**3.5 AGEs - advanced glycation endproducts**

*Veganism - a Fashion Trend or Food as a Medicine*

**3.2 Vitamin D**

**3.3 Iron**

30% in V-S).

**3.4 Iodine**

long-chain n-3 fatty acids.

vegans and 147 μg/l in vegetarians.

cycle is inhibited and HCy is not degraded to methionine.

because plant proteins contain less of this amino acid. The results shows a higher incidence of mild hyperhomocysteinemia in lacto-ovo-vegetarians and vegans, in which remethylation predominates, but in vitamin B12 deficiency the remethylation

Subjects with limited animal food intake may be at greater risk of vitamin D deficiency compared to non-vegetarians because the food that provides the highest amounts of vitamin D is of all animal origin [32]. The authors of Crowe et al. [33] reported that plasma concentrations of 25 (OH) vitamin D reflect the rate of elimination of consumption of animal products. Meat consumers had the highest average vitamin D intake (3.1 μg / day) and a mean plasma concentration of 25 (OH) D (77.0 nmol / l), vegans had the lowest average intake and plasma concentration (0.7 μg /day) and 55.8 nmol/l). Our results show that under conditions of the same and low intensity of sunlight (spring - April) a significantly reduced plasma concentration of vitamin D was found in V-LO, while in V-S (white meat consumers) this concentration was balanced with non-vegetarians. A higher incidence of deficit values was found in V-LO versus NV and V-S (67% versus 46% and 50%). It should be noted that vitamin D concentrations are low in all three groups examined (the lower limit of recommended values is 30 ng/ml), suggesting the need for supplementation or pharmaceuticals in the winter and early spring months.

Decreased utilization of minerals and trace elements from food has been observed in people with a dominant consumption of plant foods due to the high content of phytic acid in plant food (whole grains, legumes) as well as fiber (whole grains, legumes, seeds, nuts) [34]. Phytic acid and fiber form undesirable insoluble complexes with some minerals and trace elements, which cannot be used by the organism. These food commodities are significantly more consumed by vegetarians versus non-vegetarians. We observed significantly reduced serum iron concentrations in the V-LO group, hyposiderinemia occurred in 44% versus 20% in NV and

In addition to known iron deficiency disorders and diseases, the latest and lesser-known finding is that iron deficiency adversely affects the biosynthesis of

The iodine content of food of plant origin is lower compared to food of animal origin due to the low iodine content of the soil. On the other hand, regular consumption of animal products (eggs, cheese, milk, meat, fish and poultry) can make a significant contribution to overall income. The literature review indicates that in vegans and vegetarians not consuming iodine supplements and seafood, iodine consumption is inadequate [35]. A wide range of mental, psychomotor and growth abnormalities cause iodine deficiency [36]. Determination of iodine is a more exact criterion than iodine intake, and urinary iodine excretion expresses the degree of saturation in the body. In group V-V we measured urinary iodine excretion 78 μg /l, in V-LO 172 μg /l and in group NV 216 μg /l. A clinically significant deficit (less than 50 μg /l) was reported in 27% V-V, 10% V-LO, but no non-vegetarian. The authors Leung et al. (14) measured median urinary iodine concentrations of 78.5 μg /l in

**46**

These products (AGEs - advanced glycation endproducts) are formed by the non-enzymatic reaction of an aldehyde or keto group of reducing sugars with a free amino group of amino acids, proteins, nucleic acids, phospholipids and other macromolecules; the reaction is called the Maillard reaction or glycation [37]. AGEs negatively affect the functional properties of proteins, lipids and DNA [38]. These chemical modifications accumulate in the body with age and may contribute to the pathophysiological processes associated with aging and to the complications of diabetes, atherosclerosis and chronic renal failure [39, 40]. AGEs are produced from monosaccharides (glucose, fructose), but also from dicarbonyl intermediates of the Maillard reaction, sugar autoxidation, and other metabolic pathways [41, 42]. The reactivity of monosaccharides in AGE formation is given by the ratio between the occurrence of the acyclic and cyclic forms. Only open chain sugar can enter the glycation [43]. Fructose is more reactive because it has a higher proportion of the acyclic form [44]. The mentioned processes of the Maillard reaction in the organism and exogenous AGE from food (especially culinary and technologically modified) are the main sources of intracellular and plasma AGEs [45]. CML (N<sup>ε</sup> -carboxymethyllysine) values and fluorescence AGE values are significantly higher in vegetarians. CML, a major product of oxidative modification of glycated proteins, represents a common marker of oxidative stress and long-term protein damage in the aging process, atherosclerosis, and diabetes [46]. Vegetarians consume less protein and carbohydrates, and lysine intake is significantly reduced. They prefer the use of lower temperatures and shorter periods in food preparation. Some dairy products, specially cooked and with added sugar and stabilizers, have a higher CML content [47]. V-LO consumes significantly smaller amounts of dairy products (220–17 g / day versus 469–41 g/day NV, traditional nutrition) [48]. By excluding all of the above options for increasing plasma AGE values in vegetarians, we focused on monosaccharides. Fluorescence as an index of advanced glycation has been shown to increase linearly for human serum albumin incubated with glucose and exponentially using fructose [44]. The fructose-induced AGE fluorescence was higher than the glucose-induced AGE fluorescence due to the higher content of the more reactive acyclic form of fructose versus glucose.

## **3.6 Amino acids**

The body needs to take in all the essential amino acids and in the optimal amount. Only under these conditions can amino acids from food be adequately used for protein synthesis [48]. The limiting amino acid in the protein mixture consumed (which is the lowest) is crucial for the productive utilization of all essential amino acids for anabolic processes by initiating peptide chain synthesis. Additional amino acids are incorporated into the peptide chain depending on the availability of an amount of limiting amino acid. The major limiting amino acids in plant proteins are methionine, lysine and tryptophan. The content of tryptophan is approximately the same in plant and animal proteins. Significantly reduced methionine and lysine intake in subjects with dominant or exclusive consumption of plant proteins may indicate a reduced rate of proteosynthesis, which is expressed by deficient plasma protein concentrations. Hypoproteinemia has been reported in 20% of adult vegans. The incidence of hypoproteinemia in children was higher - 33% in vegans and 11% in vegetarians. In our earlier experimental study using labeled amino acids, we found that protein synthesis was significantly reduced in young animals during the period of growth fed with plant protein (wheat gluten) compared to animal protein (milk casein). Caso et al. [49] also used the isotope technique and two diets with the

same energy and protein content but with different protein sources. They reported that albumin synthesis in healthy volunteers was significantly reduced after eating plant food (67% plant protein, 33% animal protein) compared to eating 74% animal protein and 26% plant protein).

## **3.7 Microflora of the gastrointestinal tract**

The microflora of the large intestine is an important indicator of human health. Currently, many studies point to the association of various diseases with the quantitative or qualitative representation of individual microorganisms in the gastrointestinal tract. This complex community of microorganisms can "communicate" with cells of the gastrointestinal immune system and thus coordinate the immune response to harmful pathogens. The microflora is also involved in the production of various substances such as certain vitamins or enzymes that help the proper digestion of food, but also acids, bacteriocins and the like that inhibit the growth and adhesion of harmful microorganisms to the surface of the intestinal epithelium. To ensure digestion and immune function of the intestine, it is necessary to properly represent the intestinal microflora, which is influenced by many factors, but to a large extent by the composition of the diet.

The gastrointestinal microflora consists of a very complex community of microorganisms consisting of more than 400 different bacterial species. The number of bacteria increases from 103/ ml in the stomach, 104–106/ ml in the small intestine to more than 1012/ml in the large intestine [50]. The majority of intestinal bacteria are coliform bacteria, streptococci, lactobacilli and strictly anaerobic bacteria of the genera Bacteroides, Bifidobacterium, Fusobacterium and Clostridium. Quantitatively, the microflora of the intestinal tract represents huge numbers of microorganisms approaching a trillion bacterial cells [51]. This huge proportion of bacteria makes up about half the weight of stool [52].

Up to 25–70% of diseases can be prevented by eating optimal food, its specific and balanced components. I. Mečnikov was already thinking about the connection: diet - microbes - health - disease. The bacterial flora can affect colorectal carcinogenesis by producing enzymes that transform procarcinogens into active carcinogens. These include β-glucuronidase, glycosidase, nitroreductase. The main effector mechanisms by which the microflora affects the development of cancer include: activation of procarcinogens, fermentation leading to the formation of short-chain fatty acids, formation of diacylglycerol, synthesis of pentanes and adsorption of hydrophobic molecules [53].

In our study, we divided the quantitative and qualitative representation of the microflora according to age categories and eating habits, while the numbers of microorganisms were expressed as logarithmic values. In the age category 21–30 years we found the largest differences in the total number of clostridia, in non-vegetarians this number was almost 2 orders of magnitude higher than in vegetarians, as evidenced by several studies [54]. In the case of lecithinase-positive clostridia, which play an important role in certain diseases such as e.g. We have not seen a significant difference in colon cancer in terms of eating habits. The number of spores was slightly higher in vegetarians and we assume that they enter the digestive tract mainly through plant food.

In non-vegetarians, we observed a slightly higher number of probiotic bacteria (genus Lactobacillus, Bifidobacterium), which may be due to higher intake of sour milk products in this category of people compared to vegetarians who consume these products to a lesser extent, or not at all. At the same time, we observed an increased number of staphylococci in these people (by about 2 rows), but the *Staphylococcus aureus* strain predominated in people eating plant foods. Occurrence

**49**

*Health Effects of Plant Foods and the Possibility of Reducing Health Risk*

order) of bacteria of the genus Enterococcus spp. and Listeria spp.

of this strain in the gastrointestinal tract is rare, and it can enter the GIT from contaminated food or from the upper respiratory tract and cause various disease states [55]. In vegetarians, we also observed a slightly higher number (about half an

In the etiology of colon cancer, not only genetic predisposition plays an important role, but also some microorganisms, whose quantitative and qualitative representation in the colon is largely influenced by the diet consumed. For example, some bacteria of the genus Bacteroides are able to transform certain substances into mutagens [57]. Another factor influencing this disease is the intake of carcinogenic substances that may arise during food processing [58]. Therefore, another goal was to monitor for the presence of potentially mutagenic substances in the colon. In the group of people aged 21–30 years, we recorded the presence of potentially mutagenic agents in approximately 20% of probands. In the group of non-vegetarians, we captured a slightly higher number of people (25%) compared to vegetarians (21.87%), but we did not register a significant difference between the two groups. In the age category of 31–40 years, we found a much more significant difference in the percentage of probands with detected potential mutagenic substances in the stool. In this case, it is surprising that this percentage was almost five times lower for non-vegetarians (3.84%) compared to vegetarians (19.44%). We assumed that the situation would be the opposite, as vegetarians have a higher dietary fiber intake. This is made up of important oligosaccharides that serve as prebiotics for probiotic bacteria to help prevent colon carcinogenesis. Fiber also increases the peristalsis of the large intestine, is indigestible by the human body, which mechanically "cleanses" the intestinal epithelium and removes carcinogens from the body [59]. On the other hand, people consuming a mixed traditional diet receive more frequently roasted, grilled or otherwise cooked foods in which the presence of mutagenic substances has been demonstrated [60]. However, this trend was confirmed in the category of probands aged 41–50 years, where we determined

The values in the quantitative representation of individual microorganisms of the population of people aged 31–40 were mostly balanced. We observed slight differences especially in the case of eukaryotes (yeast, fibrous fungi) and clostridia, which were increased in non-vegetarians and, conversely, the numbers of listeria, spores and veilonel were higher in vegetarians. By comparing the representation of the intestinal microflora of vegetarians and non-vegetarians in the age category 41–50, we found a difference in the number of total anaerobes, which was 0.3 logarithmically higher in non-vegetarians. In contrast, the total number of aerobic microorganisms was higher in vegetarians. The number of representatives of Bacteroides spp., Veillonella spp., LP-clostridia was comparable in both groups. In vegetarians, we observed a slight increase in Enterococcus spp., Which was approximately 0.5 logarithmically higher compared to nonvegetarians. There was a small difference in the number of bacteria of the family Enterobacteriaceae, with higher values belonged to vegetarians. At the same time, we observed an increased number of Clostridium spp. about 0.5 logarithmic order. We registered the largest difference in the coagulase-positive species *Staphylococcus aureus*. The value of *S. aureus* in vegetarians reached 1.61 ± 0.38 CTU / g stool, which is significantly higher compared to the number of 0.34 ± 0.24 CTU/g stool in non-vegetarians. By comparing the group of people aged 51–60 years, we did not notice a significant difference in the amount of total anaerobes and aerobes. However, we found a significant difference in the number of LP-clostridia by a logarithmic order of magnitude higher in nonvegetarians. The production of α-toxin by LP-clostridia causes cell endothelial damage, resulting in changes that in some cases can lead to colon cancer [56]. In the age group, we registered an increased number of coagulase-positive *S. aureus*,

*DOI: http://dx.doi.org/10.5772/intechopen.94096*

especially in non-vegetarians.

### *Health Effects of Plant Foods and the Possibility of Reducing Health Risk DOI: http://dx.doi.org/10.5772/intechopen.94096*

*Veganism - a Fashion Trend or Food as a Medicine*

**3.7 Microflora of the gastrointestinal tract**

large extent by the composition of the diet.

adsorption of hydrophobic molecules [53].

digestive tract mainly through plant food.

bacteria makes up about half the weight of stool [52].

protein and 26% plant protein).

same energy and protein content but with different protein sources. They reported that albumin synthesis in healthy volunteers was significantly reduced after eating plant food (67% plant protein, 33% animal protein) compared to eating 74% animal

The microflora of the large intestine is an important indicator of human health. Currently, many studies point to the association of various diseases with the quantitative or qualitative representation of individual microorganisms in the gastrointestinal tract. This complex community of microorganisms can "communicate" with cells of the gastrointestinal immune system and thus coordinate the immune response to harmful pathogens. The microflora is also involved in the production of various substances such as certain vitamins or enzymes that help the proper digestion of food, but also acids, bacteriocins and the like that inhibit the growth and adhesion of harmful microorganisms to the surface of the intestinal epithelium. To ensure digestion and immune function of the intestine, it is necessary to properly represent the intestinal microflora, which is influenced by many factors, but to a

The gastrointestinal microflora consists of a very complex community of microorganisms consisting of more than 400 different bacterial species. The number of bacteria increases from 103/ ml in the stomach, 104–106/ ml in the small intestine to more than 1012/ml in the large intestine [50]. The majority of intestinal bacteria are coliform bacteria, streptococci, lactobacilli and strictly anaerobic bacteria of the genera Bacteroides, Bifidobacterium, Fusobacterium and Clostridium. Quantitatively, the microflora of the intestinal tract represents huge numbers of microorganisms approaching a trillion bacterial cells [51]. This huge proportion of

Up to 25–70% of diseases can be prevented by eating optimal food, its specific and balanced components. I. Mečnikov was already thinking about the connection: diet - microbes - health - disease. The bacterial flora can affect colorectal carcinogenesis by producing enzymes that transform procarcinogens into active carcinogens. These include β-glucuronidase, glycosidase, nitroreductase. The main effector mechanisms by which the microflora affects the development of cancer include: activation of procarcinogens, fermentation leading to the formation of short-chain fatty acids, formation of diacylglycerol, synthesis of pentanes and

In our study, we divided the quantitative and qualitative representation of the microflora according to age categories and eating habits, while the numbers of microorganisms were expressed as logarithmic values. In the age category 21–30 years we found the largest differences in the total number of clostridia, in non-vegetarians this number was almost 2 orders of magnitude higher than in vegetarians, as evidenced by several studies [54]. In the case of lecithinase-positive clostridia, which play an important role in certain diseases such as e.g. We have not seen a significant difference in colon cancer in terms of eating habits. The number of spores was slightly higher in vegetarians and we assume that they enter the

In non-vegetarians, we observed a slightly higher number of probiotic bacteria (genus Lactobacillus, Bifidobacterium), which may be due to higher intake of sour milk products in this category of people compared to vegetarians who consume these products to a lesser extent, or not at all. At the same time, we observed an increased number of staphylococci in these people (by about 2 rows), but the *Staphylococcus aureus* strain predominated in people eating plant foods. Occurrence

**48**

of this strain in the gastrointestinal tract is rare, and it can enter the GIT from contaminated food or from the upper respiratory tract and cause various disease states [55]. In vegetarians, we also observed a slightly higher number (about half an order) of bacteria of the genus Enterococcus spp. and Listeria spp.

The values in the quantitative representation of individual microorganisms of the population of people aged 31–40 were mostly balanced. We observed slight differences especially in the case of eukaryotes (yeast, fibrous fungi) and clostridia, which were increased in non-vegetarians and, conversely, the numbers of listeria, spores and veilonel were higher in vegetarians. By comparing the representation of the intestinal microflora of vegetarians and non-vegetarians in the age category 41–50, we found a difference in the number of total anaerobes, which was 0.3 logarithmically higher in non-vegetarians. In contrast, the total number of aerobic microorganisms was higher in vegetarians. The number of representatives of Bacteroides spp., Veillonella spp., LP-clostridia was comparable in both groups. In vegetarians, we observed a slight increase in Enterococcus spp., Which was approximately 0.5 logarithmically higher compared to nonvegetarians. There was a small difference in the number of bacteria of the family Enterobacteriaceae, with higher values belonged to vegetarians. At the same time, we observed an increased number of Clostridium spp. about 0.5 logarithmic order. We registered the largest difference in the coagulase-positive species *Staphylococcus aureus*. The value of *S. aureus* in vegetarians reached 1.61 ± 0.38 CTU / g stool, which is significantly higher compared to the number of 0.34 ± 0.24 CTU/g stool in non-vegetarians. By comparing the group of people aged 51–60 years, we did not notice a significant difference in the amount of total anaerobes and aerobes. However, we found a significant difference in the number of LP-clostridia by a logarithmic order of magnitude higher in nonvegetarians. The production of α-toxin by LP-clostridia causes cell endothelial damage, resulting in changes that in some cases can lead to colon cancer [56]. In the age group, we registered an increased number of coagulase-positive *S. aureus*, especially in non-vegetarians.

In the etiology of colon cancer, not only genetic predisposition plays an important role, but also some microorganisms, whose quantitative and qualitative representation in the colon is largely influenced by the diet consumed. For example, some bacteria of the genus Bacteroides are able to transform certain substances into mutagens [57]. Another factor influencing this disease is the intake of carcinogenic substances that may arise during food processing [58]. Therefore, another goal was to monitor for the presence of potentially mutagenic substances in the colon. In the group of people aged 21–30 years, we recorded the presence of potentially mutagenic agents in approximately 20% of probands. In the group of non-vegetarians, we captured a slightly higher number of people (25%) compared to vegetarians (21.87%), but we did not register a significant difference between the two groups. In the age category of 31–40 years, we found a much more significant difference in the percentage of probands with detected potential mutagenic substances in the stool. In this case, it is surprising that this percentage was almost five times lower for non-vegetarians (3.84%) compared to vegetarians (19.44%). We assumed that the situation would be the opposite, as vegetarians have a higher dietary fiber intake. This is made up of important oligosaccharides that serve as prebiotics for probiotic bacteria to help prevent colon carcinogenesis. Fiber also increases the peristalsis of the large intestine, is indigestible by the human body, which mechanically "cleanses" the intestinal epithelium and removes carcinogens from the body [59]. On the other hand, people consuming a mixed traditional diet receive more frequently roasted, grilled or otherwise cooked foods in which the presence of mutagenic substances has been demonstrated [60]. However, this trend was confirmed in the category of probands aged 41–50 years, where we determined the presence of potentially mutagenic substances, especially in non-vegetarians. The percentage of the population in the age category 51–60 was relatively balanced in both groups, but at the same time almost half lower compared to the young (21–30 years) generation of probands.

Diet is one of the important indicators affecting the composition of the intestinal microflora. It is important to monitor and at the same time modulate the composition of food intake in the prevention or treatment of certain diseases. From our results of intestinal microflora values, it is clear that a randomly selected population consumes a varied diet, i. the intake of animal food is supplemented by a plantbased diet. The result of such a diet is a balanced intestinal microflora. Under certain circumstances and on the basis of certain measured parameters, it can be assessed that the conventional diet is "more advantageous" than a predominantly plant-based diet. Increased intake of beneficial bacteria in the form of probiotic products could have a positive effect on health in old age.
