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Plant-based diets have become popular as a means of reducing the environmental footprint of the diet and promoting human health and animal welfare. Although the percentages of vegetarians and vegans are low compared to omnivores, their numbers have increased significantly in the last years. The use of non-animal food products other than meat alternatives is also increasing and this tendency constitutes an opportunity for the food industry. In this review, we present that plant-based meat and milk alternatives are consolidated but that there is a niche for egg, seafood alternatives, and new products which may not resemble any traditional animal food. However, not all animal food substitutes are sustainable and some of them are even ultra-processed. In addition, there are concerns on safety and labeling, and consumers demand clear information and regulation. The challenges in this field are connected with food design and technology, sensory science, nutrition, and dietetics. Moreover, adequate selection and combination of foods is important in order to achieve consumer acceptance while preventing nutritional deficiencies in those who choose this type of diet.

Vitamin B12 is an essential nutrient that is not made by plants; consequently, unfortified plant-based foods are not a reliable supply. Recent estimates suggest high rates of vitamin B12 deficiency among the vegetarian and vegan populations, particularly in pregnant women or women of child-bearing age who, for ethical and health reasons, are shifting towards higher consumption of plant-based foods in ever-increasing numbers. Vitamin B12 plays crucial metabolic roles across the life-course and in particular during pregnancy and in early development (first 1000 days of life). Evidence now implicates vitamin B12 deficiency with increased risk to a range of neuro, vascular, immune, and inflammatory disorders. However, the current UK recommended nutrient intake for vitamin B12 does not adequately consider the vitamin B12 deficit for those choosing a plant-based diet, including vegetarianism and in particular veganism, representing a hidden hunger. We provide a cautionary note on the importance of preventing vitamin B12 deficits for those individuals choosing a plant-based diet and the health professionals advising them.

Background Diet was a potentially modifiable factor in the prevention of depression. We aimed to investigate associations of an overall plant-based diet index (PDI), a healthful PDI (hPDI), and an unhealthful PDI (uPDI) with the prevalence of depression. We hypothesized that plant-based diets especially the hPDI may be associated with lower depression, whereas uPDI would increase the depression. Methods This is a cross-sectional study using data from the US National Health and Nutrition Examination Survey 2005–2018. Diet was assessed by 24-hour recalls. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). Odds ratios (ORs) and percentage changes (%) were calculated by logistic regression and linear regression, respectively. Results Among the 31,622 participants aged 20 years or older, the age-standardized prevalence of major depression (PHQ-9 score ≥ 10) was 8.8% ( n  = 2,744). The overall PDI was not associated with odds of depression (OR comparing extreme quintiles 0.84, 95% confidence interval [CI]: 0.66–1.07; p trend =0.168), whereas it was associated with lower PHQ-9 scores in multiple linear regression ( β =-0.07, 95%CI: -0.13, -0.02, p trend =0.045). Participants with higher hPDI scores had lower odds of depression (OR = 0.69, 95%CI: 0.55, 0.87, p trend = 0.007) and lower PHQ-9 scores ( β =-0.07, 95%CI: -0.14, 0.00, p trend = 0.013). Conversely, higher uPDI scores were positively associated with prevalence of depression (OR = 1.78, 95%CI: 1.44–2.20, p trend < 0.001) and PHQ-9 scores ( β  = 0.19, 95%CI: 0.14, 0.24, p trend < 0.001). Conclusions Plant-based diets, especially when they are enriched with healthier plant foods, may be beneficial for primary prevention of depression. However, plant-based diets that emphasize less healthy plant foods are associated with higher depression levels among US adults.

Consumers are increasingly interested in decreasing their dietary intake of animal-based food products, due to health, sustainability, and ethical concerns. For this reason, the food industry is creating new products from plant-based ingredients that simulate many of the physicochemical and sensory attributes associated with animal-derived foods, including milk, eggs, and meat. An understanding of how the ingredient type, amount, and organization influence the desirable physicochemical, sensory, and nutritional attributes of these plant-based foods is required to achieve this goal. A potential problem with plant-based diets is that they lack key micronutrients, such as vitamin B12, vitamin D, calcium, and ω-3 fatty acids. The aim of this review is to present the science behind the creation of next-generation nutritionally fortified plant-based milk substitutes. These milk-like products may be formed by mechanically breaking down certain plant materials (including nuts, seeds, and legumes) to produce a dispersion of oil bodies and other colloidal matter in water, or by forming oil-in-water emulsions by homogenizing plant-based oils and emulsifiers with water. A brief overview of the formulation and fabrication of plant-based milks is given. The relationship between the optical properties, rheology, and stability of plant-based milks and their composition and structure is then covered. Approaches to fortify these products with micronutrients that may be missing from a plant-based diet are also highlighted. In conclusion, this article highlights how the knowledge of structural design principles can be used to facilitate the creation of higher quality and more sustainable plant-based food products.

Purpose This observational study aimed to examine the relationship between three plant-based diet (PBD) indices and the risk of all-cause and cardiovascular disease (CVD) mortality in patients with sarcopenia. Methods Adults with sarcopenia from the 1999–2006 and 2011–2018 National Health and Nutrition Examination Survey were included. A total plant-based diet index (PDI), a healthful PDI (hPDI) and an unhealthful PDI (uPDI) were created based on 17 food groups and were assessed for their associations with all-cause and CVD mortality risk using Cox proportional hazards regression models, restricted cubic spine analysis, and interaction analysis. Results A total of 684 (222 from CVD) deaths were documented in 2218 participants (mean age 51.36 years; 53.90% men) during a median follow-up of 117 months. Compared with the lowest quartile, the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause mortality in the highest quartile were 0.49 (0.33–0.75) for total PDI, 0.27 (0.19–0.39) for hPDI, and 1.85 (1.30–2.65) for uPDI. Similarly, for CVD mortality, the HRs and 95% CIs in the highest quartile were 0.29 (0.12–0.69) for total PDI, 0.30 (0.18–0.50) for hPDI, and 2.65 (1.21–5.77) for uPDI, compared to the lowest quartile. The protective associations of hPDI with all-cause and CVD mortality were more pronounced in participants younger than 45 years. Conclusion Higher adherence to PDI and hPDI is associated with a lower risk of all-cause and CVD mortality, whereas higher adherence to uPDI is linked to an increased risk of mortality in US adults with sarcopenia.

Plant-based foods are increasing in popularity as more and more people are concerned about personal and planetary health. The consumption of plant-based dairy alternatives (PBDAs) has assumed a more significant dietary role in populations shifting to more sustainable eating habits. Plant-based drinks (PBDs) made from soya and other legumes have ample protein levels. PBDs that are appropriately fortified have adequate levels of important vitamins and minerals comparable to dairy milk. For the PBDs examined, the greenhouse gas emissions were diminished by 59–71% per 250 mL, and the land use and eutrophication impact was markedly less than the levels displayed by dairy milk. The water usage for the oat and soya drinks, but not rice drinks, was substantially lower compared to dairy milk. When one substitutes the 250 mL serving of dairy milk allowed within the EAT Lancet Planetary Health Diet for a fortified plant-based drink, we found that the nutritional status is not compromised but the environmental footprint is reduced. Combining a nutrient density score with an environmental index can easily lead to a misclassification of food when the full nutrition profile is not utilized or only a selection of environmental factors is used. Many PBDAs have been categorized as ultra-processed foods (UPFs). Such a classification, with the implied adverse nutritional and health associations, is inconsistent with current findings regarding the nutritional quality of such products and may discourage people from transitioning to a plant-based diet with its health and environmental advantages.

Concerns about environmental impact and sustainability, animal welfare, and personal health issues have fueled consumer demand for dairy alternatives. The aim of this study was to conduct a cross-sectional survey of plant-based non-dairy beverages from three different continents (USA, Australia, and Western Europe) to assess their nutritional content and health profile. A total of 148 non-dairy beverages were analyzed from the nutrition label and ingredients listed on the commercial package or from the information located on the website of the manufacturer or retailer. The different types of beverages were extracts of nuts or seeds (n = 49), grains (n = 38), legumes (n = 36), coconut (n = 10), and mixed blends (n = 15). On average, the plant-based beverages generally scored well in terms of not containing high levels of sodium, saturated fat, or calories. Over half of the beverages were fortified with calcium to levels equal to or greater than that of dairy milk. The protein content varied from 0 to 10 g/serving. Levels of vitamin D and B12 fortification were quite low. Consumers should be informed of the nutritional profile and potential health benefits of plant-based dairy alternatives as the nutritional content can vary greatly between the different types of beverages.

The great environmental impact of increasing animal product consumption requires the willingness to reduce or to substitute meat consumption. A possible substitute product, plant-based meat substitute, is made from plants and offers a sensory experience similar to conventional meat. In this narrative review, we focus on the consumer acceptance of plant-based meat alternatives. We searched for peer-reviewed studies in SCOPUS and Web of Science (WoS) up to December 2021. Of all 111 records identified, 28 were eligible, and, thus, included in this narrative review. The results imply that established consumer behavior has complex socio-economic implications for the adoption of plant-based meat substitutes. Plant-based meat was consistently rated more favorably than other meat substitute products, but sensory and nutritional implications still exist. Environmental and health-related factors may contribute to the market spread of plant-based meat substitutes, but these factors alone are not sufficient. Furthermore, so far there is no information available about how the hypothetical measurements used in the studies (such as willingness to pay) will translate to real life consumer behavior. Despite these barriers, there is certainly a great market potential for plant-based meat alternatives, which is expected to be more pronounced in the future, with increasing environmental and health awareness.

Only a few studies have investigated the association between psychological stress and the healthfulness of plant-based diets while accounting for variances in age groups and regions. In light of this, this study aimed to identify the food groups that contribute the most to the relationship between the healthfulness of plant-based diets and psychological stress in female students in Saudi Arabia. This cross-sectional study, which included 401 female college students aged 19–35 years, collected data on blood, anthropometric indices, the perceived stress scale-10 (PSS-10) and diet using the Saudi food frequency questionnaire. An overall plant-based diet index (PDI), healthy PDI, and an unhealthy PDI (uPDI) were defined. Multiple linear regression analyses were applied to examine the associations between PSS-10 and PDI and hPDI and uPDI. No associations between the PSS-10 score and the overall PDI or uPDI scores were found; however, a six-point higher hPDI score was associated with a 0·16-point lower PSS-10 score (95 % CI, –0·24, –0·08) after controlling for lifestyle factors. Moreover, adjustments for healthy food groups, including vegetables and fruits, attenuated the association between the hPDI and PSS-10. In conclusion, healthy plant-based diets are associated with lower psychological stress in young Saudi women. This finding highlights the importance, especially for female students, of following diets that are not only plant-based but are also healthy and rich in fruits and vegetables.

Purpose Recent evidence suggests that plant-based diets may reduce the risk of breast cancer (BC). However, the macronutrient composition of plant-based diets and its potential impact on BC risk has not been well explored. This analysis investigated the association of macronutrient composition with BC risk across a spectrum of plant-based diet indexes using a multidimensional approach. Design This study followed 64,655 participants from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l’Education Nationale (E3N) cohort from 1993 to 2014. Diets were evaluated using validated 208-item diet history questionnaires at baseline (1993) and follow-up (2005), to calculate adherence to the overall plant-based diet (PDI), healthful plant-based diet (hPDI), and unhealthful plant-based diet (uPDI). The association of macronutrient composition with BC risk was assessed via generalized additive time-dependent Cox models across different levels of these indexes. Response surfaces were generated to visualize compositional associations at the 25th, 50th, and 75th percentile of each index (low, moderate, and high). Results A total of 3,932 incident BC cases were identified during the 21-year follow-up. There was a significant association between macronutrient composition and BC risk for hPDI, uPDI, and PDI (all P  < 0.001). Akaike information criterion favored the hPDI model for characterizing the association between macronutrients and BC. BC risk was highest for individuals with a lower hPDI score who also consumed a diet containing lower protein (10%), lower carbohydrate (35%), and higher fat (55%). The lowest risk of BC was observed in those with higher hPDI scores with the lowest intake of protein (10%). At higher PDI and uPDI, diets containing higher protein (30%) and fat (45%) had the highest BC risk. Conclusion These results demonstrate a complex relationship between macronutrient composition, plant-based diet quality, and BC risk. Further research is needed to examine specific foods that may be driving these associations. Registry The protocol is registered at clinicaltrials.gov as NCT03285230.