hjerteinfarkt): Craig, W. J. og Mangels, A. R. Position of the American Dietetic Association: vegetarian diets (2009) J.Am.Diet.Assoc. (109), 7, 1266-1282. http://www.vrg.org/nutrition/2009_ADA_position_paper.pdf
•Pettersen BJ, Anousheh R, Fan J, et al. Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2). Public Health Nutr. 2012;10:1-8.
•Crowe FL, Appleby PN, Travis RC, Key TJ. Risk of ischaemic heart disease among British vegetarians and non-vegetarians: results from the EPIC-Oxford cohort study. Proceedings of the Nutrition Society. 2012.
•Szeto YT, Kwok TCY, Benzie IFF. Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition. 2004;20:863–6.
•Appleby PN, Davey GK, Key TJ. Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford. Public Health Nutr. 2002;5(5):645–54.

Vegetarisk/plantebasert  kosthold og diabetes type to

•Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc
Dis. 2013 Apr;23(4):292-9. doi: 10.1016/j.numecd.2011.07.004. Epub 2011 Oct 7. PubMed PMID: 21983060; PubMed Central PMCID: PMC3638849.  http://www.ncbi.nlm.nih.gov/pubmed/21983060
•Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009;32(5):791-6.  http://www.ncbi.nlm.nih.gov/pubmed/19351712
•Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutrition, Metabolism and Cardiovascular Diseases. 2011.
•Rizzo NS, Sabaté J, Jaceldo-Siegl K, et al. Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2. Diabetes Care. 2011;34(5):1225-7.

Vegetarisk/plantebasert kosthold og overvekt

•Huang RY, Huang CC, Hu FB, Chavarro JE. Vegetarian Diets and Weight Reduction: a Meta-Analysis of Randomized Controlled Trials. J Gen Intern Med. 2015 Jul 3.
[Epub ahead of print] PubMed PMID: 26138004. http://www.ncbi.nlm.nih.gov/pubmed/26138004
•Barnard ND, Levin SM, Yokoyama Y. A systematic review and meta-analysis of changes in body weight in clinical trials of vegetarian diets. J Acad Nutr Diet. 2015 Jun;115(6):954-69. doi: 10.1016/j.jand.2014.11.016. Epub 2015 Jan 22. Review. PubMed PMID: 25620754. http://www.ncbi.nlm.nih.gov/pubmed/25620754
•Kim MK, Cho SW, Park YK. Long-term vegetarians have low oxidative stress, body fat, and cholesterol levels. Nutr Res Pract. 2012;6(2):155-61.
•Rizzo NS, Sabaté J, Jaceldo-Siegl K, et al. Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2. Diabetes Care. 2011;34(5):1225-7.
•Tonstad S, Butler T, Yan R, et al. Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care. 2009;32(5):791-6.

Vegetarisk/plantebasert  kosthold og livslengden

•Michael J. Orlich, MD; Pramil N Singh, DrPH; Joan Sabaté, MD, DrPH; Karen Jaceldo-Siegl, DrPH; Jing Fan, MS; Synnove Knutsen, MD, PhD; W. Lawrence Beeson, DrPH; Gary E. Fraser, MBchB, PhD: Vegetarian Dietary Patterns and Mortality in Adventist Health Study 2. JAMA Intern Med. 2013;173(13):1230-1238. doi:10.1001/jamainternmed.2013.6473.
•Huang T., Yang B.a, Zheng J., Li G.a, Wahlqvist M.L., Li D.: Cardiovascular Disease Mortality and Cancer Incidence in Vegetarians: A Meta-Analysis and Systematic Review. Ann Nutr Metab 2012;60:233–240 (DOI:10.1159/000337301)

Uttalelser fra organisasjoner

•Foreningen for hjerteleger USA, American College of Cardiology, 2014, anbefalte vegansk kosthold til pasienter
•LHL – Landsforeningen for hjerte og lungesyke. Plantebasert kosthold, ved Erik Arnesen, ernæringsfysiolog, master i samfunnsernæring  https://www.lhl.no/spor-eksperten/sporsmal/Plantebasert-kosthold/
•Weight Control the Vegan Way. Vegetarian Resource Group  http://www.vrg.org/journal/vj2006issue1/vj2006issue1weight.htm
•Preventing Osteoporosis: Building Strong Bones Over a Lifetime. Reed Mangels, PhD, RD. Vegetarian Journal 2005 Issue 2 Full Text: http://www.vrg.org/journal/vj2005issue2/vj2005issue2bones.htm  This article explains what osteoporosis is and what vegans can to at every age to reduce their risk of developing it.
•The Vegetarian Society of the United Kingdom. Fact Sheets: Vegetarian and Vegan Diets: http://www.vegsoc.org/page.aspx?pid=784