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Moran L.J.,University of Adelaide | Moran L.J.,Monash University | Ko H.,Center for Clinical Effectiveness | Ko H.,Center for Health Services Research | And 10 more authors.
Journal of the Academy of Nutrition and Dietetics | Year: 2013

While lifestyle management is recommended as first-line treatment of polycystic ovary syndrome (PCOS), the optimal dietary composition is unclear. The aim of this study was to compare the effect of different diet compositions on anthropometric, reproductive, metabolic, and psychological outcomes in PCOS. A literature search was conducted (Australasian Medical Index, CINAHL, EMBASE, Medline, PsycInfo, and EBM reviews; most recent search was performed January 19, 2012). Inclusion criteria were women with PCOS not taking anti-obesity medications and all weight-loss or maintenance diets comparing different dietary compositions. Studies were assessed for risk of bias. A total of 4,154 articles were retrieved and six articles from five studies met the a priori selection criteria, with 137 women included. A meta-analysis was not performed due to clinical heterogeneity for factors including participants, dietary intervention composition, duration, and outcomes. There were subtle differences between diets, with greater weight loss for a monounsaturated fat-enriched diet; improved menstrual regularity for a low-glycemic index diet; increased free androgen index for a high-carbohydrate diet; greater reductions in insulin resistance, fibrinogen, total, and high-density lipoprotein cholesterol for a low-carbohydrate or low-glycemic index diet; improved quality of life for a low-glycemic index diet; and improved depression and self-esteem for a highprotein diet. Weight loss improved the presentation of PCOS regardless of dietary composition in the majority of studies. Weight loss should be targeted in all overweight women with PCOS through reducing caloric intake in the setting of adequate nutritional intake and healthy food choices irrespective of diet composition. © 2013 Academy of Nutrition and Dietetics.


Marsh K.A.,Northside Nutrition and Dietetics | Munn E.A.,Sanitarium Health and Wellbeing | Baines S.K.,University of Newcastle
Medical Journal of Australia | Year: 2012

A vegetarian diet can easily meet human dietary protein requirements as long as energy needs are met and a variety of foods are eaten.Vegetarians should obtain protein from a variety of plant sources, including legumes, soy products, grains, nuts and seeds.Eggs and dairy products also provide protein for those following a lacto-ovo-vegetarian diet.There is no need to consciously combine different plant proteins at each meal as long as a variety of foods are eaten from day to day, because the human body maintains a pool of amino acids which can be used to complement dietary protein.The consumption of plant proteins rather than animal proteins by vegetarians may contribute to their reduced risk of chronic diseases such as diabetes and heart disease. © 2012 Australasian Medical Publishing Co. Ltd. All rights reserved.


Zeuschner C.L.,Sydney Adventist Hospital | Hokin B.D.,Sydney Adventist Hospital | Marsh K.A.,Northside Nutrition and Dietetics | Saunders A.V.,Sanitarium Health and Wellbeing | And 2 more authors.
The Medical journal of Australia | Year: 2013

Vitamin B₁₂ is found almost exclusively in animal-based foods and is therefore a nutrient of potential concern for those following a vegetarian or vegan diet. Vegans, and anyone who significantly limits intake of animal-based foods, require vitamin B₁₂-fortified foods or supplements. Vitamin B₁₂ deficiency has several stages and may be present even if a person does not have anaemia. Anyone following a vegan or vegetarian diet should have their vitamin B₁₂ status regularly assessed to identify a potential problem. A useful process for assessing vitamin B₁₂ status in clinical practice is the combination of taking a diet history, testing serum vitamin B₁₂ level and testing homocysteine, holotranscobalamin II or methylmalonic acid serum levels. Pregnant and lactating vegan or vegetarian women should ensure an adequate intake of vitamin B₁₂ to provide for their developing baby. In people who can absorb vitamin B₁₂, small amounts (in line with the recommended dietary intake) and frequent (daily) doses appear to be more effective than infrequent large doses, including intramuscular injections. Fortification of a wider range of foods products with vitamin B₁₂, particularly foods commonly consumed by vegetarians, is likely to be beneficial, and the feasibility of this should be explored by relevant food authorities.


PubMed | Sanitarium Health and Wellbeing, Sanitarium Health and Wellbeing Services, Sydney Adventist Hospital and Northside Nutrition and Dietetics
Type: Journal Article | Journal: The Medical journal of Australia | Year: 2014

Vitamin B is found almost exclusively in animal-based foods and is therefore a nutrient of potential concern for those following a vegetarian or vegan diet. Vegans, and anyone who significantly limits intake of animal-based foods, require vitamin B-fortified foods or supplements. Vitamin B deficiency has several stages and may be present even if a person does not have anaemia. Anyone following a vegan or vegetarian diet should have their vitamin B status regularly assessed to identify a potential problem. A useful process for assessing vitamin B status in clinical practice is the combination of taking a diet history, testing serum vitamin B level and testing homocysteine, holotranscobalamin II or methylmalonic acid serum levels. Pregnant and lactating vegan or vegetarian women should ensure an adequate intake of vitamin B to provide for their developing baby. In people who can absorb vitamin B, small amounts (in line with the recommended dietary intake) and frequent (daily) doses appear to be more effective than infrequent large doses, including intramuscular injections. Fortification of a wider range of foods products with vitamin B, particularly foods commonly consumed by vegetarians, is likely to be beneficial, and the feasibility of this should be explored by relevant food authorities.


PubMed | University of Newcastle, Northside Nutrition and Dietetics, Sanitarium Health and Wellbeing and Sydney Adventist Hospital
Type: Journal Article | Journal: The Medical journal of Australia | Year: 2014

Surveys over the past 10 years have shown that Australians are increasingly consuming more plant-based vegetarian meals. Many studies demonstrate the health benefits of vegetarian diets. As with any type of eating plan, vegetarian diets must be well planned to ensure nutritional needs are being met. This clinical focus project shows that well planned vegetarian diets can meet almost all the nutritional needs of children and adults of all ages. Sample single-day lacto-ovo-vegetarian meal plans were developed to comply with the nutrient reference values - including the increased requirements for iron and zinc at 180% and 150%, respectively, for vegetarians - for both sexes and all age groups set by Australias National Health and Medical Research Council and the New Zealand Ministry of Health. With the exception of vitamin D, long-chain omega-3 fatty acids and extended iron requirements in pregnancy for vegetarians, the meal plans meet key requirements with respect to energy; protein; carbohydrate; total fat; saturated, poly- and monounsaturated fats; -linolenic acid; fibre; iron; zinc; calcium; folate; and vitamins A, C, E and B.


PubMed | University of Newcastle, Sanitarium Health and Wellbeing and Northside Nutrition and Dietetics
Type: Journal Article | Journal: The Medical journal of Australia | Year: 2014

A vegetarian diet can easily meet human dietary protein requirements as long as energy needs are met and a variety of foods are eaten. Vegetarians should obtain protein from a variety of plant sources, including legumes, soy products, grains, nuts and seeds. Eggs and dairy products also provide protein for those following a lacto-ovo-vegetarian diet. There is no need to consciously combine different plant proteins at each meal as long as a variety of foods are eaten from day to day, because the human body maintains a pool of amino acids which can be used to complement dietary protein. The consumption of plant proteins rather than animal proteins by vegetarians may contribute to their reduced risk of chronic diseases such as diabetes and heart disease.


Marsh K.,Northside Nutrition and Dietetics | Zeuschner C.,Northside Nutrition and Dietetics | Saunders A.,Northside Nutrition and Dietetics
American Journal of Lifestyle Medicine | Year: 2012

There is now a significant amount of research that demonstrates the health benefits of vegetarian and plant-based diets, which have been associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease. Although a well-planned vegetarian or vegan diet can meet all the nutritional needs of an individual, it may be necessary to pay particular attention to some nutrients to ensure an adequate intake, particularly if the person is on a vegan diet. This article will review the evidence for the health benefits of a vegetarian diet and also discuss strategies for meeting the nutritional needs of those following a vegetarian or plant-based eating pattern. © 2012 The Author(s).


Marsh K.,Northside Nutrition and Dietetics | Barclay A.,Australian Diabetes Council | Colagiuri S.,University of Sydney | Brand-Miller J.,University of Sydney
Current Diabetes Reports | Year: 2011

Medical nutrition therapy is the first line of treatment for the prevention and management of type 2 diabetes and plays an essential part in the management of type 1 diabetes. Although traditionally advice was focused on carbohydrate quantification, it is now clear that both the amount and type of carbohydrate are important in predicting an individual's glycemic response to a meal. Diets based on carbohydrate foods that are more slowly digested, absorbed, and metabolized (i.e., low glycemic index [GI] diets) have been associated with a reduced risk of type 2 diabetes and cardiovascular disease, whereas intervention studies have shown improvements in insulin sensitivity and glycated hemoglobin concentrations in people with diabetes following a low GI diet. Research also suggests that low GI diets may assist with weight management through effects on satiety and fuel partitioning. These findings, together with the fact that there are no demonstrated negative effects of a low GI diet, suggest that the GI should be an important consideration in the dietary management and prevention of diabetes. © Springer Science+Business Media, LLC 2011.

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