As the demand for plant-based meat analogues (PBMAs) continues to surge globally, understanding the marketing strategies that drive consumer choice becomes imperative(1). This research project, part of a larger study at Massey University, explores the design and packaging of vegan food products, specifically focusing on processed PBMAs and how this influences vegan diet consumption choices in New Zealand vegans. We examined the packaging of vegan processed food available in New Zealand supermarkets and those promoted online, with a focus on processed PBMAs. This informed the development of an online survey including: demographics, motivations for following a vegan diet, and questions related to perceptions and preferences about vegan diets and processed PBMA packaging. The survey was offered to individuals who had previously participated in vegan research at Massey University and followed a strict vegan diet. There were 235 participants of whom 198 completed the survey. This consisted of primarily females (n = 156, 74%) and individuals of New Zealand European descent (n = 159, 71%), aged 18 to 76 years (37.8 ± 12.3). The participants had varying durations of following a vegan diet, with the largest group (n = 87, 42%) adopting it for 5 to 10 years. The primary motivation for following a vegan diet was animal welfare (n = 205), followed by environmental concerns (n = 189) and health (n = 175). Participants were able to select more than one option, suggesting there are often multiple reasons for choosing to follow a vegan diet. Factors influencing purchase decisions for PBMAs included nutrient claims on packaging, with protein having the highest positive influence. Environmental concerns also played a significant role, with eco-friendly packaging and positive environmental claims being important. Packaging images, particularly of the final prepared product, had a significantly positive impact on purchasing decisions (4.12 ± 0.78) where 1 represented a negative influence and 5 represented a positive influence on a Likert Scale. The majority sometimes, or always checked the nutrition information panel (n = 167, 85%) and examined the ingredients (n = 191, 98%). Participants reported concern about the nutritional value of processed PBMAs (n = 94), and reported that they are aware that these foods are classified as ‘ultra-processed (n = 91). This research provides valuable insights into the reasons people choose vegan diets and what influences their choices when it comes to purchasing PBMAs. It highlights the significance of marketing strategies in the plant-based meat alternatives industry. However, to gain a more comprehensive understanding of this evolving market, further research is necessary. Future research should consider a wider range of demographics and regional distinctions to better understand how consumer preferences in plant-based diets are changing. This should also include looking at how the market is maturing, with buyers becoming more aware of things like nutrients and the processing of food, which can impact the sustainable food choices individuals make.

The popularity of a vegan diet is growing worldwide. Data analysed from the 2018 NZ Attitudes and Values study showed that 1.1% of New Zealanders followed a vegan diet(1). Though there are potential nutrient deficiencies in a vegan diet, it is generally accepted that a vegan diet, with its emphasis on a variety of vegetables, fruit, grains, legumes, and pulses, has greater metabolic benefits than a Western-style diet high in red meat and processed foods and lower in plants(2). This observational cross-sectional study aimed to explore the dietary intake (4-day food diary) and metabolic health status (including anthropometry, blood pressure, lipids, body fat percentage, omega-3 index and glycaemic control) of adults who had been consuming a vegan diet for 2+ years. Participants (N = 212) were predominantly female (N = 155) with a mean (SD) age of 39.5 (12.4) years. Mean cardiometabolic markers of systolic and diastolic blood pressure, BMI, waist circumference, HbA1c, total cholesterol, LDL-cholesterol, HDL-cholesterol, Chol:HDL ratio and triglycerides were all below the thresholds for disease risk. Omega-3 index results <4% placed most participants (86.3%) in the high-risk category for heart disease. Many female participants (71%) had >30% body fat, compared to 5.3% of males. With reference to the AMDR (total fat 20-35%, carbohydrate 45-65% and protein 15-25%), the intake of total fat was at the upper end (males 34.4%, females 35.9%), carbohydrate was at the lower end (males 46.2%, females 44.7%), and protein was below the lower end (males 14.9%, females 14.2%). Saturated fat intakes ranged from 4.0-65.9 g/d, with a mean (SD) of 24.9 (10.5) g/d for males and 20.2 (9.9) g/d for females. The mean (SD) dietary fibre intake was much higher than the AI set by the Ministry of Health of 25g/d for females and 30g/d for males, at 55.0 (17.8) g/d for males and 43.4 (12.8) g/d for females, ranging from 10.9-133.9g/d. This is the first New Zealand study to examine the metabolic health and dietary intake of adult vegans. The results of cardiometabolic health markers indicate that the vegan diet confers cardioprotective benefits. However, the low Omega-3 index of most participants is concerning, which warrants longitudinal research to assess the level of risk conferred by a low Omega-3 index result in a population with no other cardiometabolic risk factors. The findings of the present study may help guide the growing New Zealand vegan community towards a nutritionally optimal vegan diet.

The adoption of dietary patterns emphasising higher intakes of plant foods and lower intakes of animal foods (plant-based diets, PBDs), continue to rise worldwide. PBDs have been associated with a lower risk of cardiovascular morbidity and mortality as well as major risk factors such as overweight/obesity and type 2 diabetes. Evidence regarding the dietary profile and disease risk associated with various PBDs in comparison to traditional meat-eating diets are scarce within the Australian population. The aim of this study is to investigate the 5-year and 10-year risk of developing cardiovascular disease (CVD) among Australians habitually following various PBDs compared to a regular meat diet (RMD). The Plant-based Diet (PBD) Study is a cross-sectional study consisting of healthy adults between aged 30-75 years from the Hunter Region (NSW) between 2021-2023. A validated FFQ was used to assess eligibility and categorise individuals who were habitually consuming one of five dietary patterns for at least 6 months into the following groups: vegan (nil animal products), lacto-vegetarian (LOV, including eggs and dairy), pesco-vegetarian (PV, including seafood with/without dairy and eggs), semi-vegetarian (SV, minimal consumption of animal products) or RMDs (including animal meat daily or multiple times/day)(1). 5-year and 10-year CVD risk was quantified using the Framingham Risk Equation(2) and the Australian Absolute CVD risk calculator, respectively. CVD risk and other quantitative measures was compared using One-way ANOVA or Kruskal Wallis, and Chi-square or Fisher’s Exact for qualitative data. Directed acyclic graphs displayed confounding variables and mediators and a regression model was used to adjust for these. A total of 240 participants (median age 55(16), 77.5% female) with 48 participants in each group showed a significant difference in predicted 5-year risk of CVD (P<0.05), however 10-year risk did not significantly differ across groups. 5-year CVD risk was significantly lower in the vegan group (1%) compared to the RMD, SV, PV, and LOV diet groups (all 2%). In comparison to a vegan diet, crude association showed those consuming a RMD had a 2.4% (95% CI 0.7, 4.1) higher 5-year risk of developing CVD, followed by 1.7% in LOV (95% CI 0.6, 2.9), 1.8% in PV (95% CI 0.5, 3), and 1.1% in SV (95% CI 0.2, 2.1). Significance was lost after adjusting for confounders such as age, gender, smoking status, alcohol intake, physical activity levels and BMI. This is the first study to purposefully sample Australians habitually following PBD, presenting novel population-based evidence for CVD risk. These findings suggest more restrictive PBDs such as vegan diets when compared to RMD may lead to lower CVD risk, however population-based longitudinal studies primary investigating the development of CVDs in the context of PBDs are warranted.

The fundamental principle of veganism is to avoid all possible animal exploitation and therefore, animal ethics has always been a primary motivator. Nowadays, the environment and health are also common motivators. Omission of all animal products leads to dietary exclusion of vitamin B12, limited intake of omega-3 fatty acids, specifically EPA and DHA, and intake of low bioavailable iron sources1. Obtaining the knowledge to appropriately plan and replace nutrients through food or supplementation is key to avoiding deficiencies and subsequent consequences. This study aimed to determine the effect of motivation for being vegan on intake of key nutrients and nutritional knowledge. This cross-sectional, observational study recruited participants, who had followed a vegan diet for minimum 2 years. Demographics and nutrition knowledge were obtained from questionnaires. Motivation type was determined using the validated vegetarian eating motives inventory (VEMI) – participants scored the importance of animal ethic, environment and health. Intakes of vitamin B12 and iron, were collected using a 4-day food diary and assessed against Estimated Average Requirement (EAR). Blood samples were taken to determine status of vitamin B12, haemoglobin, serum ferritin, and omega-3 index. Omega-3 index score ≤4 indicates increased risk of coronary heart disease. Animal ethics was the greatest motivator to become vegan, with 83.5% of participants scoring it as very important, compared to 71.7% of people stating the environment, and 53.3% stating health. No association was found between all motivation types and intake of vitamin B12 and iron, nor omega-3 index. Mean vitamin B12 intake (supplements excluded) of 2.11ug/day ± 3.43 exceeded the EAR of 2.0ug/day for both men and women, however intakes ranged between 0.00 and 37.63ug/day. Mean intake of iron (18.77mg/day) exceeded the EAR for both men and women. Overall mean omega-3 index was 3.16%. Both men (162.24g/L) and women (151.44g/L) had adequate mean Hb serum concentrations. Mean serum ferritin was within normal range for both men (64.86ug/L ± 43.48) and women (32.55ug/L ± 26.04). Overall mean serum vitamin B12 was within normal range (316.54pmol/L ± 146.18), however a large range was observed from 72.00pmol/L to 1,015pmol/L. Males and females had similar knowledge, with only one question regarding fibre content in cornflakes found to be significantly different (P = 0.012). Knowledge was varied e.g., 100% of participants could identify that pasta was a carbohydrate source, yet could not identify which fats are most important to reduce. Mean vitamin B12 intake exceeding EAR and normal status despite limited vegan sources, indicates high consumption of high bioavailable fortified foods, and supplementation. Iron status shows large consumption of iron rich foods to overcome bioavailability issues, reflected by adequate iron intake, after increasing EAR by 80% to meet recommendations. The mean omega-3 index shows a low cardioprotective omega-3 fatty acid intake.

As concerns grow about the impact of animal farming on the environment, the appeal of plant-based diets has increased(1). The most extreme of these diets is the vegan diet which excludes all animal and insect sourced products. The vegan diet is often lauded as being beneficial for cardiovascular health, with the exclusion of saturated fats from animal meats, and the high intake of fibre from fruit and vegetables. More lately, however, there has been an exponential increase in the availability of vegan ultra-processed (UPFs), ready to eat foods which may not be so heart healthy. This study aimed to audit the vegan-labelled, plant-based meat and dairy analogues (PBMAs and PBDAs) available in New Zealand supermarkets. The objective was to compare the nutrient content against foods of animal origin that these products emulate. The audit was completed between March and June 2022 using a combination of on-site data collection and online sources. Data were collected from New Zealand’s five major supermarkets, Countdown, Fresh Choice, New World, Pak’nSave and Four Square. The audit recorded vegan and plant-based labelled products imitating animal meats (chicken, mince, beef, sausage, burgers, bacon, nuggets), and dairy (milk, cheese, yoghurt). Nutrient composition was taken from the Nutrition Information Panel (NIP) for each product and then a mean (SD) derived from a sample of each category. Nutrient composition for the comparison meat and dairy products was taken from NZ FOODFiles(2). All nutrients were reported per 100g or100ml. The PBMAs generally had higher energy, sodium and fibre, and lower protein than their meat counterparts. For example, plant-based burgers compared with beef burgers had 863kJ vs 761kJ energy, 436g vs 130g sodium, 2.3g vs 1.2g fibre, 15g vs 19g protein per 100g. Total fat and saturated fat were mostly lower in the meat products than in PBMAs, except for sausages. The plant-based milk analogues were lower in protein and fat than dairy milk, except soy (protein) and coconut (fat) milks. PBDAs were either completely lacking in calcium or were fortified to a similar level as dairy milk. Most plant-based cheeses and yoghurts were not fortified with calcium and were higher in energy, total fat and saturated fat than dairy. Vitamin B12 fortification of all plant-based products varied widely but contained less than meats and dairy. The wide range of plant-based UPFs included in this audit demonstrated little or no health advantage over animal derived meats and dairy products. The high salt and saturated fat content of these products suggest increased cardiometabolic risk if consumed as a regular part of the vegan diet despite higher fibre content.

Maternal diet influences breast milk nutritional profile; however, it is unclear which nutrients and contaminants are particularly responsive to short- and long-term changes in maternal intake, and the impact of specific exclusion diets, such as vegan or vegetarian. This study systematically reviewed the literature on the effects of maternal nutrient intake, including exclusion diets, on both the nutrient and contaminant content of breast milk. The electronic databases, PubMed, CENTRAL, Web of Science and CINALH were systematically searched until 4 June 2023, with additionally searches of reference lists (PROSPERO, CRD42020221577). The quality of the studies was examined using Cochrane Risk of Bias tool and Newcastle–Ottawa scale. Eighty-eight studies (n 6577) met the search criteria. Due to high heterogeneity, meta-analysis was not possible. There was strong evidence of response to maternal intakes for DHA and EPA, vitamins A, E and K, iodine and Se in breast milk composition, some evidence of response for α-linolenic acid, B vitamins, vitamin C and D, ovalbumin, tyrosine and contaminants, and insufficient evidence to identify the effects arachidonic acid, Cu, Fe, Zn and choline. The paucity of evidence and high heterogeneity among studies reflects the need for more high-quality trials. However, this review identified the importance of maternal intake in the nutritional content of breast milk for a wide range of nutrients and supports the recommendation for supplementation of DHA and vitamin B12 for those on restrictive diets.

Plant-based diets have emerged as athletic performance enhancers for various types of exercise. Therefore, the present study evaluated the effectiveness of plant-based diets on aerobic and strength/power performances, as well as on BMI of physically active individuals. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science and SPORTDiscus, was performed. On the basis of the search and inclusion criteria, four and six studies evaluating the effects of plant-based diets on aerobic and strength/power performances in humans were, respectively, included in the systematic review and meta-analysis. Plant-based diets had a moderate but positive effect on aerobic performance (0·55; 95 % CI 0·29, 0·81) and no effect on strength/power performance (–0·30; 95 % CI −0·67, 0·07). The altogether analyses of both aerobic and strength/power exercises revealed that athletic performance was unchanged (0·01; 95 % CI −0·21, 0·22) in athletes who adopted plant-based diets. However, a small negative effect on BMI (–0·27; 95 % CI −0·40, –0·15) was induced by these diets. The results indicate that plant-based diets have the potential to exclusively assist aerobic performance. On the other hand, these diets do not jeopardise strength/power performance. Overall, the predicted effects of plant-based diets on physical performance are impactless, even though the BMI of their adherents is reduced.

Meat-based food production has a detrimental impact on the environment and health. In response, Veganuary (an international non-profit organisation) encourages people to go vegan each January. We investigated the effects of a Veganuary campaign in workplace cafeterias which increased the availability and salience of plant-based products. We conducted an interrupted time series analysis on a large dataset from a UK catering company, which comprised 2,255,404 meals sold between 2016 and 2022, with Veganuary activity starting from 2019. Analysis indicated that Veganuary activity had a positive effect on sales of vegan products in 2020, 2021 and 2022, estimated at an initial increase of 86–113% in the proportion of weekly sales (relative to the baseline, depending on year). The effects of the 2020 and 2021 campaigns were still present – at approximately one third of their initial magnitude – one year following the campaigns. There was a positive effect on vegetarian products in 2019, 2021 and 2022; initial effects were smaller – 23–79% – due to higher levels of pre-campaign consumption. The effects of the 2019 and 2021 campaigns endured, with a small impact present after one year for 2019 and six months for 2021.

An increasing number of food-based recommendations promote a plant-based diet to address health concerns and environmental sustainability in global food systems. As the main sources of iodine in many countries are fish, eggs and dairy products, it is unclear whether plant-based diets, such as the EAT-Lancet reference diet, would provide sufficient iodine. This is important as iodine, through the thyroid hormones, is required for growth and brain development; adequate iodine intake is especially important before, and during, pregnancy. In this narrative review, we evaluated the current literature and estimated iodine provision from the EAT-Lancet reference diet. There is evidence that those following a strict plant-based diet, such as vegans, cannot reach the recommended iodine intake from food alone and are reliant on iodine supplements. Using the EAT-Lancet reference diet intake recommendations in combination with iodine values from UK food tables, we calculated that the diet would provide 128 μg/d (85 % of the adult recommendation of 150 μg/d and 51–64 % of the pregnancy recommendation of 200–250 μg/d). However, if milk is replaced with unfortified plant-based alternatives, total iodine provision would be just 54 μg/d (34 % and 22–27 % of the recommendations for adults and pregnancy, respectively). Plant-based dietary recommendations might place consumers at risk of iodine deficiency in countries without a fortification programme and where animal products provide the majority of iodine intake, such as the UK and Norway. It is essential that those following a predominantly plant-based diet are given appropriate dietary advice to ensure adequate iodine intake.

Our conventional wisdom about animal ethics, as embodied in the animal welfare position, is that animals are not things to whom we can have no moral obligations. Animals who are sentient, or subjectively aware, have a morally significant interest in not suffering. But, because they are not self-aware, they do not as an empirical matter have an interest in continuing to live. So we may use and kill animals as long as we do so ‘humanely’ and do not impose ‘unnecessary’ suffering on them. There are at least two serious problems with our conventional wisdom in this regard. First, because animals are chattel property, we undervalue or ignore their interests in not suffering. Second, we cannot justify the view that animals who are sentient do not have a morally significant interest in continuing to live. If animals are not things and matter morally, our institutionalized exploitation of them cannot be justified, and veganism is a moral imperative.

Vegan and vegetarian diets are widely supported and adopted, but individuals following such diets remain at greater risk of iodine deficiency. This systematic review and meta-analysis was conducted to assess the iodine intake and status in adults following a vegan or vegetarian diet in the modern day. A systematic review and quality assessment were conducted from October 2020 to December 2022 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidance. Studies were identified in Ovid MEDLINE, Web of Science, PubMed, and Scopus. Eleven articles were eligible for review containing 4421 adults (aged ≥ 18 years). Vegan groups had the lowest median urinary iodine concentration (mUIC) (12·2/l). None of the dietary groups had mUIC within the optimal range for iodine status (100–200 µg/l) (WHO). Vegan diets had the poorest iodine intake (17·3 µg/d) and were strongly associated with lower iodine intake (P = < 0·001) compared with omnivorous diets. Lower intake in vegan diets was influenced by sex (P = 0·007), the presence of voluntary or absence of Universal Salt Iodisation (USI) programmes (P = 0·01 & P = < 0·001), and living in a country with adequate iodine nutrition (P = < 0·001). Vegetarians and particularly vegans living in countries with no current USI programme continue to have increased risk of low iodine status, iodine deficiency and inadequate iodine intake. Further research into the usefulness of mandatory fortification of vegan appropriate foods is required.

Iodine is essential for thyroid hormone synthesis. Individuals adhering to vegan and vegetarian diets have been found to be vulnerable to iodine deficiency. Yet, iodine has not been monitored in these groups across time. This study aims to investigate iodine status, intake and knowledge in vegans, vegetarians and omnivores and determine changes between 2016–2017 and 2019. Dietary intake (µg/d) was estimated by 3-d food diaries and iodine FFQ. Urinary iodine concentration, analysed by inductively coupled plasma mass spectrometry, assessed iodine status according to WHO criteria. Iodine knowledge was scored by an adapted questionnaire. IBM SPSS was used for statistical analysis. Ninety-six adults (18–60 years) were recruited in October 2016–2017 (vegans: 12; vegetarians: 5; omnivores: 43) and June 2019 (vegans: 7; vegetarians: 10;omnivores: 19). Median dietary iodine was below the Reference Nutrient Intake for all groups. Vegans and vegetarians had the lowest iodine intake. Vegans had significantly lower iodine intake than omnivores (2016–2017, P = 0 032; 2019, P = 0 001). Omnivores had the highest iodine status (2016–2017, 79 4 µg/l; 2019, 72 4 µg/l) and vegans the lowest (2016–2017, 31 2 µg/l; 2019, 12 2 µg/l). Iodine knowledge was poor but did not differ between dietary groups (2016–2017, P = 0 219; 2019, P = 0 532). Vegans and vegetarians continue to be at risk of iodine deficiency. Further, iodine intake in the UK is poor independent of dietary choice. Iodine education is needed along with research into improving iodine nutrition at national level.

Plant-based (PB) diets are associated with good health and are also recommended for environmental sustainability. The present review aimed to summarise the definitions of PB diets globally and to investigate the nutritional role of PB diets in adults. This review found that there is a wide range of PB definitions ranging from the traditional vegetarian diets (including vegan) to semi-vegetarian/flexitarian diets. Furthermore, other diets which were originally developed due to their associations with positive health outcomes, such as the portfolio, Mediterranean-style, DASH, healthy US-style, planetary health and Nordic-style diets, have been encompassed in PB definitions due to their emphasis on certain PB components. This review has highlighted that those consuming a PB diet are more likely to meet recommended intakes for carbohydrate, dietary fibre and vitamin E and are less likely to meet recommendations for protein, vitamin B12 and iodine compared to omnivores. Regardless of consumer type, neither PB consumers nor omnivores met recommendations for intakes of vitamin D, calcium and sodium. While intakes of protein, n-3, iron and zinc were generally sufficient from the PB diet, it is important to acknowledge the lower bioavailability of these nutrients from PB foods compared to animal-derived products. As dietary patterns shift towards a more PB diet, there is a need for further studies to investigate the role of PB diets for nutritional adequacy and status in populations currently accustomed to consuming a primarily omnivorous diet.

The concept of plant-based diets has become popular due to the purported benefits for both human health and environmental impact. Although ‘plant-based’ is sometimes used to indicate omnivorous diets with a relatively small component of animal foods, here we take it to mean either vegetarian (plant-based plus dairy products and/or eggs) or vegan (100% plant-based). Important characteristics of plant-based diets which would be expected to be beneficial for long-term health are low intakes of saturated fat and high intakes of dietary fibre, whereas potentially deleterious characteristics are the risk of low intakes of some micronutrients such as vitamin B12, vitamin D, calcium and iodine, particularly in vegans. Vegetarians and vegans typically have lower BMI, serum LDL cholesterol and blood pressure than comparable regular meat-eaters, as well as lower bone mineral density. Vegetarians in the EPIC-Oxford study have a relatively low risk of IHD, diabetes, diverticular disease, kidney stones, cataracts and possibly some cancers, but a relatively high risk of stroke (principally haemorrhagic stroke) and bone fractures, in comparison with meat-eaters. Vegans in EPIC-Oxford have a lower risk of diabetes, diverticular disease and cataracts and a higher risk of fractures, but there are insufficient data for other conditions to draw conclusions. Overall, the health of people following plant-based diets appears to be generally good, with advantages but also some risks, and the extent to which the risks may be mitigated by optimal food choices, fortification and supplementation is not yet known.

The association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3 %), lacto-ovo-vegetarians (44·3 %), pesco-vegetarians (10·6 %) and non-vegetarians (NV) (37·3 %). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95 % CI 0·45, 0·73), 0·72 (95 % CI 0·59, 0·88) and 0·72 (95 % CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95 % CI 0·25, 0·83) and 0·62 (95 % CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.