Vegetarian Nutrition (VN) DPG Public Library

Pohl, Schünemann, Bersiner, et al.
Journal: Nutrients
Published: 2021

Key Points

• Objective: The purpose is to 1) summarize the evidence on the relationship between vegetarian/vegan diets and strength and endurance-related exercise performance, and 2) discuss the impact of vegetarian/vegan diets on systemic and molecular muscle adaptations through training.

• Methods: This review includes research from 1999 to 2021 related to exercise and vegan/vegetarian diets. 14 articles were identified and met the inclusion criteria of this review.

• Results—Nutrient intake: 

  • Vegan diets are usually higher in carbohydrates and fiber, but lower in fat compared to omnivorous and vegetarian diets ¹.

  • Vegans consume significantly fewer saturated fatty acids and unsaturated DHA compared to

    omnivores.¹

  • Protein intake of vegans is slightly lower compared to omnivores but similar to lacto-ovo vegetarians. Omnivores tend to consume the highest amount of dietary protein.

• Results—Performance:

  • VO2max is used to measure endurance. It is influenced by cardiac output and hemoglobin concentration of blood.^2,3 A vegan diet may positively affect cardiac output by creating a lower relative (heart) wall thickness in relation to the chamber dimension 11 and improving left ventricular systolic and diastolic function4, which are positively affected by the antioxidant properties of vegan and vegetarian diets.^5-8 The improved diastolic function in vegans can be

    attributed in part to the lower intake of saturated fatty acids.⁹

  • Omnivores, vegetarians and vegans, tend to consume the same amount of iron, but the bioavailability of animal-derived heme-iron (15–35% absorption) compared to plant-derived non-heme-iron (2–20% absorption) may affect hemoglobin concentrations.¹⁰ Inadequate intake of iron can result in less hemoglobin synthesis which can negatively affect VO2max.¹¹

  • When exercise reaches an intensity of more than 60% of the VO2max, carbohydrates are used for energy.^12,13 Lower-intensity exercises such as endurance exercises utilize fat oxidation more than carbohydrates.¹⁴ Vegans and vegetarians tend to consume more carbohydrates than omnivores which could be an advantage in endurance performance.

  • Plant-based proteins tend to contain fewer amounts of essential amino acids, especially leucine.¹⁵ Muscle protein synthesis responses after ingestion of animal-derived proteins is higher compared to the ingestion of an equivalent amount of plant-based protein.¹⁶

  • Eight studies (three cross-sectional, five experimental) examined the influence of a vegetarian or vegan diet on strength performance.^17-22 The findings of these studies lead to the conclusion that a vegetarian and vegan diet can be sufficient for strength improvement, but meatcontaining diets provide an increase in skeletal muscle mass more quickly than a vegan or vegetarian diet.

• Results—The Microbiome:

  • Research shows that microbiota can be modulated by exercise training ^23,24 and diet.^25,26 Exercise affects the epithelial cells’ integrity and thus intestinal epithelium permeability.²⁷ High-volume endurance training increases epithelium permeability, promoting the passing of bacterial toxins and pathogens into the bloodstream.²⁸

  • Changes in the gut microbiome through diet occur after 24 hours and will reverse to baseline 48 hours after discontinuation.²⁹ Modulation of the immune response, oxidative stress, metabolic processes, and nutrient bioavailability all are ways in which the microbiota affects training and adaptation.²⁸

  • A high-fiber diet has a positive effect on gut microbiome composition suggesting that a diet high in fiber is favorable for positive adaptation to endurance exercise.

  • Excessive intake of protein affects the gut microbiome negatively by lowering the intestinal pH, favoring the proliferation of pathogenic bacteria. High-fat diets also reduce the favorable diversity of bacterial strains of the gut microbiome. Vitamin D contributes to intestinal homeostasis since it can influence bacterial colonization and has anti-inflammatory properties. As vegans’, vegetarians’, and omnivorous’ intake differ in these nutrients, dietary regimens might have an impact on gut microbiome health.^{26, 29}

Conclusion

Different macro- and micronutrient intake between plant-based diets may affect cardiac output, oxygen-carrying capacity, mitochondrial function, the microbiome, and substrate availability. Due to less fat intake and higher fiber intake, the vegetarian and vegan diet may positively influence the microbiome which in turn may enhance endurance exercise and immune function. Muscle mass and strength performance depend on a positive muscle protein balance over time. This can be achieved by adequate protein and essential amino acid intake from plant sources, in combination with resistance exercise.

 References

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2. Pawlak, R.; Berger, J.; Hines, I. Iron Status of Vegetarian Adults: A Review of Literature. Am. J. Lifestyle Med. 2018, 12, 486–498

3. Król, W.; Price, S.; Śliż, D.; Parol, D.; Konopka, M.; Mamcarz, A.; Wełnicki, M.; Braksator, W. A Vegan Athlete’s Heart—Is It Different? Morphology and Function in Echocardiography. Diagnostics 2020, 10, 477.

4. Król, W.; Price, S.; Śliż, D.; Parol, D.; Konopka, M.; Mamcarz, A.; Wełnicki, M.; Braksator, W. A Vegan Athlete’s Heart—Is It Different? Morphology and Function in Echocardiography. Diagnostics 2020, 10, 477.

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8. Monsen, E.R. Iron nutrition and absorption: Dietary factors which impact iron bioavailability. J. Am. Diet. Assoc. 1988, 88, 786–790.

9. Dini, F.L.; Galeotti, G.G.; Terlizzese, G.; Fabiani, I.; Pugliese, N.R.; Rovai, I. Left Ventricular Mass and Thickness. Hear. Fail. Clin. 2019, 15, 159–166

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14. Król, W.; Price, S.; Śliż, D.; Parol, D.; Konopka, M.; Mamcarz, A.; Wełnicki, M.; Braksator, W. A Vegan Athlete’s Heart—Is It Different? Morphology and Function in Echocardiography. Diagnostics 2020, 10, 477.

15. Lynch, H.M.; Wharton, C.M.; Johnston, C.S. Cardiorespiratory Fitness and Peak Torque Differences between Vegetarian and Omnivore Endurance Athletes: A Cross-Sectional Study. Nutrients 2016, 8, 726.

16. Boutros, G.H.; Landry-Duval, M.-A.; Garzon, M.; Karelis, A.D. Is a vegan diet detrimental to endurance and muscle strength? Eur. J. Clin. Nutr. 2020, 74, 1550–1555

17. Page, J.; Erskine, R.M.; Hopkins, N.D. Skeletal muscle properties and vascular function do not differ between healthy, young vegan and omnivorous men. Eur. J. Sport Sci. 2021, 1–10

18. Hietavala, E.-M.; Puurtinen, R.; Kainulainen, H.; Mero, A.A. Low-protein vegetarian diet does not have a short-term effect on blood acid–base status but raises oxygen consumption during submaximal cycling. J. Int. Soc. Sports Nutr. 2012, 9, 50

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23. van Vliet, S.; Burd, N.A.; van Loon, L.J. The Skeletal Muscle Anabolic Response to Plant- versus Animal-Based Protein Consumption. J. Nutr. 2015, 145, 1981–1991.

24. Simons, S.M.; Kennedy, R.G. Gastrointestinal Problems in Runners. Curr. Sports Med. Rep. 2004, 3, 112–116. 

25. Hevia-Larraín, V.; Gualano, B.; Longobardi, I.; Gil, S.; Fernandes, A.L.; Costa, L.A.R.; Pereira, R.M.R.; Artioli, G.G.; Phillips, S.M.; Roschel, H. High-Protein Plant-Based Diet Versus a Protein-Matched Omnivorous Diet to Support Resistance Training Adaptations: A Comparison Between

26. Singh, R.K.; Chang, H.-W.; Yan, D.; Lee, K.M.; Ucmak, D.; Wong, K.; Abrouk, M.; Farahnik, B.; Nakamura, M.; Zhu, T.H.; et al. Influence of diet on the gut microbiome and implications for human health. J. Transl. Med. 2017, 15, 1–17.

27. Przewłócka, K.; Folwarski, M.; Kaźmierczak-Siedlecka, K.; Skonieczna-Żydecka, K.; Kaczor, J. Gut-Muscle AxisExists and May Affect Skeletal Muscle Adaptation to Training. Nutrients 2020, 12, 1451.

28. Simons, S.M.; Kennedy, R.G. Gastrointestinal Problems in Runners. Curr. Sports Med. Rep. 2004, 3, 112–116.

29. David, L.A.; Maurice, C.F.; Carmody, R.N.; Gootenberg, D.; Button, J.E.; Wolfe, B.E.; Ling, A.V.; Devlin, A.S.; Varma, Y.; Fischbach, M.; et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature 2014, 505, 559–563.