Fortified foods and dietary supplements key to bone health in vegan diets

A study conducted at the University of Helsinki found that children and adults who follow a vegan diet had on average adequate intakes of calcium and vitamin D, nutrients important to bone health, but their bone metabolism differed from those who follow an omnivorous diet.

The MIRA2 study conducted at the University of Helsinki investigated bone metabolism and the intakes of nutrients critical to bone health, such as calcium, vitamin D and protein. The study involved children residing in Helsinki aged between two and seven who followed a vegan, vegetarian or omnivorous diet, as well as their caregivers.

The study subjects following a vegan diet adhered almost without exception also to the recommendations on the consumption of dietary supplements and fortified foods, and they had on average adequate vitamin D and calcium intakes. The children on a vegan diet had higher vitamin D intake than those on an omnivorous or a vegetarian diet due to more active consumption of vitamin D supplements with higher doses. On average, vitamin D status measured from blood was also adequate in all diet groups.

The study found that the more plant-based diets, namely vegan and vegetarian ones, were in adults associated with higher concentrations of bone formation and resorption markers, which may indicate accelerated bone metabolism. In contrast, more plant-based diets among children were associated with higher parathyroid hormone concentrations, which have been associated with more active bone resorption. While these observations can indicate long-term adverse effects on bone health, their clinical significance is unclear.

“The calcium naturally occurring in plant-based foods is fairly poorly absorbed. In fact, the widespread vitamin D and calcium fortification of plant-based dairy alternatives in Finland is important for the adequate intake of these nutrients among vegans and, consequently, for their bone health,” says Docent Suvi Itkonen from the Faculty of Agriculture and Forestry, University of Helsinki.

Many international studies have raised concerns about the potential adverse effects of vegan diets on bone health. However, these studies have typically targeted populations where vitamin D intake is low, the selection of vegan products on the market is narrow, and the consumption of fortified foods or dietary supplements is less widespread than in Finland. 

Vegan diets require careful planning especially for children

The researchers found that vegans and vegetarians had lower protein intake compared to those who followed an omnivorous diet, although on average it was adequate. Proteins are composed of amino acids.

“It’s possible that the poorer absorption and different amino acid composition of plant-based proteins compared to animal proteins partly explain the observed differences in bone metabolism, but more research is needed on the topic. In fact, we will next investigate amino acid intake among the MIRA2 subjects and the amino acid composition of vegan diets,” Itkonen says.

The MIRA2 dataset was collected in Helsinki, where vegan food in daycare centres and various vegan food products are abundantly available. The families who participated in the study were well versed in guidelines for vitamin D supplementation and fortified food consumption.

“People in the Helsinki Metropolitan Area live in a kind of veggie bubble. Due to that one has to keep in mind that the findings of the study are not directly applicable to the populations of other regions or countries,” Itkonen points out.

The nutrition recommendations published last autumn emphasise a predominantly plant-based diet, restricting meat consumption and moderating milk consumption. If a food is entirely excluded from the diet, it is important to replace it with nutritionally comprehensive alternatives. When planning a vegan diet for children and adolescents, a visit to a registered dietitian is recommended.

“In terms of bone health, it is essential when consuming plant-based drinks and yoghurt-like products to choose the option fortified with calcium and vitamin D. Children should take a daily vitamin D supplement throughout the year. If the daily diet contains no margarines, dairy products or plant-based drinks fortified with vitamin D, and if fish is eaten less than 2–3 times per week, it’s important to ensure adequate vitamin D intake, especially during the dark season, by taking a vitamin D supplement. Among vegans, the need for vitamin D supplementation is common,” Itkonen notes. 

Acupuncture treatment improves disabling effects of chronic low back pain in older adults

 

According to a study funded by the National Institutes of Health (NIH), older Americans with chronic low back pain who received acupuncture had greater improvement in physical function and reduced pain than those who received usual medical care only, generally prescribed medications or physical therapy. Chronic low back pain is the leading cause of disability worldwide and affects over one-third of older adults in the United States. Treatment options range from pain-relieving drugs to complementary therapies, including acupuncture. There is an urgent need for safe, effective, and non-addictive pain management approaches.  

 

“Of the different treatments we have for chronic low back pain, most have a somewhat modest effect. They often reduce pain by about a third at best and can help people function better,” said lead author Lynn L. DeBar, Ph.D., Kaiser Permanente distinguished investigator. “Our clinical results suggests that acupuncture is working as well as many things that are more familiar to people. We found that the size of this effect, while modest, was positive and sustained.” 

 

The clinical trial, known as BackInAction, enrolled 800 participants, with results based upon self-reported pain-related disability assessments following treatment that either included or omitted acupuncture. Researchers looked at whether manual acupuncture needling, which is eligible for Medicare coverage, could improve function and reduce pain for older adults who have chronic or persistent low back pain.  

 

Acupuncture, with its origins in traditional East Asian medicine, has gained in popularity in the United States since the 1970s. The manual acupuncture needling technique entails inserting fine needles into the skin at points that follow a prescribed anatomical grid. The practice provides various benefits, including reduced discomfort from back, joint or neck pain. While acupuncture has been found to be safe and effective for chronic low back pain in adults overall, few acupuncture studies have focused on adults 65 years of age and older. 

 

Participants in BackInAction included men and women aged 65 and older with a medical history of low back pain for at least three months. All participants had health coverage and were not restricted from receiving usual medical care for their back pain. A third of those received up to 15 acupuncture treatments over three months (standard acupuncture treatment), and another third received an additional six acupuncture treatments (maintenance sessions) over the following three months.  

 

At three study milestones — after three, six and 12 months from enrollment — participants provided self-assessment of their pain and physical limitations. Their agreement with any of 24 statements that describe everyday activities made difficult because of back pain contributed to the participant’s disability score. The researchers used additional tools for insights into pain levels, degree of physical functioning, depression and anxiety.  

 

At the six-month and 12-month assessment, both groups who received acupuncture had greater reductions in pain disability than those who received usual medical care alone. The acupuncture-treated groups also had reduced pain intensity and greater physical function after six months as compared to participants who did not receive acupuncture. The researchers also reported that acupuncture treatment was associated with fewer anxiety symptoms as compared to usual medical care alone at the six and 12-month assessments.  

 

“What sets the BackInAction study apart is that it focused specifically on adults 65 years of age and older, and it was pragmatically designed,” DeBar said. “We worked hard to involve adults in multiple regions of the country so that participant demographics were consistent with the U.S. census for older adults—and we worked with licensed acupuncturists in the community, who are most likely to deliver these services.” 

 

The study authors suggest that access to acupuncture is important for older adults with chronic back pain and that if acupuncture practitioners could bill Medicare directly it could greatly improve access to such services.  

 

“We saw very little in the way of adverse effects during the clinical trial,” said co-lead researcher Andrea J. Cook, Ph.D., Kaiser Permanente senior biostatistics investigator. “Older adults often are dealing with other medical problems in addition to back pain. Acupuncture offers a less invasive option that has a better safety profile than a lot of the common treatments for back pain in older adults.” 

 

Reference: “Acupuncture for Chronic Low Back Pain in Older Adults: A Randomized Pragmatic Clinical Trial” 2025. JAMA Network Open. DOI: 1E0.1001/jamanetworkopen.2025.31348 

Diet rich in vegetable protein and fiber helps maternal and infant health

 A Mediterranean-style diet, rich in fibre, vegetable proteins and healthy fats, benefits maternal health during pregnancy and breastfeeding. In addition to improving intestinal function and mucosal immunity, it also prevents fat accumulation and optimizes the composition of the microbiota in the digestive system. In babies, this maternal dietary pattern helps to reduce the incidence and severity of infections.

These conclusions come from two studies published in the journal eBioMedicine, carried out with the support of La Marató de TV3 (2017). The research was jointly led by Francisco José Pérez-Cano, professor at the Faculty of Pharmacy and Food Sciences of the University of Barcelona and director of the Nutrition and Food Safety Research Institute (INSA-UB), based at the UB’s Torribera Food Campus, and the expert M. Carmen Collado, from the Institute of Agrochemistry and Food Technology (IATA-CSIC).

Led by researcher Karla Rio Aige (INSA-UB) as first author, the studies, coordinated globally by the UB, used data from the MAMI (Maternal Microbiome) cohort to identify relevant observations. Researchers also developed a preclinical model with animal models using the diets detected in the cohort with the aim of understanding the mechanisms of action involved.

Nutrition and mother-child health: many open questions

A balanced diet and a healthy lifestyle and habits are important for good health in pregnancy. Therefore, establishing optimal nutritional habits during pregnancy, lactation and early life is crucial for the health and well-being of mother and baby. However, the associated mechanisms linking maternal diet to maternal and infant health outcomes are still poorly understood.

María José Rodríguez Lagunas, a member of the project’s research team and of the UB’s Department of Biochemistry and Physiology, notes that understanding how maternal diet influences mother and infant physiology “is crucial, as its effects extend to short- and long-term outcomes for both mother and child.” However, she adds that “there is a notable lack of research on the underlying mechanisms, particularly those that could improve the physiological recovery of the mother after childbirth”.

The first study, at the preclinical level, compared the effects of two different diets during gestation and lactation on microbiota composition, immunity and lipid metabolism: the Mediterranean-like D1 diet, rich in fibre and vegetable protein, and a Western D2 diet, richer in animal protein and fats. During the nutritional intervention, various biological samples were analysed to see the effects of each diet on the epithelial barrier, lipid metabolism, microbiota composition, metabolites and immunity.

“The results reveal that a diet similar to the Mediterranean diet and enriched with fish oil, soya protein and inulin has beneficial effects on lipid metabolism, the composition of the microbiota and the immune response during pregnancy and breastfeeding, and improves maternal health,” says Professor Francisco J. Pérez-Cano.

“Furthermore, if this diet is maintained during breastfeeding, it seems to more effectively reverse the physiological changes that occur during pregnancy, supporting immune function and limiting fat accumulation,” adds the expert.

Improving child health through maternal diet

The second study shows that a maternal diet rich in plant protein, fibre and polyunsaturated fatty acids reduces the severity and frequency of infections in infants through the modulating effect of gut microbiota on the immune system.

The study, conducted on infants and animal models, analyses the effect of maternal diet on the health of offspring and reinforces the importance of maternal nutrition during pregnancy and lactation to strengthen infant health. The synergy of the INSA-UB and IATA-CSIC teams — institutions recognized with the María de Maeztu and Severo Ochoa seals of excellence, respectively — was key to obtaining the results.

In this context, the influence of the maternal diet emerges as a key factor in the composition of the defensive elements of milk during lactation. As essential elements, immunoglobulin A (IgA) in human milk and the diversity of the microbiota demonstrate their protective role against infections in infants.

These studies provide new insights that may lead to more precise dietary guidelines for pregnant and breastfeeding women. On the one hand, they would help to strengthen the health of mothers and support their physiological recovery, and on the other hand, they would protect infant development in the early stages of life by reducing the risk of infections, thus supporting the wellbeing of babies.

“The study may also help to better understand the relationship between maternal diet, bioactive components of breast milk, infant microbiota and infant immunity. In the future, further research will be necessary to obtain more solid conclusions and better understand the mechanisms involved,” conclude experts M. Carmen Collado and Francisco José Pérez-Cano.
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Healthy eating cuts chronic pain

 We all know the benefits of a healthy diet. But new research from the University of South Australia shows that eating nutritious food is about far more than ticking off the five food groups – it can also significantly reduce chronic pain.

 

In a weight-loss study of 104 Australian adults living with overweight or obesity, researchers found that people who improved their diet quality over a three-month period reported far less joint and muscle pain, with the benefits not simply explained by weight lost.

 

The findings challenge common assumptions that weight loss is the primary way to reduce chronic musculoskeletal pain, highlighting the power of diet quality in managing health and wellbeing.

 

Lead researcher and PhD candidate, UniSA’s Sue Ward, says the results open new doors for pain management strategies.

 

“Chronic musculoskeletal pain is one of the most common and debilitating conditions worldwide. While excess weight is often thought to put stress on joints and drive pain, our study shows that what you eat may independently influence chronic pain,” Ward says.

 

“While weight loss helps many people, this study suggests that improving diet quality itself also eases the severity of people’s pain. This is a very hopeful finding for people living with chronic pain.”

 

The three-month dietary intervention reduced participants’ energy intake by 30% (from about 9100 to 5800 kilojoules per day) by following the Australian Dietary Guidelines.

 

After three months, participants had not only improved the quality of their diet (through the consumption of more fruits, vegetables, whole grains and lean meats/alternatives) but also reduced their intake of discretionary foods and alcohol.

 

Specifically, they improved diet quality by 22%, reduced chronic musculoskeletal pain from 50% to 24%, and reported less pain severity and better pain-related quality of life. Most participants had also lost around seven kilograms of body weight.

 

Importantly, in the participants presenting with pain, researchers found that despite changes in weight, waist circumference, and body fat improvements in pain severity were directly linked to their improved diet quality.

 

Co-researcher, UniSA’s Dr Alison Hill, says the results reinforce the importance of dietary guidelines.

 

“Eating well isn’t just about long-term disease prevention – it can also have an immediate and tangible impact on how we feel day to day,” Dr Hill says.

 

“This study shows that adopting a healthier diet may lead to meaningful reductions in pain which improve overall wellbeing.”

 

While more research needs to be done, the study underscores the vital role of nutrition in chronic pain management and adds to a growing body of evidence that healthy eating supports both physical and mental health.

Keto diet linked to reduced depression symptoms

 A new study shows an association between at least 10 weeks of following a well-formulated ketogenic diet and a roughly 70% decrease in depression symptoms among a small group of college students.

Beyond the reduction in self-reported and clinician rated depression, the students’ global well-being increased nearly three-fold and their performance improved on several cognitive tasks. All but one participant also lost weight.

The 16 students who completed the pilot trial were receiving medication, counseling, or both for major depressive disorder before beginning the keto diet. The findings suggest achieving nutritional ketosis through diet is a feasible adjunctive therapy for depression and pave the way for a larger clinical trial, researchers say.

The pilot study did not have a non-keto control group for comparison. Previous research has suggested medications and counseling reduce depressive symptoms by about 50% in a similar time period.

“So many people are suffering right now, so it’s rewarding to potentially bring forward a solution,” said Jeff Volek, PhD, lead author of the study and a professor of human sciences at The Ohio State University. “There is more science yet to do, but because there is evidence of a benefit, expanding accessibility to a well-formulated ketogenic diet as an augmentation to treatment for depression is something to think about.”

The study is published in the journal Translational Psychiatry.

Volek’s lab teamed with Ohio State mental health experts to design and complete the trial with young adults studying at the university.

Stress, anxiety and depression are the No. 1 impediment to academic performance for U.S. college students, said co-author Ryan Patel, DO, a psychiatrist in Ohio State’s Office of Student Life Counseling and Consultation Service: About 40% of college students report depression symptoms, and about half of them are receiving treatment of some kind.

“We have a treatment gap in that we have more students suffering from mental health concerns than can feasibly receive professional treatment,” Patel said. “There is a need for finding ways of helping students on a large scale. And nutrition is one way we can do that.”

Twenty-four students were enrolled in the trial and 16 students – 10 women and six men with an average age of 24 – completed the entire study.

Participants received extensive education on the keto diet, consisting of fewer than 50 grams of carbs per day combined with higher fat and moderate protein intake. The keto diet converts fat into ketones used by cells in the body and brain as an alternative to glucose, and is designed to put the body in a state of nutritional ketosis, when it has greater access to ketones as both fuel and a signaling molecule. 

“It was very important to make sure participants knew what they were getting themselves into,” said Drew Decker, MS, first author of the study and a graduate student in Volek’s lab. “And a big part of increasing chances for adherence to the diet was talking to each individual about what they like and don’t like to eat so we could tailor some suggestions for how they could structure their diet.”

The team also provided 10 complete starter meals, offered consistent advice and snacks for the first half of the trial, and communicated throughout the study with participants through a private app. The students were advised to eat when they were hungry and finish eating when they were full, and not to worry about calories.

At baseline and over the course of 10 to 12 weeks, the students reported depressive symptoms using the Patient Health Questionnaire-9 (PHQ-09), the standard instrument to measure the severity of depression in clinical settings, and completed the World Health Organization-Five Well-Being Index (WHO-5). They also took a series of cognitive tests assessing episodic and working memory, processing speed, executive function, and attention and inhibitory control.

Co-author Jennifer Cheavens, PhD, professor of clinical psychology at Ohio State, oversaw clinical assessments of participants before and throughout the trial.

“One of the things we really wanted to make sure of is that we were providing a treatment for people who met the diagnostic criteria for having major depressive disorder,” Cheavens said. “Each participant had about a 2 1/2-hour interview at the beginning, and then weekly assessments of their symptoms.”

Students were also screened to ensure that they did not have any contraindications to a ketogenic diet, such as Body Mass Index under 20, eating disorders, pregnancy or high alcohol consumption.

Results included:

• Participants achieved ketosis, based on a measure of ketone values in their blood, 73% of the time – an indication of good adherence to the diet.
  Self-reported depression scores decreased 37% by week two and reached 69% of improvement at week 10-12. The range of symptom severity varied, but nobody’s symptoms worsened.
• Clinician-rated assessments of depression at week six and week 10-12 decreased by 59% and 71%, respectively.
• By week two, perceived ratings of global wellness had increased two-fold, which improved to nearly three-fold at the end of the intervention.
• As a group, participants lost an average of 11 pounds and their body fat decreased by 2.4% – with most exceeding the clinically significant drop of 5% weight loss.
• As a group, participants’ performance improved on cognitive tasks assessing episodic memory, processing speed and executive function.
• No significant changes in cholesterol or triglycerides were found.

Patel, who met with the students throughout the trial, said the magnitude of the reduction in depressive symptoms linked to the keto diet was notable.

“The average effect size for medications and counseling after 12 weeks is about 50%, and we saw a substantially greater result,” he said. “That is an impressive finding, that across the board, in this real-world setting, everybody got better, and across the board, our participants did not need more treatment or emergency intervention.”

For over two decades, Volek has been studying therapeutic applications of ketosis for conditions such as heart disease and cancer as well as athletic performance and soldier health and resilience.

“The idea is that the ketogenic diet is working through a variety of potentially different mechanisms – there’s a whole range of physiological metabolic adaptations to the diet that could overlap with some of the pathophysiology of depression,” Volek said.

The team collected a range of biological data on changing levels of proteins related to inflammation and brain function in this pilot that may help inform a future study examining potential mechanisms behind the diet’s effects.

“We haven’t teased out those mechanisms here because this is a proof-of-concept study for an adjunctive therapy,” Volek said. “This is one of the first really well-controlled studies and it has limitations, but the results encourage us to want to keep pursuing it.”

Yoga less effective than traditional exercise in improving vascular and heart function

 Contrary to widespread belief, yoga may be less effective than conventional forms of exercise in enhancing vascular health, according to a new study published in Advances in Integrative Medicine.

The study systematically reviews existing literature, including randomized controlled trials, crossover trials, and non-randomized studies, comparing yoga and other exercise interventions in sedentary adults.

The researchers point out that their aim has been to assess the impact of these interventions on vascular function, as measured by ultrasound.

Vascular function refers to the ability of blood vessels to efficiently transport blood to tissues. The elasticity and responsiveness of these vessels are critical indicators of cardiovascular health.

Sedentary behavior and prolonged sitting are known to impair vascular function, increasing the risk of hypertension, cholesterol buildup, and thrombosis.

Co-author Dr. Leena David, a specialist in medical diagnostic imaging and lecturer at the University of Sharjah, says:

“Think of blood vessels like flexible garden hoses. If they stiffen, the risk of heart attacks and strokes increases. Our study shows that structured exercise keeps those hoses flexible, while yoga provides some benefits but not as reliably. Middle-aged and older adults often notice improvements from yoga, but younger adults might not.”

The findings are particularly relevant for the estimated 300 million people worldwide who practice yoga and the more than 620 million individuals affected by cardiovascular disease as of 2023.

The researchers conclude that traditional exercise modalities, such as Tai Chi, Pilates, and high-intensity interval training, consistently outperform yoga in improving vascular function among sedentary individuals.

Dr. David emphasizes that while movement is essential, the type, intensity, and consistency of physical activity are key determinants of vascular health.

“Even simple routines can make arteries more resilient. Blood vessels have a memory—and every workout helps them forget the damage of sitting all day,” she adds.

She also describes prolonged sitting as “the new smoking—silent, sneaky, and stealing years from your arteries,” adding that “movement is the perfect antidote.”

While yoga remains accessible and culturally significant, the study suggests that individuals seeking consistent cardiovascular benefits may need to supplement yoga with more vigorous forms of exercise.

The authors advocate for a nuanced approach to physical activity, especially in public health messaging.

“Yoga has deep cultural roots and shows promise as an inclusive, accessible health intervention,” Dr. David notes.

“At the same time, the fitness and digital health industries can leverage these insights to develop structured exercise programs and technology-driven solutions for sedentary populations.”

The researchers hope their findings will encourage healthcare providers to recommend exercise not only for weight management but also as a proven strategy for improving vascular health.

Although yoga may not consistently enhance vascular function, it remains a valuable option, particularly for older adults and those unable or unwilling to engage in high-intensity workouts.

“On a larger scale, public health campaigns could emphasize that movement is medicine,” Dr. David explains. “This may encourage a mix of exercise and yoga to make heart health more accessible and culturally appropriate.

Forget the fitness goals—this is about protecting your body's internal GPS system that keeps you alive.”

Low-fat, plant-based diet that includes soy can significantly reduce hot flashes

 As Menopause Awareness Month approaches in October, a new poll finds that just 43% of women believe that diet influences the number and intensity of hot flashes for women experiencing menopause, despite research showing that a low-fat, plant-based diet that includes soy can significantly reduce hot flashes.

The Physicians Committee for Responsible Medicine/Morning Consult poll, which was conducted Aug. 6 to 7, 2025, and included 1,155 women, also found:

• 19% thought that women experiencing menopause should avoid soy products, while 21% thought that they didn’t need to avoid soy products.
• 11% thought consumption of ultra-processed plant foods (such as plant-based meat and dairy alternatives) reduces hot flashes, while 22% thought it increases hot flashes.
• 13% thought consumption of ultra-processed plant foods led to weight loss for women experiencing menopause, while 26% thought it increased weight.

“Our research has found that a low-fat plant-based diet that includes soybeans can significantly reduce hot flashes and weight in postmenopausal women,” says Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee. “Women can even experience these health benefits when their diet includes plant-based foods that are considered ultra-processed—like soy milk and plant-based meat alternatives.”

Dr. Kahleova and Neal Barnard, MD, president of the Physicians Committee, led the Women’s Study for the Alleviation of Vasomotor Symptoms (WAVS) trial, which was published in the journal Menopause in 2023. The study found that a plant-based diet rich in soy reduced moderate to severe hot flashes by 88% and helped women lose 8 pounds, on average, in 12 weeks. A secondary analysis of the study found that women experienced a reduction in hot flashes and weight regardless of the level of processing—from unprocessed to ultra-processed—of the plant-based foods.

The study included 84 postmenopausal women reporting two or more hot flashes per day. They were randomly assigned either to an intervention group—consisting of a low-fat, vegan diet, including half a cup of cooked soybeans daily—or to a control group that made no diet changes for 12 weeks. The study was the second phase of a two-part trial, the first of which was published in Menopause in 2021.

Approximately 75% of women experience hot flashes as they go through menopause, but these symptoms receive inadequate attention in primary care settings, according to a study published by the Menopause Society last year.

“This Menopause Awareness Month—and all year long—I urge physicians and other clinicians to encourage their patients who are in any phase of menopause to try a plant-based diet to help fight hot flashes, reduce their weight if needed, and improve other health conditions,” says Vanita Rahman, MD, clinic director of the Barnard Medical Center in Washington, D.C., who recently presented on menopause at the International Conference on Nutrition in Medicine.