Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies
Background: There is growing evidence that substituting animal-based with plant-based foods is associated with a lower risk of cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality. Our aim was to summarize and evaluate the evidence for the substitution of any animal-based foods with plant-based foods on cardiometabolic health and all-cause mortality in a systematic review and meta-analysis. Methods: We systematically searched MEDLINE, Embase, and Web of Science to March 2023 for prospective studies investigating the substitution of animal-based with plant-based foods on CVD, T2D, and all-cause mortality. We calculated summary hazard ratios (SHRs) and 95% confidence intervals (95% CI) using random-effects meta-analyses. We assessed the certainty of evidence (CoE) using the GRADE approach. Results: In total, 37 publications based on 24 cohorts were included. There was moderate CoE for a lower risk of CVD when substituting processed meat with nuts [SHR (95% CI): 0.73 (0.59, 0.91), n = 8 cohorts], legumes [0.77 (0.68, 0.87), n = 8], and whole grains [0.64 (0.54, 0.75), n = 7], as well as eggs with nuts [0.83 (0.78, 0.89), n = 8] and butter with olive oil [0.96 (0.95, 0.98), n = 3]. Furthermore, we found moderate CoE for an inverse association with T2D incidence when substituting red meat with whole grains/cereals [0.90 (0.84, 0.96), n = 6] and red meat or processed meat with nuts [0.92 (0.90, 0.94), n = 6 or 0.78 (0.69, 0.88), n = 6], as well as for replacing poultry with whole grains [0.87 (0.83, 0.90), n = 2] and eggs with nuts or whole grains [0.82 (0.79, 0.86), n = 2 or 0.79 (0.76, 0.83), n = 2]. Moreover, replacing red meat for nuts [0.93 (0.91, 0.95), n = 9] and whole grains [0.96 (0.95, 0.98), n = 3], processed meat with nuts [0.79 (0.71, 0.88), n = 9] and legumes [0.91 (0.85, 0.98), n = 9], dairy with nuts [0.94 (0.91, 0.97), n = 3], and eggs with nuts [0.85 (0.82, 0.89), n = 8] and legumes [0.90 (0.89, 0.91), n = 7] was associated with a reduced risk of all-cause mortality. Conclusions: Our findings indicate that a shift from animal-based (e.g., red and processed meat, eggs, dairy, poultry, butter) to plant-based (e.g., nuts, legumes, whole grains, olive oil) foods is beneficially associated with cardiometabolic health and all-cause mortality. https://doi.org/10.1186/s12916-023-03093-1
Dried Fruit Consumption Associated with Lower Risk of Idiopathic Pulmonary Fibrosis
The study included data from 451,025 individuals
In a recent study published in BMC Pulmonary Medicine, researchers conducted a two-sample Mendelian randomization study to investigate the causal relationship between dietary intake and idiopathic pulmonary fibrosis, a chronic progressive interstitial lung disease of unknown cause.
Data on the intake of various types of food were taken from the UK Biobank, while data on idiopathic pulmonary fibrosis came from the EBI database of 451,025 individuals.
Dried fruit intake was found to be associated with a reduced risk of idiopathic pulmonary fibrosis (odds ratio = 0.995). The researchers inferred that this effect could be due to the antioxidant properties of dried fruit. These findings suggest that the consumption of dried fruit could have a preventive effect on idiopathic pulmonary fibrosis.
Zhang, Y., Gan, Y., & Zhang, H. (2023). Dietary intake and incidence risk of idiopathic pulmonary fibrosis: a Mendelian randomization study. BMC Pulmonary Medicine, 23(1), 376.
Specially Formulated Toothpaste May Lower Risk of Allergic Reaction to Peanut
The findings support continued development of the toothpaste for children
A recent study found that a specially formulated toothpaste can be successfully used for oral mucosal immunotherapy in adults with peanut allergy. The abstract for the study was presented by the author, allergist William Berger, MD, at the Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in November.
The study included 32 adults with peanut allergy in a 3:1 ratio of treatment to control. Over the course of the 48-week trial, participants received either an escalating dose of peanut toothpaste or a placebo. Safety was monitored during the up-dosing and maintenance phases, exploratory biomarkers were evaluated, and oral food challenges were conducted.
All subjects in the treatment group consistently tolerated the maximum dose of peanut toothpaste. No moderate or severe systemic reactions were observed. Non-systemic adverse reactions were mostly local (oral itching), mild and transient. Adherence to treatment was 97% and exploratory biomarkers were consistent with an immunologic response.
The results of the study suggest that oral mucosal immunotherapy is a safe and convenient option for individuals with food allergies. The findings also support continued development of the peanut toothpaste in the pediatric population.
Berger, W. (2023). A Randomized, Placebo-Controlled Phase 1 Safety Study of OMIT in Adults with Peanut Allergy. Annals of Allergy, Asthma & Immunology, 131(5), Supplement 2, S231.
Walnut Intake Found to Have Beneficial Effects on Gut Microbial Metabolism
Greater expression of key microbial genes may lower cardiovascular disease risk
A study published in Clinical Nutrition set out to assess the effect of walnut-related modulation of gut microbiota composition on microbiota functionality. Specifically, the researchers characterized the effect on bacterial gene expression of a walnut-enriched diet containing 18% of energy from walnuts (57 grams/day) compared to a fatty acid-matched diet devoid of walnuts and a diet where oleic acid replaced alpha-linolenic acid.
This randomized, crossover, controlled-feeding study included 35 participants, 40% of whom were female. In the first stage, participants were given a standard Western diet for two weeks. Subsequently, participants were given the walnut-enriched diet, the fatty acid-matched diet and the oleic acid diet in random order. Metatranscriptomic analyses were performed as an exploratory outcome.
The results showed greater expression of many bacterial genes following the walnut-enriched diet compared to the fatty acid-matched diet and the oleic acid diet. In particular, greater expression of metabolism-related genes encoding glycine amidinotransferase and arginine deiminase was observed compared to the fatty acid-matched diet. Greater expression of glycine amidinotransferase by Gordonibacter was also observed following the walnut-enriched diet versus the other two diets.
The findings suggest that walnut intake may increase endogenous production of homoarginine through gut microbiota-mediated upregulation of glycine amidinotransferase, which is a novel mechanism by which walnuts may lower cardiovascular disease risk.
This study was funded by the California Walnut Commission.
Petersen, K. S., Chandra, M., Chen See, J. R., Leister, J., Jafari, F., Tindall, A., Kris-Etherton, P. M., & Lamendella, R. (2023). Walnut consumption and gut microbial metabolism: Results of an exploratory analysis from a randomized, crossover, controlled-feeding study. Clinical Nutrition (Edinburgh, Scotland), 42(11), 2258–2269.
Regular Nut Consumption Could Increase Male Fertility
Eating two handfuls of nuts per day improves sperm parameters
A recent systematic review and meta-analysis published in Advances in Nutrition set out to present up-to-date evidence regarding the association between nut intake and fertility outcomes.
The researchers searched the Ovid MEDLINE, Embase, CINAHL and Scopus databases from inception to June 2023. Eligible articles were interventional or observational studies in human subjects of reproductive age (18-49 years) that assessed the effects of nut consumption on fertility-related outcomes for a minimum of three months. Four studies involving 875 participants were included in the review.
Meta-analysis of two randomized controlled trials involving 223 healthy men indicated that consumption of at least 60 grams/day of nuts increased sperm motility, vitality and morphology in comparison to controls. The findings show that including at least two servings of nuts daily as part of a Western-style diet improves sperm parameters, which are predictors of male fertility.
Cardoso, B. R., Fratezzi, I., & Kellow, N. J. (2023). Nut consumption and fertility: a systematic review and meta-analysis. Advances in Nutrition (Bethesda, Md.), 100153. Advance online publication.
Replacing Processed Meat with Nuts May Reduce Cardiovascular Disease Risk by 27%
Switching to nuts is also associated with lower risk of type 2 diabetes and all-cause mortality
In a recent systematic review and meta-analysis published in BMC Medicine, researchers summarized and evaluated the evidence for associations between replacing animal-based foods with plant-based foods and cardiometabolic health and all-cause mortality.
The study included 37 prospective cohort studies based on data from 24 cohorts in the United States, Europe and Asia. The results showed that replacing 50 grams/day of processed meat with 28-50 grams/day of nuts was associated with a 27% reduction in the risk of cardiovascular disease. Replacing 50 grams/day of red or processed meat with 10-28 grams/day of nuts was associated with an 8% and 22% lower risk, respectively, of type 2 diabetes incidence. Moreover, replacing 50 grams/day of red meat with 10-50 grams/day of nuts was associated with a 7% lower risk of all-cause mortality, while replacing 50 grams/day of processed meat with 28-50 grams/day of nuts reduced all-cause mortality by 21%.
These findings suggest that a shift in dietary habits away from animal-based foods —especially red and processed meat— and towards nuts would have an important impact on cardiometabolic health.
Neuenschwander, M., Stadelmaier, J., Eble, J., Grummich, K., Szczerba, E., Kiesswetter, E., Schlesinger, S., & Schwingshackl, L. (2023). Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies. BMC Medicine, 21(1), 404.
November 2023 News Brief
Registration Now Open for the INC Congress in Vancouver
Act now to get the early-bird rate
Registration for the 2024 INC Congress in Vancouver is now officially open! This event promises to be the most exceptional gathering of nut and dried fruit professionals from all over the world, with more than 60 expert speakers and 1,300 attendees. Register now to take advantage of the early-bird rate! [Register now]
Check Out the Latest Issue of the Nutfruit Magazine
November issue available online
This edition of Nutfruit covers a wide range of topics and provides valuable insight into the nut and dried fruit industry. You can read about how the INC is setting the global industry agenda for nut and dried fruit promotion and get a sneak peek at plans for next year’s INC Congress in Canada. In the Feature Articles section, you can read about the 30th anniversary of the INC NREF, blockchain-based traceability practices, fair and sustainable macadamias from rural Kenya, almonds as a key ingredient in cutting-edge edible batteries, and advances in the use of drones and AI for early almond yield forecasting. This issue also features interviews with Michelin-starred chef Sriram Aylur and Christina Chen, Vice Chairman of ChaCha Foods. You can also learn about cashews from West Africa in this edition of the Country/Product Spotlight and read up on the latest industry statistics in our Global Statistical Review. Log in to access the Members Area, and then click on Members Area and Magazine.
INC Participates in UN Agricultural Quality Standards Meeting
Key topics of discussion included the prevention of food loss and food waste
The INC took part in the 78th Session of the UNECE Working Party on Agricultural Quality Standards in Geneva, Switzerland, from November 13-15, 2023. The INC was represented at the event by Mr. Michael Waring, Chairman, Mr. Pino Calcagni, Chairman of the Sustainability, Scientific and Government Affairs Committee, Mrs. Goretti Guasch, Executive Director, and Ms. Irene Gironès, Statistics and Technical Projects Manager. The meeting served as a venue to assess the work of the… [More information]
INC Attends 36th European Trade Meeting in Hamburg
The theme of the meeting was “Paths to Sustainability”
The INC attended the 36th European Trade Meeting, organized by the Waren-Verein der Hamburger Börse e.V., on November 17, 2023, in Hamburg, Germany. The meeting, which focused on the theme of “Paths to Sustainability,” brought together around 100 participants representing companies and organizations in the nut and dried fruit sector across 13 different countries. The INC was represented by Mr. Michael Waring, INC Chairman, Mr. Pino Calcagni, Chairman of the INC Sustainability… [More information]
INC Participates in Scientific Conference for the Tree Nut Sector in Italy
The event featured 20 presentations by experts from some of Italy’s most prestigious academic institutions
In late October, the INC took part in the “Giornate Scientifiche SOI per il Comparto della Frutta a Guscio,” a scientific conference focused on the tree nut sector. The event was hosted by the Edmund Mach Foundation, a training, research and technology-transfer center in northern Italy that boasts approximately 700 collaborators, including food technicians, scientists, professors, researchers and farmers involved primarily in tree nuts and vine fruit. The INC was represented… [Read more]
Replacing Red Meat with Nuts Is Associated with Lower Diabetes Risk
Study underscores the importance of nuts as an alternative source of protein
A new study published in the American Journal of Clinical Nutrition assessed the relationships between intakes of total, processed and unprocessed red meat and risk of type 2 diabetes and estimated the effects of replacing red meat with healthy plant-based protein sources, including nuts and legumes. The prospective cohort study looked at health data from 216,695 participants in the United States, of whom 81% were women. Diet was assessed with food frequency questionnaires every two to four years, for up to 36 years… [Read more]
Almond-Enriched Diet Leads to Weight Loss and Supports Cardiometabolic Health
Participants who ate almonds saw greater improvements in key lipoprotein subfractions
A recent study published in Obesity evaluated weight and cardiometabolic outcomes after a three-month energy-restricted diet (−30%) containing either almonds or carbohydrate-rich snacks (phase 1), followed by six months of weight maintenance (phase 2). This nine-month, randomized controlled, parallel-arm dietary intervention included 140 overweight or obese participants. Participants were randomly assigned to eat either an almond-enriched diet (in which 15% of their energy intake comprised unsalted whole almonds with skins) or a nut-free control diet… [Read more]
Tree Nut Consumption Associated with Decreased Prevalence of Cardiovascular Disease
Other benefits included lower cardiometabolic risk factors
A recent study published in Current Developments in Nutrition set out to estimate the usual tree nut intake of a nationally representative sample of US adults and examine the association between tree nut consumption and cardiometabolic health outcomes. The study sample included 18,150 adults over 20 years of age who had participated in the 2011–2018 National Health and Nutrition Examination Survey (NHANES). Participants’ usual tree nut intake was estimated using the National Cancer Institute Method. Approximately 8% of… [Read more]
European Parliament Adopts Position on Packaging and Packaging Waste Legislation
The text includes some exemptions from reuse obligations
On November 22, 2023, the European Parliament adopted its position on new EU-wide rules on packaging and packaging waste. Under the Parliament-approved text, packaging that is in direct contact with food would be exempt from reuse obligations. The revamped text will become the Parliament’s mandate for negotiations with EU governments, once the Council has adopted its position. [Read more]
INC Shares Latest Sustainability News
The latest INC sustainability update includes information about the publication of the Food and Agriculture Organization’s annual flagship report, the European Parliament’s rejection of a Commission proposal on the sustainable use of plant protection products, and Brazil’s decision to incorporate the IFRS Sustainability Disclosure Standards into its regulatory framework. [Read more]
International Trade News Monitored by INC
The INC’s latest installment of trade news includes an update on the free trade agreement signed by China and Serbia, European Union’s amendment of the regulation on tariff and statistical nomenclature and on the Common Customs Tariff, the Specialty Crops Reporting on Opportunities and Promotion Act (Specialty CROP Act) introduced in the US Congress, and more. [Read more]
INC Provides Updates on Food Safety News
The INC’s latest update on food safety covers the publication of the FAO/WHO recommended allergic threshold values for Brazil nuts, macadamias and pine nuts, the European Commission’s intention to proceed with the renewal of the approval of glyphosate for a 10-year period, the publication of the Turkish Food Codex Contaminants Regulation in the country’s official gazette, and more. [Read more]
INC Monitors Marketing Standards and Labeling News
The INC’s latest update on marketing standards and labeling focuses on the publication of new marketing standards for the fruit and vegetables sector. New requirements under this regulation include the extension of origin labeling to some products that used to be exempted. [Read more]
European Parliament Adopts Position on Packaging and Packaging Waste Legislation
The text includes some exemptions from reuse obligations
On November 22, 2023, the European Parliament adopted its position on new EU-wide rules on packaging and packaging waste. Under the Parliament-approved text, packaging that is in direct contact with food would be exempt from reuse obligations.
The revamped text will become the Parliament’s mandate for negotiations with EU governments, once the Council has adopted its position.
As reported by FRUCOM, the relevant changes introduced in the Parliament-approved draft are as follows:
Article 22, Annex V, row 1
| Text proposed by the Commission | ||
| Single-use plastic grouped packaging | Plastic packaging used at retail level to group goods sold in cans, tins, pots, tubs, and packets designed as convenience packaging to enable or encourage end users to purchase more than one product. This excludes grouped packaging necessary to facilitate handling distribution. | Collation films, shrink wrap |
| Amendment adopted | ||
| Single-use plastic grouped packaging | Plastic packaging used at the point of sale to group goods sold in cans, tins, pots, tubs, and packets designed as convenience packaging to enable or encourage consumers to purchase more than one product. This excludes grouped packaging necessary to facilitate handling in business-to-business distribution. | Collation films, shrink wrap |
Article 26, Paragraph 12, Subparagraph 1, Introductory Part
| Text proposed by the Commission |
| Transport packaging used by an economic operator shall be reusable where it is used for transporting products: |
| Amendment adopted |
| From 1 January 2030, 95% of the transport packaging used by an economic operator shall be reusable where it is used for transporting products: |
Article 26, Paragraph 13, Subparagraph 1
| Text proposed by the Commission |
| Economic operators delivering products to another economic operator within the same Member State shall use only reusable transport packaging for the purpose of the transportation of such products. |
| Amendment adopted |
| From 1 January 2030, economic operators, including online platforms, delivering products to another economic operator within the same Member State shall use only reusable transport packaging for the purpose of the transportation of such products. |
Article 26, Paragraph 15 b (new)
| Amendment adopted |
| Economic operators shall be exempted from the obligation to meet the targets laid down in paragraphs 7, 12 and 13 of this Article for all transport packaging that is in direct contact with food as defined in Regulation (EC) No 178/2002 and feed. |
For more information, see the full text approved by the Parliament and the Parliament’s press release.
Food Safety Update: November 2023
FAO/WHO: Recommended Threshold Values for Food Allergens
The report on the fifth meeting of the ad hoc FAO/WHO Expert Committee on Food Allergens was recently published. The report establishes maximum safe limits for Brazil nuts, macadamias and pine nuts, among other food products.
EU: Commission Expected to Renew Approval of Glyphosate for 10 Years
On November 16, 2023, the EU Member States failed to reach the required qualified majority to renew or reject the approval of glyphosate during a vote at the Appeal Committee. This follows a vote at the Standing Committee on Plants, Animals, Food and Feed (SCOPAFF) on October 13, in which Member States also failed to reach the required majority to renew or reject the proposal. In a statement, the European Commission said that it intended to “proceed with the renewal of the approval of glyphosate for a period of 10 years, subject to certain new conditions and restrictions,” including a prohibition of pre-harvest use as a desiccant and the need for certain measures to protect non-target organisms.
EU: Committee Approves Methods of Sampling and Analysis for Mycotoxins
In a meeting on September 22, 2023, the Standing Committee on Plants, Animals, Food and Feed, Section Novel Food and Toxicological Safety, approved a draft Commission Implementing Regulation laying down the methods of sampling and analysis for the control of the levels of mycotoxins in food and repealing Regulation (EC) No 401/2006.
EU: Non-Renewal of Approval of Triflusulfuron-Methyl
The European Commission published Implementing Regulation (EU) 2023/2513 of 16 November 2023 concerning the non-renewal of the approval of the active substance triflusulfuron-methyl, in accordance with Regulation (EC) No 1107/2009 of the European Parliament and of the Council, and amending Commission Implementing Regulation (EU) No 540/2011.
EU: Changes in Substances and Food Additives Authorized for Use in Organic Production
The European Commission published Implementing Regulation (EU) 2023/2229 of 25 October 2023 amending and correcting Implementing Regulation (EU) 2021/1165 authorizing certain products and substances for use in organic production and establishing their lists. The changes affect the following substances: chitosan, chitosan hydrochloride, ascorbic acid, lecithins, sodium tartrates, potassium tartrates and potassium sodium tartrate.
Türkiye: Food Codex Contaminants Regulation
The Turkish Food Codex Contaminants Regulation was published in Türkiye’s official gazette on November 5, 2023. This regulation establishes maximum limits for certain contaminants in food products and sets out the responsibilities of food business operators to determine, prevent, reduce and eliminate sources of risk.
Latest Trade News and Agreements: November 2023
China-Serbia: Free Trade Agreement
China and Serbia signed a free trade agreement on October 17, 2023. In order for the agreement to enter into force, the two sides must now complete their respective domestic procedures.
China: Update on Peanut Exporting Facility Registration Process
A recent USDA GAIN report provided an update on China’s requirements regarding the registration of facilities that export peanuts to China. The General Administration of Customs of the People’s Republic of China (GACC) Department of Animal and Plant Quarantine (DAPQ) requires that facilities that export peanuts (raw/uncooked, shelled or in-shell) be registered with GACC prior to product shipment.
EU: Amendment of Regulation on Tariff and Statistical Nomenclature and on Common Customs Tariff
Commission Implementing Regulation (EU) 2023/2364 of 26 September 2023 amending Annex I to Council Regulation (EEC) No 2658/87 on the tariff and statistical nomenclature and on the Common Customs Tariff was published in the Official Journal of the European Union on October 31, 2023. The amendment shall apply from January 1, 2024.
EU: Proposal for a Regulation on Combating Late Payment in Commercial Transactions
The European Commission has introduced a proposal for a regulation on combating late payment in commercial transactions. This regulation would cap payment terms at 30 days for B2B transactions.
Spain: First Spanish Companies Authorized to Export Almond Kernels to China
The agricultural cooperatives Unió Nuts and Dcoop have been approved by the Chinese government to export almond kernels to China, becoming the first Spanish companies authorized to do so. This milestone comes after the Spanish Ministry of Agriculture signed an agreement in March with the Chinese General Administration of Customs that sets out the conditions for exporting Spanish almonds to China.
US: Proposed Legislation to Help Farmers Fight Through Trade Barriers
On November 14, 2023, a bipartisan group of Congress members introduced a bill intended to help farmers fight through trade barriers and sell more specialty crops —including tree nuts and dried fruits— in foreign markets. The Specialty Crops Reporting on Opportunities and Promotion Act (Specialty CROP Act) responds to continued high tariffs, burdensome labeling requirements and other trade barriers that restrict US products from accessing foreign markets.