Adherence to a vegan diet may lower risk of cardiovascular disease among African Americans (AAs). Feasibility and sustainability of adopting a vegan diet may be challenging among AAs who live in ...regions where soul food is a predominant cuisine. Our hypothesis was that AAs randomized to a culturally adapted vegan diet will have greater adherence to their assigned diet compared with those randomized to a culturally adapted omnivorous diet. AAs (N = 113) with overweight/obesity from South Carolina were included. Dietary intake was measured at months 0, 3, 6, and 12 using 24-hour recalls. Adherence was defined based on recommended animal product intake for each group. Differences in nutrient intakes and dietary indices (Alternative Healthy Eating Index 2010 and healthy plant-based diet index) between groups were evaluated using t-tests. At 12 months, adherence was higher to the vegan (51%) versus omnivorous (35%) diet. Participants assigned to the vegan diet had higher intake of carbohydrates (P = .01) and fiber (P < .001), and lower intake of cholesterol P< .001) and protein (P = .001) compared with participants assigned to the omnivorous diet. Participants adherent to the vegan diet had lower cholesterol intake (P < .001) and higher fiber intake (P = .02) compared with those adherent to the omnivorous diet. Compared with those assigned to the omnivorous diet, participants assigned to the vegan diet had higher Alternative Healthy Eating Index 2010 (P = .01) and healthy plant-based diet index (P < .001) scores. AAs with overweight/obesity were more adherent to a culturally adapted vegan diet versus an omnivorous diet after 1 year, and nutrient and food group intake changes were sustained.
We analyzed data from 113 African Americans with overweight/obesity from the Nutritious Eating with Soul Study. Compared with participants assigned to a culturally adapted omnivorous diet, participants assigned to a culturally adapted vegan diet had greater adherence, higher consumption of carbohydrates and fiber, lower consumption of cholesterol and protein, and higher diet quality after 1 year. AHEI-2010, Alternative Healthy Eating Index 2010; hPDI, healthy plant-based diet index. Display omitted
The US Dietary Guidelines (USDG) form the basis of nutrition guidelines, but the research informing the 3 USDG dietary patterns (Healthy US-Style H-US, Mediterranean Med, and vegetarian Veg) has been ...drawn largely from observational studies among White populations.
The Dietary Guidelines 3 Diets study was a 3-arm, 12-wk randomly assigned intervention among African American (AA) adults at risk of type 2 diabetes mellitus that tested the 3 USDG dietary patterns.
The AAs (ages 18–65 y, BMI 25–49.9 kg/m2, and BMI was measured in kg/m2) with ≥3 type 2 diabetes mellitus risk factors were recruited. Weight, HbA1c, blood pressure, and dietary quality (healthy eating index HEI) were collected at baseline and 12 wk. In addition, participants attended weekly online classes that were designed using material from the USDG/MyPlate. Repeated measures, mixed models with maximum likelihood estimation, and robust computation of standard errors were tested.
Of the 227 participants screened, 63 were eligible (83% female; age 48.0 ± 10.6 y, BMI 35.9 ± 0.8 kg/m2) and randomly assigned to the Healthy US-Style Eating Pattern (H-US) (n = 21, 81% completion), healthy Mediterranean-style eating pattern (Med) (n = 22, 86% completion), or healthy vegetarian eating pattern (Veg) (n = 20, 70% completion) groups. Within-group, but not between groups, weight loss was significant (−2.4 ± 0.7 kg H-US, −2.6 ± 0.7 kg Med, −2.4 ± 0.8 kg Veg; P = 0.97 between group). There was also no significant difference between groups for changes in HbA1c (0.03 ± 0.05% H-US, −0.10 ± 0.05% Med, 0.07 ± 0.06% Veg; P = 0.10), systolic BP (−5.5 ± 2.7 mmHg H-US, −3.2 ± 2.5 mmHg Med, −2.4 ± 2.9 mmHg Veg; P = 0.70), diastolic blood pressure (−5.2 ± 1.8 mmHg H-US, −2.0 ± 1.7 mmHg Med, −3.4 ± 1.9 mmHg Veg; P = 0.41), or HEI (7.1 ± 3.2 H-US, 15.2 ± 3.1 Med, 4.6 ± 3.4 Veg; P = 0.06). Post hoc analyses showed that the Med group had significantly greater improvements in HEI compared to the Veg group (difference = −10.6 ± 4.6; 95% CI: −19.7, −1.4; P = 0.02).
The present study demonstrates that all 3 USDG dietary patterns lead to significant weight loss among AA adults. However, none of the outcomes were significantly different between groups.
This trial was registered at clinicaltrials.gov as NCT04981847.
Previous research has found that African American (AA) vegetarians/vegans have a significantly lower body mass index and risk of hypertension compared to omnivores.
The Nutritious Eating with Soul ...(NEW Soul) study partnered with local soul food restaurants/chefs to deliver two behavioral nutrition interventions to AA adults. NEW Soul examines the impact of two different culturally tailored diets (vegan and omnivorous low-fat) on changes in risk factors for cardiovascular disease (CVD).
AA adults with overweight or obesity are recruited from the community in the Midlands of South Carolina. Eligible participants are randomized to follow one of two different culturally-adapted, soul food diets: a vegan diet emphasizing minimally-processed whole foods from plants or a low-fat omnivorous diet. Participants attend weekly group classes for the first six months, bi-weekly for the next six months, and monthly meetings for the last year. In addition to face-to-face content, participants also have access to private Facebook groups for their diet, podcasts, and online newsletters starting at six months. Primary outcomes include changes in body weight and CVD risk factors (lipids, blood pressure, glucose, and insulin) at 12 months. Secondary outcomes include changes in dietary intake. Participants complete assessments at baseline and at months 6, 12, and 24.
The NEW Soul study is an innovative intervention aimed at improving dietary intake while maintaining traditional AA cultural food choices. Primary outcomes are expected by 2021.
Adopting a plant-rich or plant-based diet is one of the major recommendations for addressing obesity, overweight, and related health conditions in the United States. Currently, research on African ...Americans’ food choices in the context of plant-based diets is limited. The primary aim of this study was to understand food-related experiences and perceptions of African Americans who were participating in the Nutritious Eating with Soul (NEW Soul) study, a culturally tailored dietary intervention focused on increasing the consumption of plant-based foods. The roles of gender and ethnicity were also examined to identify how eating patterns were chosen or maintained. Twenty-one African American adults in South Carolina, who were randomly assigned to either a vegan diet (n = 11) or a low-fat omnivorous diet (n = 10) in the NEW Soul study, completed one-on-one, qualitative interviews. Emerging themes included awareness, being in control, and identity. The study revealed that access to social support and coping strategies for addressing negative comments about plant-based food choices may be important components to include in future nutrition interventions focused on African Americans.
More African American individuals die from cardiovascular disease (CVD) than any other chronic disease condition. Despite this disparity, African American individuals are underrepresented in ...nutrition and CVD interventions.
To compare the effects of an entirely plant-based (vegan) or low-fat omnivorous (omni) diet on change in body weight and lipids during a 2-year intervention.
The Nutritious Eating With Soul (NEW Soul) study was a 2-year, randomized clinical trial conducted in 2 cohorts (2018-2020 and 2019-2021) that took place in a university teaching kitchen in Columbia, South Carolina (before March 2020), and via online videoconference sessions (after March 2020). Participants included African American adults aged 18 to 65 years with overweight or obesity (body mass index of 25.0-49.9) and without type 2 diabetes, uncontrolled thyroid disease, recent weight loss, or pregnancy. Data assessors and statisticians were blinded to study condition. Data analysis was performed from March to June 2022.
The intervention included weekly nutrition classes for 6 months biweekly classes for 6 months, and monthly classes for 12 months. Dietary interventions either emphasized no animal product intake (vegan) or a low-fat omnivorous diet (omni). Both dietary patterns emphasized soul food cuisine (traditional African American southern foodways).
Primary outcomes included change in body weight and lipid measures at 12 months.
There were 568 participants who completed an online screening questionnaire; 409 were excluded and 159 were randomized (77 to the vegan group and 82 to the omni group). Of the 159 participants (mean SD age, 48.4 10.6 years; 126 female 79%) who began the study, the main outcome of body weight was obtained for 121 participants (76%) at 12 months. There were no differences in outcomes between groups, including 12-month changes in weight (mean, -2.39 kg 95% CI, -3.48 to -1.30 kg for the vegan group vs -2.03 kg 95% CI, -3.07 to -1.00 kg for the omni group; P = .64), total cholesterol (-1.05 mg/dL 95% CI, -9.60 to 7.50 mg/dL for the vegan group vs 1.66 mg/dL 95% CI, -7.20 to 10.50 mg/dL for the omni group; P = .67), or low-density lipoprotein cholesterol (mean, -2.56 mg/dL 95% CI, -9.52 to 4.40 mg/dL for the vegan group vs -0.79 mg/dL 95% CI, -7.98 to 6.40 mg/dL for the omni group; P = .73). Weight loss at 12 months among cohort 1, whose weight was assessed in 2019 before the COVID-19 pandemic, was significantly greater than that for cohort 2, whose weight was assessed summer 2020 during COVID-19 (-3.45 kg 95% CI, -4.67 to -2.22 kg vs -1.24 kg 95% CI, -2.24 to -0.25 kg; P = .01).
In this randomized clinical trial examining weight loss and CVD risk factor reduction among African American adults, there were no differences between the groups, and the magnitude of changes overall was small.
ClinicalTrials.gov Identifier: NCT03354377.
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