Potential risks of a non-matched vegan diet on biomarkers of health status, body composition and performance in young female athletes – a 12-week randomized controlled trial

Potential risks of a non-matched vegan diet on biomarkers of health status, body composition and performance in young female athletes – a 12-week randomized controlled trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Potential risks of a non-matched vegan diet on biomarkers of health status, body composition and performance in young female athletes – a 12-week randomized controlled trial Joshua Dissemond, Alessio Lesch, Sarah Valder, Jan Schalla, Saskia Friedrichsen, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7319305/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background A vegan diet is frequently associated with a health-conscious lifestyle and has become increasingly adopted by athletes. However, empirical evidence regarding its impact on athletic performance and health—particularly in young female athletes—remains limited. This study aimed to investigate the effects of a vegan dietary pattern on health markers, immune function, body composition, and physical performance. Methods In a 12-week randomized controlled two-arm trial, 22 young female athletes were assigned to follow either a vegan or an omnivorous diet. Blood samples, body composition, and performance metrics were assessed at baseline and at four-week intervals. A certified nutritionist and medical personnel supervised the intervention. Results Significant between-group differences were found in total energy intake, macronutrient distribution, and micronutrient consumption. The vegan group consumed significantly less energy (p = 0.011), protein (p = 0.007), essential amino acids (p = 0.010) including L-leucine (p = 0.005), calcium (p = 0.002), and vitamin B12 (p < 0.001), but had higher intakes of carbohydrates (p = 0.011), sugar (p = 0.028), and iron (p = 0.004). While no significant differences were observed in lipid profile, liver and kidney function, or sex hormones, a significant group difference was observed for iron concentration after 12 weeks (p = 0.019). In terms of body composition, the vegan group showed a significant reduction in body weight (p < 0.001) and BMI (p = 0.004), with no differences in fat-free mass, skeletal muscle mass, or fat mass. Performance measures revealed a significant decrease in 1-RM squat performance in the vegan group (p = 0.031), along with group differences at weeks 4 (p < 0.05 and 8 (p < 0.05) in relative squat performance. A significant difference in squat jump performance was also noted at week 4 (p < 0.05). Conclusion A non-matched vegan diet may impair strength-related performance and reduce iron status in young female athletes, underscoring the need for carefully structured nutritional planning to ensure adequate energy as well as macro- and micronutrient intake. German Clinical Trials Register (DRKS00031633) vegan diet female athletes performance risks body composition health Figures Figure 1 Figure 2 Figure 3 Key points The vegan group consumed less energy, protein, calcium, and vitamin B12, but more absolute carbohydrates, sugar, and iron Strength and squat jump performance declined significantly in the vegan group in the first weeks Close supervision with precise dietary planning is essential to prevent nutritional deficiencies in vegan athletes. 1. Introduction Nutritional strategies and a balanced diet are an important part in competitive sports. Alongside training, periodisation, and recovery, nutrition should also be specifically tailored to the individual athlete. In terms of an optimal and healthy diet, the consumption of animal products such as milk and meat has been the subject of lively debate for some years now [ 1 – 3 ]. Avoiding animal products and following a vegan lifestyle can have positive effects on the cardiovascular system and exhibit anti-inflammatory properties [ 2 ]. As a result, the risk of developing hypertension or diabetes is reduced and cardiovascular mortality decreases [ 4 – 6 ]. Based on the health-promoting effects of a vegan diet, even competitive athletes decided to avoid animal products. In this context, the potential risks of a vegan diet on performance and adaptability are often discussed. However, initial studies on performance show no differences between athletes who follow a vegan or omnivorous diet [ 7 , 8 ]. With regard to strength training and muscular adaptations, the lower biological value of plant proteins is also often part of the lively debate. However, current studies with recreational athletes and trained individuals show no differences in performance and the adaptations of skeletal muscle mass (SMM) with a high protein and a calorie-matched diet [ 9 , 10 ]. This is confirmed by current reviews on signal activation through a vegan diet [ 11 ]. However, it is known that potential difficulties in implementing new behavioural patterns such as changes in diet can occur. It has been shown that a vegan diet often has a lower calorie density and that it changes the macronutrient distribution [ 12 ]. It was found that protein consumption is slightly lower with a vegan diet than with an omnivorous lifestyle, whereas the proportion of carbohydrates is slightly higher [ 12 – 14 ]. Although a lower dietary energy density may provide advantages for weight management in the general Western population, a reduced energy intake in athletes carries the risk of relative energy deficiency (RED). This condition can lead to potentially serious consequences, including an increased risk of injury, decreased bone mineral density, and impaired muscular as well as cardiovascular performance [ 15 ]. To prevent RED-related symptoms, an energy intake of more than 45 kcal/kg of fat-free mass (FFM) is recommended for athletes [ 15 ]. In addition, potential risk of deficiencies such as vitamin B12, zinc, calcium and selenium are often reported [ 16 , 17 ]. Studies on athletes' eating behaviour indicate that capability (knowledge, skills), motivation (intentions, goals) and opportunity (resources, social influence) are key factors in this context [ 18 ]. Even if the motivation to change one's diet or to adhere to dietary recommendations is present, access to resources, the daily routine or financial aspects can influence eating behaviour. Currently, there is limited evidence regarding the vegan diet and the potential challenges associated with transitioning from an omnivorous to a vegan lifestyle. Initial studies with recreational athletes showed no difference in body weight, body mass index (BMI) and lower and upper body strength after changing to a vegan diet [ 13 ]. It was also observed that, despite the requirement to maintain the macronutrient distribution, protein intake decreased while carbohydrate intake increased significantly. A similar change was also observed in healthy young trained women [ 14 ]. In contrast to the recreational athletes, a significant decrease in SMM was also observed during the vegan phase [ 14 ]. In this study, the participants were also instructed not to change the macronutrient distribution. Besides, in both studies, the participants were supervised by a nutrition coach, but there was no active intervention in the distribution of macronutrients or energy intake. Based on these initial findings, it can be assumed that athletes may encounter difficulties in implementing a vegan diet during the first few weeks. The potential effects and risks of a supervised dietary change for competitive athletes are currently unknown. Given that young women in particular are inclined to adopt a vegan lifestyle [ 19 , 20 ], the present study examined how switching to a vegan diet affects health and performance in young competitive athletes. 2. Material and Methods 2.1 Study design A twelve-week randomised controlled two-arm study was conducted. The effects of a vegan diet on various biomarkers for health statue, body composition and performance were analysed. At the beginning, all participants (T-1) received information on a balanced diet for female athletes. The nutritional guidelines are based on the statement of the International Society of Sports Nutrition [ 21 , 22 ]. Afterwards, a one-week familiarisation phase followed, during which the participants were instructed on how to document their diet using the Food Diary Food Database FDDB (version 2.3.17, Food Database GmbH, 28217 Bremen, Germany). Performance diagnostics and blood samples were carried out every four weeks (T0, T1, T2, T3). All participants were recruited from a handball performance centre (Bergischer Handball Club Solingen, Germany). Throughout the entire period, there was no intervention regarding training or match planning. The diet was monitored over the entire period by a nutritionist using FDDB Explorer. In addition, the participants were supervised by the team's athletics coach and team physician throughout the entire period. The study was approved by the local ethics committee of the German Sports University in Cologne, Germany (125/2021) and was registered in the German Clinical Trials Register (DRKS00031633). The study design is shown in Fig. 1 . 2.2 Participants Thirty-four young female competitive athletes were recruited for this study. All participants were part of the U19 or U17 handball team of the Bergischer Handball Club and all took part in qualifying for the highest division in their respective age group. All participants followed the same training protocol and match frequency over the entire period (5 training sessions of 120 min each + 1–2 matches/week). The participants level of performance can be classified as highly trained (Tier 3) [ 23 ]. At the beginning of the study, none of the athletes adhered to a vegan lifestyle. Of those approached, five declined to participate, while 29 agreed to take part. For athletes who were underage, written consent had to be provided by their parents. After stratified randomization (height, body weight, 1RM in the squat and whether they were in the starting line-up), the participants were divided into a vegan (VG, n = 15) or omnivorous group (OG, n = 14). After four weeks (T1), four subjects (VG = 2, OG = 2) had to discontinue the study due to ankle injuries, muscle injuries and academic stress. After eight weeks, three more athletes had to terminate the study early due to shoulder injuries, extreme weight loss and doctor's orders. A total of 22 competitive athletes successfully completed the study. The consort flow diagram is shown in Fig. 2 . 2.3 Dietary strategies 2.3.1 omnivore diet The control group followed an omnivorous lifestyle. A vegan or vegetarian diet was prohibited. The nutritionist was in contact with all participants from both groups several times a week and could be contacted at any time with questions about feasibility or dietary suggestions. The general macronutrient distribution of the ISSN for both groups was 45–55% carbohydrate, 15–20% protein and 15–25% fat [ 22 ]. To assess individual feasibility under real-life conditions, no specific gram-per-kilogram body weight recommendations were provided.The diet was documented over the entire period using the FDDB Explorer. The online food diary is a valid method [ 24 ] and has already been used in previous studies [ 13 , 14 , 25 , 26 ]. All participants were instructed to eat ad libitum and to adhere to the recommendations as best as possible. The nutritional diary entries were requested weekly by the nutritionist but analysis was only carried out at the end of the intervention. If the participants felt unwell or lacked energy, the nutritionist and the team physician were contacted. Individual nutrition plans were then reviewed and recommendations made. If deficiency symptoms were identified by the blood analyses and the recommendations were not followed, the participants were excluded from the study. 2.3.1 Vegan diet At the beginning, the VG was informed in detail by a nutritionist about a balanced vegan diet for female athletes [ 22 , 27 , 28 ]. The guidelines were based on current recommendations so that theoretically no deficits or deficiency symptoms should occur [ 28 ]. During the entire period, the consumption of animal products was prohibited for the VG. Alternatives to meat and animal substitute products were made available at the beginning. The unconscious consumption of animal products did not directly lead to exclusion from the study. All other recommendations, specifications and options were identical to those of the OG. 2.4 Diagnostic procedure All performance diagnostics, blood samples and body composition measurements were taken between 5.00 pm and 8.00 pm. Before the measurements, the participants were instructed to have a last large meal at 2 pm and a last snack and sufficient water (400-500ml) at 4 pm. Exact meal times and macronutrient requirements were not given to the participants. However, similar meals and snacks were to be consumed on all four test days. The sequence of procedures on the test days was as follows : 5.00 pm Arrival and blood sampling 5.15 pm Measurement of body composition using bioelectrical impedance analysis (BIA) 5.30 pm Warm-up and examination of jumping ability 6.00 pm Strength test in the lower body 6.30 pm Examination of endurance capacity 2.5 Outcomes 2.5.1 Biomarkers Two tubes containing 8.5 ml of venous whole blood were taken by the team physician. All blood parameters were directly analyzed by a local analysis laboratory in Cologne (Labor Dr. Wisplinghoff, Horbeller Str. 18–20 50858 Cologne, Germany). 2.5.1.1 Blood lipids For the blood lipid profile triglycerides, cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) concentrations were analyzed. In addition, further ratios such as cholesterol/HDL, LDL/cholesterol, HDL/LDL were subsequently formed. 2.5.1.2 Hematology: Immune cell activity Blood samples were analyzed for routine complete blood count (CBC) including hemoglobin and total white blood cells (WBC) count and differential for WBC sub fractions using a BC2300 hematology analyzer (Mindray Medical International Systems, Shenzhen, China).To identify immune cell activity, the neutrophil granulocyte/lymphocyte (NLR), platelet/lymphocyte (PLR) and systemic immune-inflammation index (SII) ratios were calculated [ 29 ]. 2.5.1.3 Liver and kidney function To examine liver function, the enzyme activity of glutamate–oxaloacetate transaminase (GOT), gamma-glutamyl transferase (GGT) and glutamate–pyruvate transaminase (GPT) were evaluated. Creatinine (CREA) concentration was analyzed for kidney function. 2.5.1.4 Muscle damage and oxidative stress markers The creatine kinase (CK) and myoglobin (MYO) concentrations were examined to monitor as indirect marker for muscular damage and oxidative LDL (oxLDL) and total anti-oxidative capacity (TOC) for oxidative stress caused by training and match days. 2.5.1.5 Hormone concentration and Iron Level The menstrual cycle was monitored over the entire period via estradiol (E2) and progesterone (p) concentration. In addition, a cycle diary was used for the length of the menstrual cycle. In addition, the iron (FE) concentration was examined over the entire period. 2.5.2 Body composition Body composition was assessed using bioelectrical impedance analysis (BIA 101, Akern, Firenze, Italy). The BIA Akern 101 is a valid and reliable alternative method to dual-energy X-ray absorptiometry (DXA) for verification of body composition [ 30 , 31 ] and was used in previous studies with male and female subjects [ 32 , 33 ]. Before analyses, the participants lay on the floor for 10 minutes with their arms and legs stretched out. The measurements were taken using the four-point method on the right side (2 electrodes on the hand, 2 on the foot). Jewelry and other electrically conductive objects were removed from the body. During the analysis, total body water (TBW), FFM, fat mass (FM), SMM and BMI were recorded. BW was assessed using a digital scale (Etekcity EB4074C, Anaheim, CA, United States of America) wearing short sportswear without shoes. 2.5.3 Performance All performance diagnostics were carried out following the guidelines of the NSCA [ 34 ] and the framework concept plan of the German Handball Federation [ 35 ]. All performance tests were known to the participants before the start of the examination and were part of the athletics training and general performance diagnostics. 2.5.3.1 Jumping ability – squat jump, countermovement jump, drop jump After a general warm-up phase of 10 minutes with 5 minutes of running and 5 minutes of mobility exercises, the jumping ability was tested. As a measure of jumping ability, the flight time was determined using an Optojump photocell (Microgate, Bolzano, Italy). All participants started with the squat jump (SJ). Two test jumps were performed beforehand followed by a total of three performance jumps. A break of 60 seconds was set between the jumps. This was followed by a test of the countermovement jump (CMJ). After a test jump, three performance jumps were also carried out, each with a pause time of 60 seconds. Finally, the performance in the drop jump (DJ) was tested. A maximum ground contact time of 200ms was set. Three performance jumps were also carried out after a test jump. For all jump variants, only the best jump was evaluated. 2.5.3.2 One repetition maximum barbell back squat To assess strength in the lower body, one repetition maximum in the back squat (1RM SQ) with the barbell was tested. A standardized barbell with a weight of 20 kg was used and the exercise was performed in a squat rack for the safety of the athletes. In addition, two spotters were positioned to the side of the barbell during the performance diagnostics if the weight could no longer be moved independently. The depth of the squat was standardized using boxes so that a 90-degree angle was achieved in the knee joint. The participants were instructed to maintain brief contact with the box and then return to the starting position. After at least four warm-up sets with 50–80% (50% 10 repetition, 60% 6–8 repetition, 70% 4–6 repetition, 80% 2–4 repetition) of maximum performance capacity, 4–8 maximum strength tests were performed. The first maximal test was performed at approximately 90% of the estimated 1RM SQ. The weight was then continuously increased by 5-10kg until the load could no longer be managed. If a load could not be overcome, the participants could try again or reduce the weight by 2.5kg. The break time between the warm-up phases was set at 2 minutes, between the last warm-up set and the first performance test at 3 minutes and then between the performance tests at 4 minutes. 2.5.3.3 Shuttle run test – IFT 30/15 The Intermittent Fitness Test 30 − 15 (IFT 30 − 15) was used to determine sport-specific endurance performance. The test is the standard for testing endurance performance in handball players and is specified by the DHB [ 35 ]. The IFT 30 − 15 is a shuttle run endurance test over a distance of 40 meters. The marked 40-metre field is divided into five zones: a 14-metre running track (2x), a 3-metre zone (2x) and a central 6-metre zone (see Fig. 3). The test subjects must complete shuttle runs between lines A and C at a specified running speed during the 30-second exercise period. The running speed is increased by 0.5 km/h per lap, starting at 10 km/h. The running speed is controlled by an acoustic signal. There are two different types of signals, a bright tone indicating that the test subjects must now have reached the next zone and a short tone sequence signaling the end of the lap. As the speed increases steadily, the distance travelled per 30 seconds per lap also increases. As speed and time are known, conclusions can be drawn about the distance covered. After the 30 seconds of exertion, there is a 15-second rest while the next line (A, B or C) is walked. This is explicitly announced after the tone sequence at the end of the round. The pause is followed by the next exercise period of 30 seconds at an increased speed. The test ends when a test subject has not reached the next zone twice in succession or three times during the acoustic signal. The last completed lap was then included in the evaluation. 2.6 Statistical Analysis All data were analyzed individually for each test parameter using the statistical software R (Version 4.3.0;RRID:SCR_001905). Linear mixed-effects models (LMMs) were applied using the lme4 package[ 36 , 37 ],with each test parameter serving as the dependent variable. Prior to model fitting, the distribution of all outcome variables was visually assessed using Q-Q plots. Variables not approximately normally distributed were transformed as follows: – Log-transformation was applied to Fe, HDL, LDL, OxLDL, LDL/HDL, Trigl, GOT, GGT, CK and LmAnOx. – Box-Cox transformation was used for GPT, E2, and MM. If assumptions of normality could not be achieved even after transformation, generalized linear mixed models (GLMMs) were fitted using the glmmTMB or lme4 package, assuming a Gamma distribution with a log-link function (or inverse Gaussian if appropriate). This approach was applied to BW, BMI, NLR, PLR, SII, Chol, and P. All models included subject ID as a random intercept to account for repeated measures over time. Fixed effects included Group (Omnivore vs. Vegan), Time (T0–T3), and their interaction (Group × Time). Model diagnostics were performed using the DHARMa package, including residual simulation, tests for dispersion, zero inflation, and outliers. In the case of body weight (BW), a significant under dispersion was observed. Since under dispersion tends to result in conservative estimates and no zero inflation was detected, the Gamma GLMM was retained as a robust and pragmatic model choice. Attempts to fit alternative models (e.g., Tweedie) failed due to convergence issues. Estimated marginal means were calculated using the emmeans package, and pairwise contrasts were FDR-adjusted using the Benjamini–Hochberg method. Significance was defined as p < .05. To assess multicollinearity, the variable Time was mean-centered, and variance inflation factors (VIF) were computed from equivalent GLMs without random effects. The model comparisons are based on the likelihood function and changes in the Akaike information criterion ( AIC ). 3 Results The characteristics of the participants at the start of the study, including age, height, body weight, and relative maximum strength, are listed in Table 1 . There was no significant difference between the groups at the beginning of the study. Table 1 Characteristics of participants Vegan Omnivore p-values Age (y) 17.3 ± 1.3 16.5 ± 1.4 n.s. Height (cm) 170.3 ± 5.4 170.2 ± 5.2 n.s. Bodyweight (kg) 64.6 ± 8.2 59.6 ± 3.4 n.s. Relative strength (SQ) 1.16 ± 0.2 1.10 ± 0.2 n.s. Values displayed as mean ± SD; SQ, Squat; y, years; n.s., not significant; *#Significance level at p ≤ 0.05; * , 3.1 Nutrition Significant differences in dietary habits were observed throughout the study period. The omnivorous group consumed significantly higher amounts of total energy (p = 0.011), relative energy intake per kg BW (p = 0.024), protein (p = 0.007), relative protein per kg BW (p = 0.002) and FFM (p = 0.001), essential amino acids (p = 0.010) (including L-leucine (p = 0.005), relative fat per kg BW (p = 0.042) and FFM (p = 0.042), cholesterol (< 0.001), and had a higher omega-3 to omega-6 (n-3/n-6) fatty acid ratio (p = 0.003). In contrast, the vegan group had significantly higher intakes of carbohydrates (p = 0.011), sugars (p = 0.028), and dietary fiber (p = 0.015). No significant differences were found between the groups in relative energy intake per kg FFM, relative carbohydrate per kg BW and FFM, total fat intake, saturated fat acids or L-arginine consumption. Regarding micronutrients, the omnivorous group had significantly higher intakes of calcium (p = 0.002) and vitamin B12 (p < 0.001), whereas the vegan group consumed significantly more iron (p = 0.004) and potassium (p = 0.013). There were no significant differences between the groups in zinc or iodine intake. The detailed data on the macro- and micronutrient intake are presented in Table 2 . Table 2 Energy intake, Macronutrient and Micronutrient Macronutrient Vegan Omnivore P-values time P-values group Energy intake (kcal/day) 1588,27 ± 151,33 1739,00 ± 183,46 n.s. 0.011 Energy intake (g/kg BW) 25.05 ± 4.20 29.74 ± 3.08 n.s. 0.024 Energy intake (g/kg FFM) 35.75 ± 3.96 41.86 ± 5.66 n.s. n.s. Carbohydrates (g/day) 225.26 ± 18.36 206,34 ± 14,81 n.s. 0.011 Carbohydrates (g/kg BW) 3.55 ± 0.56 3.53 ± 0.26 n.s. n.s. Carbohydrates (g/kg FFM) 5.07 ± 0.51 4.96 ± 0.54 n.s. n.s. Total sugar (g/day) 72.74 ± 5.71 65.66 ± 21.65 n.s. 0.028 Total Fibre (g/day) 28.46 ± 4.35 18.96 ± 2.77 n.s. 0.015 Protein (g/day) 46.60 ± 4.38 67.86 ± 8.96 n.s. 0.007 Protein (g/kg BW) 0.74 ± 0.14 1.16 ± 0.17 n.s. 0.002 Protein (g/kg FFM) 1.05 ± 0.12 1.63 ± 0.28 n.s. 0.001 Total essential amino acids (g/day) 20.37 ± 2.01 33.13 ± 4.70 n.s. 0.010 L-Leucin (g/day) 3.26 ± 0.34 5.35 ± 0.81 n.s. 0.005 L-Arginin (g/day) 2.87 ± 0.29 3.54 ± 0.44 n.s. n.s Fat (g/day) 53.48 ± 12.99 69.00 ± 11.51 n.s. n.s Fat (g/kg BW) 0.84 ± 0.23 1.18 ± 0.18 n.s. 0.042 Fat (g/kg FFM) 1.20 ± 0.29 1.66 ± 0.30 n.s. 0.042 Saturated fatty acids (g/day) 18.44 ± 6.19 27.46 ± 4.73 n.s. 0.078 Linoleic acid (g/day) 1.29 ± 0.45 1.76 ± 0.87 n.s. n.s. O3/O6 Ratio ((O3/O6)/day) 0.11 ± 0.04 0.21 ± 0.07 n.s. 0.003 Cholesterol (mg/day) 18.67 ± 8.27 267.48 ± 110.38 n.s. < 0.001 Iron (mg/day) 79.38 ± 19.21 59.69 ± 9.46 n.s. 0.004 Calcium (g/day) 2.25 ± 0.79 4.07 ± 0.95 n.s. 0.002 Zinc (mg/day) 44.56 ± 10.82 51.70 ± 6.98 n.s. n.s. Iodine (µg/day) 213.93 ± 69.27 349.35 ± 103.17 n.s. n.s. Potassium (g/day) 15.25 ± 4.45 12.25 ± 2.58 n.s. 0.013 Vitamin B12 (µg/day) 0.70 ± 0.40 17.01 ± 4.73 n.s. < 0.001 Values displayed as mean ± SD; n.s., not significant; *Significance level at p ≤ 0.05 3.2 Blood analyses No significant differences between groups were observed in biomarkers related to general health and immune function, with the exception of iron concentrations. A significant time × group interaction was identified for iron at T3 (p = 0.019). Both groups exhibited a significant increase in oxLDL concentrations at T2 (p < 0.05). Additionally, liver enzyme activities (GOT and GGT) increased significantly at T1 (p < 0.05) and T2 (p < 0.05), with no differences between groups. Significant changes were also observed in lipid profiles at T2: LDL concentrations decreased significantly in both groups (p < 0.05), while HDL concentrations increased significantly (p < 0.05) in the omnivorous group only. Detailed data on the biomarkers related to general health and immune function are presented in Table 3 . Table 3 Biomarkers related for general health and immune function Parameter Group T0 T1 T2 T3 p-values time p-values group Creatinkinase (U/l) Vegan 132.82 ± 43.50 115.60 ± 42.94 133.80 ± 57.10 175.22 ± 40.87 n.s. n.s. Creatinkinase (U/l) Omnivore 121. 90 ± 52.13 120.50 ± 67.36 148.90 ± 105.52 213.50 ± 149.79 Myoglobin (ng/ml) Vegan < 25 < 25 < 25 < 25 LOD Myoglobin (ng/ml) Omnivore < 25 < 25 < 25 < 25 Ox LDL (U/l) Vegan 36.82 ± 66.21 61.30 ± 55.71 92.40 ± 54.14* 45.00 ± 70.25 n.s. n.s. Ox LDL (U/l) Omnivore 22.82 ± 21.17 43.73 ± 26.26 105.60 ± 69.41* 33.73 ± 26.45 LmAn Ox (U/l) Vegan 301.36 ± 101.05 267.30 ± 63.49 220.00 ± 35.83 240.67 ± 71.55 n.s. n.s. LmAn Ox (U/l) Omnivore 322.64 ± 106.90 361.64 ± 106.90 267.00 ± 37.90 250.70 ± 46.50 GOT (U/l) Vegan 22.18 ± 3.01 21.40 ± 2.73 24.89 ± 2.82* 20.20 ± 7.03 n.s. n.s. GOT (U/l) Omnivore 24.91 ± 4.78 22.27 ± 3.79* 26.64 ± 4.72 25.36 ± 5.85 GGT (U/l) Vegan 12.73 ± 2.80 14.00 ± 3.26 11.40 ± 3.50* 11.89 ± 2.60 n.s. n.s. GGT (U/l) Omnivore 13.91 ± 2.87 14.82 ± 3.04 12.18 ± 3.27* 14.45 ± 3.11 GPT (U/l) Vegan 14.45 ± 2.10 14.70 ± 1.68 15.10 ± 2.43 13.44 ± 1.26 n.s. n.s. GPT (U/l) Omnivore 16.91 ± 3.12 17.36 ± 3.14 17.36 ± 2.99 17.45 ± 5.14 Creatinine (mg/dl) Vegan 0.84 ± 0.09 0.79 ± 0.09 0.78 ± 0.14 0.77 ± 0.07 n.s. n.s. Creatinine (mg/dl) Omnivore 0.80 ± 0.09 0.79 ± 0.10 0.78 ± 0.10 0.79 ± 0.09 Progesterone (ng/dl) Vegan 164.45 ± 339.08 62.40 ± 42.95 76.60 ± 47.40 62.44 ± 30.68 n.s. n.s. Progesterone (ng/dl Omnivore 164.73 ± 251.55 212.09 ± 417.62 199.73 ± 337.38 186.45 ± 349.29 Estradiol (pg/ml) Vegan 78.00 ± 95.31 56.50 ± 79.76 61.60 ± 63.82 54.67 ± 64.06* 0.037 n.s. Estradiol (pg/ml) Omnivore 53.55 ± 50.76 108.55 ± 87.80 92.55 ± 70.57 75.91 ± 54.28 n.s. Cholesterol (mg/dl) Vegan 172.27 ± 30.30 182.80 ± 49.39 160.00 ± 30.43 174.44 ± 34.64 n.s. n.s. Cholesterol (mg/dl) Omnivore 155.91 ± 48.00 170.27 ± 20.63 149.27 ± 36.22 171.45 ± 26.58 LDL (mg/dl) Vegan 97.91 ± 22.73 102.60 ± 37.18 80.30 ± 26.00* 97.89 ± 26.17 n.s. n.s. LDL (mg/dl) Omnivore 94.36 ± 15.15 92.36 ± 14.16 80.64 ± 14.11* 96.36 ± 18.79 HDL (mg/dl) Vegan 55.91 ± 9.23 57.10 ± 8.77 62.70 ± 11.14 57.78 ± 11.73 n.s. n.s. HDL (mg/dl) Omnivore 53.82 ± 8.90 58.64 ± 7.30 64.40 ± 8.33* 57.64 ± 6.48 Triglyceride Vegan 116.82 ± 52.98 187.00 ± 165.69 148.90 ± 135.30 116.56 ± 43.59 n.s. n.s. Triglyceride Omnivore 106.36 ± 52.98 110.18 ± 43.38 113.36 ± 50.32 100.09 ± 46.80 Iron (ug/dl) Vegan 88.00 ± 34.01 85.60 ± 30.39 90.60 ± 41.42 67.00 ± 21.31# n.s. 0.019 Iron (ug/dl) Omnivore 59.54 ± 29.16 59.27 ± 28.05 68.00 ± 29.63 77.37 ± 27.73 n.s. n.s. Haemoglobin (g/dl) Vegan 13.36 ± 0.90 13.84 ± 0.76 12.94 ± 1.35 13.38 ± 0.85 n.s. n.s. Haemoglobin (g/dl) Omnivore 13.70 ± 0.58 14.34 ± 0.72 13.87 ± 0.79 13.84 ± 0.61 NLR Vegan 1.63 ± 0.62 1.28 ± 0.63 1.52 ± 0.50 1.17 ± 0.48 n.s. n.s. NLR Omnivore 2.17 ± 1.34 2.93 ± 1.28 2.47 ± 1.97 2.00 ± 0.88 PLR Vegan 0.12 ± 0.04 0.13 ± 0.04 0.13 ± 0.04 0.12 ± 0.04 n.s. n.s. PLR Omnivore 0.18 ± 0.15 0.19 ± 0.17 0.16 ± 0.14 0.17 ± 0.10 SII Vegan 444.44 ± 138.06 370.78 ± 196.61 426.85 ± 172.89 338.32 ± 138.88 n.s. n.s. SII Omnivore 805.15 ± 605.07 1199.86 ± 1688.06 954.67 ± 1222.54 741.93 ± 384.94 Values displayed as mean ± SD; LOD; below the limit of detection; n.s., not significant; *#Significance level at p ≤ 0.05; *, indicates a significant time effect; #, indicates a significant interaction effect; 3.3 Body composition A significant reduction in bodyweight (p < 0.001) and BMI (p = 0.004) was observed over time in the vegan group, with a significant time-by-group interaction favoring the vegan group over the omnivorous group (p < 0.001; p = 0.004). Both groups demonstrated significant increases in fat-free mass (p = 0.025) and muscle mass (p < 0.001) over time; however, no significant differences between the groups were detected. A significant change over time was also observed in TBW (p = 0.031). No significant changes were found in fat mass, either overtime or between groups. Detailed data for body composition are presented in Table 4 . Table 4 Body composition Parameter Group T0 T1 T2 T3 p-values time p-values group Body height (cm) Vegan 170.27 ± 5.40 170.27 ± 5.40 170.27 ± 5.40 170.27 ± 5.40 n.s. n.s. Body height (cm) Omnivore 170.18 ± 5.21 170.18 ± 5.21 170.18 ± 5.21 170.18 ± 5.21 n.s. n.s. Bodyweight (kg) Vegan 64.64 ± 8.18 64.64 ± 8.18 64.08 ± 7.78 62.47 ± 7.24*# < 0.001 < 0.001 Bodyweight (kg) Omnivore 59.64 ± 3.38 59.64 ± 3.38 60.00 ± 3.30 59.78 ± 3.32 0.711 Fat free mass (kg) Vegan 44.26 ± 2.63 44.29 ± 3.53 45.12 ± 2.63 45.00 ± 3.76* 0.025 n.s. Fat free mass (kg) Omnivore 42.61 ± 2.81 43.23 ± 2.67 44.08 ± 3.11 43.85 ± 3.01* Fat mass (kg) Vegan 20.37 ± 6.17 20.35 ± 6.51 18.96 ± 5.71 18.61 ± 7.40 n.s. n.s. Fat mass (kg) Omnivore 17.03 ± 2.50 16.41 ± 2.31 15.89 ± 2.53 15.94 ± 2.28 Skeletal muscle mass (kg) Vegan 27.43 ± 1.93 28.37 ± 3.30 29.21 ± 1.79 29.70 ± 4.09* < 0.001 n.s. Skeletal muscle mass (kg) Omnivore 26.81 ± 1.90 27.95 ± 1.93 28.92 ± 1.95* 29.48 ± 2.38* Total body water (L) Vegan 32.39 ± 1.91 32.41 ± 2.59 33.01 ± 1.93 32.94 ± 2.75 0.031 n.s. Total body water (L) Omnivore 31.16 ± 1.97 31.71 ± 1.71 31.96 ± 1.80 31.99 ± 2.06 BMI (kg/m 2 ) Vegan 22.25 ± 2.24 22.25 ± 2.24 21.97 ± 2.21 21.87 ± 2.39*# 0.004 0.004 BMI (kg/m 2 ) Omnivore 20.60 ± 0.97 20.60 ± 0.97 20.71 ± 0.91 20.64 ± 0.96 0.792 Values displayed as mean ± SD; n.s., not significant; *#Significance level at p ≤ 0.05; *, indicates a significant time effect; #, indicates a significant interaction effect; 3.4. Performance Regarding performance outcomes, the vegan group exhibited a significant reduction in absolute maximal squat strength over time (p = 0.031). Additionally, significant time-by-group interaction effects were observed at time points T1 (p < 0.05) and T2 (p < 0.05), favouring the omnivorous group (Fig. 2 A). Relative squat strength also demonstrated significant interaction effects at T1 (p < 0.05) and T2 (p < 0.05), although no significant main effect of time was observed (Fig. 2 B). In the SJ, a significant time-by-group interaction effect was found at T1 (p < 0.05); however, no significant changes over time were detected in either group (Fig. 2 C). For the CMJ and DJ, no significant main effects of time or time-by-group interactions were observed. In the 30 − 15 IFT, both groups showed a significant decline in endurance performance over time (p < 0.05), with no significant differences between groups. The detailed data for performance are presented in Table 5 . Table 5 Performance Parameter Group T0 T1 T2 T3 p-values time p-values group 1RM SQ (kg) Vegan 75.00 ± 14.40 70.45 ± 11.39# 69.00 ± 10.81 70.25 ± 10.63* 0.031 n.s. 1RM SQ (kg) Omnivore 65.45 ± 9.40 67.00 ± 8.95 68.44 ± 9.15 63.25 ± 12.91 0.547 Relative SQ (Kg/BW) Vegan 1.16 ± 0.18 1.09 ± 0.15# 1.08 ± 0.15#* 1.14 ± 0.14 n.s. n.s. Relative SQ (Kg/BW) Omnivore 1.10 ± 0.18 1.13 ± 0.17 1.15 ± 0.18 1.07 ± 0.25 Squat Jump (cm) Vegan 28.61 ± 3.01 27.64 ± 3.44# 27.98 ± 3.14 28.61 ± 3.96 n.s. n.s. Squat Jump (cm) Omnivore 28.99 ± 4.22 30.23 ± 4.54 29.44 ± 4.56 29.11 ± 4.83 CMJ (cm) Vegan 28.52 ± 4.02 28.81 ± 3.45 28.37 ± 4.43 28.69 ± 4.35 n.s. n.s. CMJ (cm) Omnivore 28.77 ± 5.14 29.09 ± 5.28 28.90 ± 5.27 28.90 ± 5.09 Drop Jump (cm) Vegan 27.40 ± 5.16 28.08 ± 4.30 27.80 ± 5.28 27.30 ± 5.36 n.s. n.s. Drop Jump (cm) Omnivore 26.94 ± 4.31 28.04 ± 3.50 27.56 ± 5.76 27.65 ± 4.50 IFT 30 − 15 (Km/h) Vegan 18.18 ± 1.81 17.05 ± 1.96* 17.30 ± 1.72* 16.90 ± 1.06* < 0.001 n.s. IFT 30 − 15 (Km/h) Omnivore 18.14 ± 1.13 17.50 ± 0.61 17.00 ± 1.20* 16.50 ± 1.27* Values displayed as mean ± SD; SQ = Squat; CMJ = Countermovement Jump; IFT = Intermittent Fitness Test; n.s., not significant; *#Significance level at p ≤ 0.05; *, indicates a significant time effect; #, indicates a significant interaction effect; Discussion This study aimed to investigate the effects of a non-matched vegan diet versus an omnivorous diet on general health markers, body composition, and performance in young female athletes. Despite ongoing supervision by a qualified nutritionist, significant differences emerged between the two dietary strategies. Concerning health markers, a significant reduction in serum iron concentration was observed in the vegan group, while no significant differences were found in lipid profiles, liver and kidney function, oxidative stress levels, or immune-related parameters such as the NLR, PLR, and SII. Regarding body composition, reductions in body weight and BMI were observed exclusively in the vegan group. In contrast, declines in strength and jump performance were also significant only within the vegan group. It is well known that the energy intake and macronutrient distribution of a non-matched vegan diet differ from those of an omnivorous dietary pattern [ 12 ]. Generally, vegan diets are characterized by lower total energy intake and protein intake [ 12 – 14 ]. These differences were also evident in the present cohort of young female athletes. Self-reported dietary records indicated that the vegan group had a significantly lower energy intake (absolute and per kg BW) compared to the omnivorous group. When additionally considering energy intake per kg of FFM (kcal/kg FFM)), both groups demonstrated reduced energy availability [ 38 ], falling below the recommended threshold of 45 kcal/kg FFM [ 15 ]. Nevertheless, the results suggest that a non-matched vegan diet may further increase the risk of reduced energy availability in athletes, particularly if adequate energy intake is not carefully monitored. Furthermore, both absolute and relative (BW and FFM) protein intake, as well as the intake of essential amino acids, particularly L-leucine, were significantly reduced in the vegan group. Despite protein and essential amino acid intakes falling below current recommendations for female athletes [ 27 ], no adverse effects were observed on FFM or SMM. Consistent with previous findings, absolute carbohydrate intake, including total sugar consumption, was significantly higher in the vegan group compared to the omnivorous group [ 12 – 14 , 28 ]. In contrast, when considering relative carbohydrate (BW and FFM) intake, no differences were observed between the two dietary strategies. However, the relative carbohydrate intake in both groups appears to be too low for competitive athletes and aligns more closely with the recommendations for recreational athletes (3–5 g/kg BW) rather than with those for high-performance athletes (≥ 5 g/kg BW) [ 22 , 27 ]. No significant difference was observed in total fat intake between the two groups, but for relative fat intake (BW and FFM). Nevertheless, the relative fat intake per kg BW in both groups are in line with current recommendations [ 22 ]. Regarding dietary fiber, micronutrients, and vitamin intake, the vegan group demonstrated a significantly lower intake of vitamin B12 and calcium, consistent with previous findings [ 12 , 16 ]. In contrast, iron and potassium intake were significantly higher in the vegan group compared to the omnivorous group. Eliminating animal products and reducing the intake of animal-based, particularly saturated, fats typically leads to a lower overall energy intake and is associated with a reduced risk of cardiovascular disease [ 2 , 4 – 6 ]. However, in the present study, no significant differences were observed at any time between the vegan and omnivorous groups in key health markers, including lipid profiles, liver and kidney function. This lack of difference may be attributed to the generally high baseline health status of the female athletes, who consistently exceeded physical activity recommendations due to their intensive training and competition schedules [ 39 ]. As such, the adoption of a vegan diet did not appear to confer additional benefits to general health in this population. Moreover, no potential pre-regenerative effects were observed, as indicated by unchanged concentration of muscle damage markers (CK and myoglobin) and oxidative stress indicators (e.g., oxLDL or LmAnOx). These findings suggest that a vegan diet does not exert a pro-regenerative effect in young female athletes. Interestingly, a significant reduction in serum iron concentration over time was observed exclusively in the vegan group, despite their reported dietary iron intake being higher throughout the study period. This finding aligns with previous research indicating that, although plant-based foods may contain substantial amounts of iron, their bioavailability is considerably lower compared to animal-derived sources [ 16 , 40 ]. It is well established that women are generally at higher risk for iron deficiency and should therefore monitor their iron status more closely [ 22 , 27 ]. Iron deficiency is associated with a range of adverse symptoms, including fatigue, weakness, and shortness of breath [ 40 – 43 ]. However, these observations should be interpreted with caution, as serum iron concentration does not directly reflect iron stores (ferritin concentration). To clearly identify iron deficiency, it would have been necessary to assess haemoglobin and ferritin levels in addition to serum iron concentration [ 44 ]. When considering haemoglobin concentrations over time in both groups, no significant differences were observed, suggesting that there is no clear indication of iron deficiency associated with a vegan diet. Nevertheless, regular monitoring of iron status (ferritin, haemoglobin and iron concentration) is particularly recommended for female athletes, with iron supplementation advised when deficiencies are detected [ 27 , 40 ]. Concerning body composition, a significant reduction in BW and BMI was observed exclusively in the vegan group. This finding is consistent with previous studies conducted in other populations [ 12 – 14 ]. Interestingly, no significant change in FM was detected. However, when considering FFM and SMM, the results suggest that the reduction in body weight was primarily attributable to a decrease in FM, as no significant reductions were observed in either FFM or SMM. In contrast to previous studies [ 14 ], no significant differences in SMM were observed between the vegan and omnivorous groups. Despite a significant difference in protein intake between the groups and with both groups falling below the recommended protein intake per kg of BW [ 22 , 27 ], no significant decline in SMM was detected. On the contrary, both groups showed an increase in SMM over time. Two plausible explanations may account for the observed findings. First, although the overall training regimen, including both sport-specific and strength-oriented components, was systematically periodized by the coaching staff, it is conceivable that modifications within the resistance training program contributed to increases in FFM or SMM. However, this interpretation appears incongruent with the observed changes in maximal strength capacity, which did not reflect corresponding improvements. This discrepancy suggests that hypertrophic adaptations alone are insufficient to explain the findings. An alternative explanation concerns the potential inaccuracy of dietary reporting. It is possible that actual protein intake exceeded the values documented, due either to underreporting or incomplete dietary records. Such limitations are well-recognized in applied sports nutrition research, where both the implementation of individualized nutritional strategies and the rigorous documentation of dietary intake pose substantial methodological challenges [ 18 ]. Furthermore, empirical evidence consistently demonstrates a decline in adherence to dietary protocols, as well as a reduction in the accuracy of self-reported intake, with increasing duration of nutritional interventions [ 45 ]. When examining performance capacity, a significant reduction in maximal squat performance was observed in the vegan group, as well as a significant interaction effect between time points T1 and T2. This decline was also evident in relative strength measures and confirmed in the SJ at T1. The significant decrease in performance in both exercises may be attributable to the markedly lower energy intake observed in the vegan group and is associated with fatigue and reduced energy availability [ 46 , 47 ], which could plausibly explain the observed performance impairments. When energy and protein intake are appropriately matched, current evidence indicates that there are no statistically significant differences in either strength performance or alterations in body composition between individuals adhering to a vegan diet and those following an omnivorous diet, irrespective of training status [ 9 , 10 ]. In contrast, no significant decline in performance was observed in the CMJ or DJ. This may be attributed to differences in movement execution compared to the SJ. Both the CMJ and DJ involve a dynamic stretch-shortening cycle, whereas the SJ is initiated from a static position following an isometric preload [ 48 ]. In the 30 − 15 IFT, however, a significant decline in performance was observed in both groups, in contrast to the power-based tests. This reduction may be explained by cumulative fatigue throughout the competitive season. It is well established that general performance metrics tend to decline as the season progresses [ 49 – 52 ], which suggests that the observed impairment in the IFT is likely attributable to seasonal fatigue rather than to any specific dietary strategy. Limitations Despite the novel and meaningful contributions of the present investigation, several methodological limitations must be acknowledged. Foremost among these is the relatively small sample size, as only 22 female athletes successfully completed the study. Given that all participants were concurrently engaged in competitive sport during the intervention period, the likelihood of participant attrition was inherently elevated compared to more controlled experimental designs. Nevertheless, this study represents the first to exclusively investigate a cohort of young female elite athletes, thereby filling a critical gap in the current literature. Another limitation concerns the lack of experimental control over training stimuli. Throughout the intervention period, all training was planned, coordinated, and implemented solely by the team’s coaching staff. As such, any potential influence of training variation on performance outcomes must be interpreted with caution. However, since all participants were recruited from the same club and subjected to a uniform training program, a degree of standardization in training exposure was preserved. Additionally, the reliability of dietary intake data warrants careful consideration. The potential for incomplete or inaccurate dietary documentation exists in both intervention groups, particularly given the extended duration of the study and the inherent challenges associated with integrating prescribed nutritional strategies and meticulous dietary recording into the daily routines of high-performance athletes. While such factors may have introduced reporting bias, it is important to note that all participants were exposed to similar conditions and constraints, thereby partially mitigating the impact of this limitation. Conclusion In conclusion, the present investigation revealed that a non-matched vegan diet, despite supervision by a qualified nutritionist, resulted in a statistically significant reduction in both energy and protein intake. Furthermore, although dietary iron intake increased over the course of the intervention, a concomitant significant decline in circulating blood iron concentrations was observed in the vegan cohort. However, reduced iron concentration alone does not allow for a definitive diagnosis of iron deficiency. The reduced energy intake of the vegan group may have adversely impacted neuromuscular performance, as evidenced by diminished 1RM squat performance and squat jump capabilities. Notably, no measurable improvements in general health biomarkers or immune function attributable to the vegan dietary regimen were detected among the athletes. It is imperative to interpret these findings with caution, given potential limitations in the completeness and accuracy of dietary intake documentation. Nonetheless, the data underscore the necessity for more stringent, tailored nutritional protocols within vegan populations, even under professional guidance, to mitigate the risk of nutrient insufficiencies and to optimize athletic performance outcomes. Declarations Acknowledgements: The authors would like to thank all participants and the medical staff for taking part in and conducting the study. Funding Open Access: funding provided by IST University of Applied Sciences Funding: No sources of funding were used to assist in the preparation of this article. Conflict of interest: All authors have no conflicts of interest that are relevant to the content of this article. Ethics approval: This study was approved by the Ethics Committee of the German Sport University (125/2021) and registered in the German register for clinical studies (DRKS00031633). Consent to participate: All participants were informed about the study design and objectives and signed a consent form before the start of the intervention. The study was conducted voluntarily by all participants. Consent for publication: all authors agree with the submitted version of the manuscript. There is also no conflict of interest with a third party. Availability of data and material : Anonymised data can be requested from the first author or the corresponding author. 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Changes in Cardiorespiratory Fitness during a Season in Elite Female Soccer, Basketball, and Handball Players. Applied Sciences 13, 9593 (2023). Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7319305","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":502874173,"identity":"080291b0-4418-4109-81a0-a13b9b6ef9ed","order_by":0,"name":"Joshua Dissemond","email":"","orcid":"","institution":"IST University of Applied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Joshua","middleName":"","lastName":"Dissemond","suffix":""},{"id":502874174,"identity":"5e1e8001-6c44-4f2b-8278-9796648b021d","order_by":1,"name":"Alessio Lesch","email":"","orcid":"","institution":"German Sports University Cologne","correspondingAuthor":false,"prefix":"","firstName":"Alessio","middleName":"","lastName":"Lesch","suffix":""},{"id":502874175,"identity":"056144ff-074c-4f95-89d2-bb2d8b14975b","order_by":2,"name":"Sarah Valder","email":"","orcid":"","institution":"German Sports University Cologne","correspondingAuthor":false,"prefix":"","firstName":"Sarah","middleName":"","lastName":"Valder","suffix":""},{"id":502874176,"identity":"d0fbcd38-bedc-40c9-87f2-790285af9caf","order_by":3,"name":"Jan Schalla","email":"","orcid":"","institution":"IST University of Applied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Jan","middleName":"","lastName":"Schalla","suffix":""},{"id":502874177,"identity":"1d6ed3b8-93ec-4201-a602-8d4ae971c785","order_by":4,"name":"Saskia Friedrichsen","email":"","orcid":"","institution":"German Sports University Cologne","correspondingAuthor":false,"prefix":"","firstName":"Saskia","middleName":"","lastName":"Friedrichsen","suffix":""},{"id":502874178,"identity":"bccc7e6b-1bfc-474a-a961-3997bc1ce082","order_by":5,"name":"Stephan Geisler","email":"","orcid":"","institution":"IST University of Applied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Stephan","middleName":"","lastName":"Geisler","suffix":""},{"id":502874179,"identity":"1a0862f6-25aa-4c41-b4a9-ba0c3da143e4","order_by":6,"name":"Sergen Belen","email":"","orcid":"","institution":"German Sports University Cologne","correspondingAuthor":false,"prefix":"","firstName":"Sergen","middleName":"","lastName":"Belen","suffix":""},{"id":502874180,"identity":"2366dd57-ce8e-4933-932d-b95d4b044945","order_by":7,"name":"Philipp Zimmer","email":"","orcid":"","institution":"TU Dortmund","correspondingAuthor":false,"prefix":"","firstName":"Philipp","middleName":"","lastName":"Zimmer","suffix":""},{"id":502874181,"identity":"c71f5643-a3e7-415b-88e4-c35986b5bded","order_by":8,"name":"Ulrich Flenker","email":"","orcid":"","institution":"German Sports University Cologne","correspondingAuthor":false,"prefix":"","firstName":"Ulrich","middleName":"","lastName":"Flenker","suffix":""},{"id":502874182,"identity":"8f38a219-1b52-462c-8053-81d98d7b239e","order_by":9,"name":"Eduard Isenmann","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABHUlEQVRIie2QMUvEMBTHnxSaJaXrOwr1K5wETgXRr9LQ4ZaiHIIIDlcpxNHV475Ep84tGboU5xNvsBTqWuh4IKaK55JD3RzyGx7J4/34vwTAYPiPWF8HchurmgPgR/NIXYIfFFrEStgquFvZggH8TnEJqZtZdHp+OGqSvoO17y7v6n4m0AcS5jpllFDGFll4ebzkAnNoGa4r5i0EMqCtNmYsqe05mcXTZy6geJM8xci2HIE8xmisU84ked042ZynT0XS5TAo03ZQ5jFedNoUCyaWk6nJ1V6Mn0owGZQAMNL/k6RMLVbytFJvqUAyXEXMo494IGirXcy9L+veyW54WpZNdw3Sdx+mdU+vTvZdEr5oY3Zj/3HeYDAYDN+8A8xYYGosw5kYAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0003-3300-5118","institution":"IST University of Applied Sciences","correspondingAuthor":true,"prefix":"","firstName":"Eduard","middleName":"","lastName":"Isenmann","suffix":""},{"id":502874183,"identity":"eb0f8dd8-146d-4526-952d-719ec2a5a069","order_by":10,"name":"Patrick Diel","email":"","orcid":"","institution":"German Sports University Cologne","correspondingAuthor":false,"prefix":"","firstName":"Patrick","middleName":"","lastName":"Diel","suffix":""}],"badges":[],"createdAt":"2025-08-07 13:28:48","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7319305/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7319305/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90077878,"identity":"c81ab37f-414b-4bc1-83c3-afeb94460763","added_by":"auto","created_at":"2025-08-28 08:18:10","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":136848,"visible":true,"origin":"","legend":"\u003cp\u003estudy design\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7319305/v1/6b402c0d0a969b122a908c2e.png"},{"id":90077879,"identity":"982f594d-b1f3-461c-8625-a4766e431f32","added_by":"auto","created_at":"2025-08-28 08:18:10","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19393,"visible":true,"origin":"","legend":"\u003cp\u003eConsort flow diagram of included participants\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7319305/v1/368032466ce276a05c680c5b.png"},{"id":90076144,"identity":"54c385f1-e086-44d3-8f18-59e0ac3b7a83","added_by":"auto","created_at":"2025-08-28 08:02:10","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":120416,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eFigure 2: A absolute squat performance; B relative squat performance; C squat jump; time effect was market with * and interaction effect with #\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7319305/v1/5cfa95c885dc1c24a6c1d419.png"},{"id":95227195,"identity":"7a619284-a8f2-4998-b61c-632464ebfc56","added_by":"auto","created_at":"2025-11-05 16:32:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2145501,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7319305/v1/a549ad49-3644-4650-8917-c065bddab1b9.pdf"}],"financialInterests":"","formattedTitle":"Potential risks of a non-matched vegan diet on biomarkers of health status, body composition and performance in young female athletes – a 12-week randomized controlled trial","fulltext":[{"header":"Key points","content":"\u003cul\u003e\n \u003cli\u003eThe vegan group consumed less energy, protein, calcium, and vitamin B12, but more absolute carbohydrates, sugar, and iron\u003c/li\u003e\n \u003cli\u003eStrength and squat jump performance declined significantly in the vegan group in the first weeks\u003c/li\u003e\n \u003cli\u003eClose supervision with precise dietary planning is essential to prevent nutritional deficiencies in vegan athletes.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"1. Introduction","content":"\u003cp\u003eNutritional strategies and a balanced diet are an important part in competitive sports. Alongside training, periodisation, and recovery, nutrition should also be specifically tailored to the individual athlete. In terms of an optimal and healthy diet, the consumption of animal products such as milk and meat has been the subject of lively debate for some years now [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Avoiding animal products and following a vegan lifestyle can have positive effects on the cardiovascular system and exhibit anti-inflammatory properties [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. As a result, the risk of developing hypertension or diabetes is reduced and cardiovascular mortality decreases [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBased on the health-promoting effects of a vegan diet, even competitive athletes decided to avoid animal products. In this context, the potential risks of a vegan diet on performance and adaptability are often discussed. However, initial studies on performance show no differences between athletes who follow a vegan or omnivorous diet [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. With regard to strength training and muscular adaptations, the lower biological value of plant proteins is also often part of the lively debate. However, current studies with recreational athletes and trained individuals show no differences in performance and the adaptations of skeletal muscle mass (SMM) with a high protein and a calorie-matched diet [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This is confirmed by current reviews on signal activation through a vegan diet [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHowever, it is known that potential difficulties in implementing new behavioural patterns such as changes in diet can occur. It has been shown that a vegan diet often has a lower calorie density and that it changes the macronutrient distribution [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. It was found that protein consumption is slightly lower with a vegan diet than with an omnivorous lifestyle, whereas the proportion of carbohydrates is slightly higher [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Although a lower dietary energy density may provide advantages for weight management in the general Western population, a reduced energy intake in athletes carries the risk of relative energy deficiency (RED). This condition can lead to potentially serious consequences, including an increased risk of injury, decreased bone mineral density, and impaired muscular as well as cardiovascular performance [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. To prevent RED-related symptoms, an energy intake of more than 45 kcal/kg of fat-free mass (FFM) is recommended for athletes [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In addition, potential risk of deficiencies such as vitamin B12, zinc, calcium and selenium are often reported [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Studies on athletes' eating behaviour indicate that capability (knowledge, skills), motivation (intentions, goals) and opportunity (resources, social influence) are key factors in this context [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Even if the motivation to change one's diet or to adhere to dietary recommendations is present, access to resources, the daily routine or financial aspects can influence eating behaviour. Currently, there is limited evidence regarding the vegan diet and the potential challenges associated with transitioning from an omnivorous to a vegan lifestyle. Initial studies with recreational athletes showed no difference in body weight, body mass index (BMI) and lower and upper body strength after changing to a vegan diet [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. It was also observed that, despite the requirement to maintain the macronutrient distribution, protein intake decreased while carbohydrate intake increased significantly. A similar change was also observed in healthy young trained women [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In contrast to the recreational athletes, a significant decrease in SMM was also observed during the vegan phase [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In this study, the participants were also instructed not to change the macronutrient distribution. Besides, in both studies, the participants were supervised by a nutrition coach, but there was no active intervention in the distribution of macronutrients or energy intake. Based on these initial findings, it can be assumed that athletes may encounter difficulties in implementing a vegan diet during the first few weeks. The potential effects and risks of a supervised dietary change for competitive athletes are currently unknown. Given that young women in particular are inclined to adopt a vegan lifestyle [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], the present study examined how switching to a vegan diet affects health and performance in young competitive athletes.\u003c/p\u003e"},{"header":"2. Material and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study design\u003c/h2\u003e\u003cp\u003eA twelve-week randomised controlled two-arm study was conducted. The effects of a vegan diet on various biomarkers for health statue, body composition and performance were analysed. At the beginning, all participants (T-1) received information on a balanced diet for female athletes. The nutritional guidelines are based on the statement of the International Society of Sports Nutrition [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Afterwards, a one-week familiarisation phase followed, during which the participants were instructed on how to document their diet using the Food Diary Food Database FDDB (version 2.3.17, Food Database GmbH, 28217 Bremen, Germany). Performance diagnostics and blood samples were carried out every four weeks (T0, T1, T2, T3). All participants were recruited from a handball performance centre (Bergischer Handball Club Solingen, Germany). Throughout the entire period, there was no intervention regarding training or match planning. The diet was monitored over the entire period by a nutritionist using FDDB Explorer. In addition, the participants were supervised by the team's athletics coach and team physician throughout the entire period. The study was approved by the local ethics committee of the German Sports University in Cologne, Germany (125/2021) and was registered in the German Clinical Trials Register (DRKS00031633). The study design is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Participants\u003c/h2\u003e\u003cp\u003eThirty-four young female competitive athletes were recruited for this study. All participants were part of the U19 or U17 handball team of the Bergischer Handball Club and all took part in qualifying for the highest division in their respective age group. All participants followed the same training protocol and match frequency over the entire period (5 training sessions of 120 min each +\u0026thinsp;1\u0026ndash;2 matches/week). The participants level of performance can be classified as highly trained (Tier 3) [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. At the beginning of the study, none of the athletes adhered to a vegan lifestyle. Of those approached, five declined to participate, while 29 agreed to take part. For athletes who were underage, written consent had to be provided by their parents. After stratified randomization (height, body weight, 1RM in the squat and whether they were in the starting line-up), the participants were divided into a vegan (VG, n\u0026thinsp;=\u0026thinsp;15) or omnivorous group (OG, n\u0026thinsp;=\u0026thinsp;14). After four weeks (T1), four subjects (VG\u0026thinsp;=\u0026thinsp;2, OG\u0026thinsp;=\u0026thinsp;2) had to discontinue the study due to ankle injuries, muscle injuries and academic stress. After eight weeks, three more athletes had to terminate the study early due to shoulder injuries, extreme weight loss and doctor's orders. A total of 22 competitive athletes successfully completed the study. The consort flow diagram is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Dietary strategies\u003c/h2\u003e\u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\u003ch2\u003e2.3.1 omnivore diet\u003c/h2\u003e\u003cp\u003eThe control group followed an omnivorous lifestyle. A vegan or vegetarian diet was prohibited. The nutritionist was in contact with all participants from both groups several times a week and could be contacted at any time with questions about feasibility or dietary suggestions. The general macronutrient distribution of the ISSN for both groups was 45\u0026ndash;55% carbohydrate, 15\u0026ndash;20% protein and 15\u0026ndash;25% fat [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. To assess individual feasibility under real-life conditions, no specific gram-per-kilogram body weight recommendations were provided.The diet was documented over the entire period using the FDDB Explorer. The online food diary is a valid method [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and has already been used in previous studies [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. All participants were instructed to eat ad libitum and to adhere to the recommendations as best as possible. The nutritional diary entries were requested weekly by the nutritionist but analysis was only carried out at the end of the intervention. If the participants felt unwell or lacked energy, the nutritionist and the team physician were contacted. Individual nutrition plans were then reviewed and recommendations made. If deficiency symptoms were identified by the blood analyses and the recommendations were not followed, the participants were excluded from the study.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\u003ch2\u003e2.3.1 Vegan diet\u003c/h2\u003e\u003cp\u003eAt the beginning, the VG was informed in detail by a nutritionist about a balanced vegan diet for female athletes [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The guidelines were based on current recommendations so that theoretically no deficits or deficiency symptoms should occur [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. During the entire period, the consumption of animal products was prohibited for the VG. Alternatives to meat and animal substitute products were made available at the beginning. The unconscious consumption of animal products did not directly lead to exclusion from the study. All other recommendations, specifications and options were identical to those of the OG.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Diagnostic procedure\u003c/h2\u003e\u003cp\u003eAll performance diagnostics, blood samples and body composition measurements were taken between 5.00 pm and 8.00 pm. Before the measurements, the participants were instructed to have a last large meal at 2 pm and a last snack and sufficient water (400-500ml) at 4 pm. Exact meal times and macronutrient requirements were not given to the participants. However, similar meals and snacks were to be consumed on all four test days. \u003cem\u003eThe sequence of procedures on the test days was as follows\u003c/em\u003e:\u003c/p\u003e\u003c/div\u003e\n\u003cp\u003e5.00 pm Arrival and blood sampling\u003c/p\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003cp\u003e5.15 pm Measurement of body composition using bioelectrical impedance analysis (BIA)\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003cp\u003e5.30 pm Warm-up and examination of jumping ability\u003c/p\u003e\u003c/div\u003e\n\u003cp\u003e6.00 pm Strength test in the lower body\u003c/p\u003e\n\u003cp\u003e6.30 pm Examination of endurance capacity\u003c/p\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Outcomes\u003c/h2\u003e\u003cdiv id=\"Sec14\" class=\"Section3\"\u003e\u003ch2\u003e2.5.1 Biomarkers\u003c/h2\u003e\u003cp\u003eTwo tubes containing 8.5 ml of venous whole blood were taken by the team physician. All blood parameters were directly analyzed by a local analysis laboratory in Cologne (Labor Dr. Wisplinghoff, Horbeller Str. 18\u0026ndash;20 50858 Cologne, Germany).\u003c/p\u003e\u003cdiv id=\"Sec15\" class=\"Section4\"\u003e\u003ch2\u003e2.5.1.1 Blood lipids\u003c/h2\u003e\u003cp\u003eFor the blood lipid profile triglycerides, cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) concentrations were analyzed. In addition, further ratios such as cholesterol/HDL, LDL/cholesterol, HDL/LDL were subsequently formed.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section4\"\u003e\u003ch2\u003e2.5.1.2 Hematology: Immune cell activity\u003c/h2\u003e\u003cp\u003eBlood samples were analyzed for routine complete blood count (CBC) including hemoglobin and total white blood cells (WBC) count and differential for WBC sub fractions using a BC2300 hematology analyzer (Mindray Medical International Systems, Shenzhen, China).To identify immune cell activity, the neutrophil granulocyte/lymphocyte (NLR), platelet/lymphocyte (PLR) and systemic immune-inflammation index (SII) ratios were calculated [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section4\"\u003e\u003ch2\u003e2.5.1.3 Liver and kidney function\u003c/h2\u003e\u003cp\u003eTo examine liver function, the enzyme activity of glutamate\u0026ndash;oxaloacetate transaminase (GOT), gamma-glutamyl transferase (GGT) and glutamate\u0026ndash;pyruvate transaminase (GPT) were evaluated. Creatinine (CREA) concentration was analyzed for kidney function.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section4\"\u003e\u003ch2\u003e2.5.1.4 Muscle damage and oxidative stress markers\u003c/h2\u003e\u003cp\u003eThe creatine kinase (CK) and myoglobin (MYO) concentrations were examined to monitor as indirect marker for muscular damage and oxidative LDL (oxLDL) and total anti-oxidative capacity (TOC) for oxidative stress caused by training and match days.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section4\"\u003e\u003ch2\u003e2.5.1.5 Hormone concentration and Iron Level\u003c/h2\u003e\u003cp\u003eThe menstrual cycle was monitored over the entire period via estradiol (E2) and progesterone (p) concentration. In addition, a cycle diary was used for the length of the menstrual cycle. In addition, the iron (FE) concentration was examined over the entire period.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section3\"\u003e\u003ch2\u003e2.5.2 Body composition\u003c/h2\u003e\u003cp\u003eBody composition was assessed using bioelectrical impedance analysis (BIA 101, Akern, Firenze, Italy). The BIA Akern 101 is a valid and reliable alternative method to dual-energy X-ray absorptiometry (DXA) for verification of body composition [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] and was used in previous studies with male and female subjects [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Before analyses, the participants lay on the floor for 10 minutes with their arms and legs stretched out. The measurements were taken using the four-point method on the right side (2 electrodes on the hand, 2 on the foot). Jewelry and other electrically conductive objects were removed from the body. During the analysis, total body water (TBW), FFM, fat mass (FM), SMM and BMI were recorded. BW was assessed using a digital scale (Etekcity EB4074C, Anaheim, CA, United States of America) wearing short sportswear without shoes.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section3\"\u003e\u003ch2\u003e2.5.3 Performance\u003c/h2\u003e\u003cp\u003eAll performance diagnostics were carried out following the guidelines of the NSCA [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] and the framework concept plan of the German Handball Federation [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. All performance tests were known to the participants before the start of the examination and were part of the athletics training and general performance diagnostics.\u003c/p\u003e\u003cdiv id=\"Sec22\" class=\"Section4\"\u003e\u003ch2\u003e2.5.3.1 Jumping ability \u0026ndash; squat jump, countermovement jump, drop jump\u003c/h2\u003e\u003cp\u003eAfter a general warm-up phase of 10 minutes with 5 minutes of running and 5 minutes of mobility exercises, the jumping ability was tested. As a measure of jumping ability, the flight time was determined using an Optojump photocell (Microgate, Bolzano, Italy). All participants started with the squat jump (SJ). Two test jumps were performed beforehand followed by a total of three performance jumps. A break of 60 seconds was set between the jumps. This was followed by a test of the countermovement jump (CMJ). After a test jump, three performance jumps were also carried out, each with a pause time of 60 seconds. Finally, the performance in the drop jump (DJ) was tested. A maximum ground contact time of 200ms was set. Three performance jumps were also carried out after a test jump. For all jump variants, only the best jump was evaluated.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec23\" class=\"Section4\"\u003e\u003ch2\u003e2.5.3.2 One repetition maximum barbell back squat\u003c/h2\u003e\u003cp\u003eTo assess strength in the lower body, one repetition maximum in the back squat (1RM SQ) with the barbell was tested. A standardized barbell with a weight of 20 kg was used and the exercise was performed in a squat rack for the safety of the athletes. In addition, two spotters were positioned to the side of the barbell during the performance diagnostics if the weight could no longer be moved independently. The depth of the squat was standardized using boxes so that a 90-degree angle was achieved in the knee joint. The participants were instructed to maintain brief contact with the box and then return to the starting position.\u003c/p\u003e\u003cp\u003eAfter at least four warm-up sets with 50\u0026ndash;80% (50% 10 repetition, 60% 6\u0026ndash;8 repetition, 70% 4\u0026ndash;6 repetition, 80% 2\u0026ndash;4 repetition) of maximum performance capacity, 4\u0026ndash;8 maximum strength tests were performed. The first maximal test was performed at approximately 90% of the estimated 1RM SQ. The weight was then continuously increased by 5-10kg until the load could no longer be managed. If a load could not be overcome, the participants could try again or reduce the weight by 2.5kg. The break time between the warm-up phases was set at 2 minutes, between the last warm-up set and the first performance test at 3 minutes and then between the performance tests at 4 minutes.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec24\" class=\"Section4\"\u003e\u003ch2\u003e2.5.3.3 Shuttle run test \u0026ndash; IFT 30/15\u003c/h2\u003e\u003cp\u003eThe Intermittent Fitness Test 30\u0026thinsp;\u0026minus;\u0026thinsp;15 (IFT 30\u0026thinsp;\u0026minus;\u0026thinsp;15) was used to determine sport-specific endurance performance. The test is the standard for testing endurance performance in handball players and is specified by the DHB [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. The IFT 30\u0026thinsp;\u0026minus;\u0026thinsp;15 is a shuttle run endurance test over a distance of 40 meters. The marked 40-metre field is divided into five zones: a 14-metre running track (2x), a 3-metre zone (2x) and a central 6-metre zone (see Fig.\u0026nbsp;3). The test subjects must complete shuttle runs between lines A and C at a specified running speed during the 30-second exercise period. The running speed is increased by 0.5 km/h per lap, starting at 10 km/h. The running speed is controlled by an acoustic signal. There are two different types of signals, a bright tone indicating that the test subjects must now have reached the next zone and a short tone sequence signaling the end of the lap. As the speed increases steadily, the distance travelled per 30 seconds per lap also increases. As speed and time are known, conclusions can be drawn about the distance covered. After the 30 seconds of exertion, there is a 15-second rest while the next line (A, B or C) is walked. This is explicitly announced after the tone sequence at the end of the round. The pause is followed by the next exercise period of 30 seconds at an increased speed. The test ends when a test subject has not reached the next zone twice in succession or three times during the acoustic signal. The last completed lap was then included in the evaluation.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec25\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Statistical Analysis\u003c/h2\u003e\u003cp\u003eAll data were analyzed individually for each test parameter using the statistical software R (Version 4.3.0;RRID:SCR_001905). Linear mixed-effects models (LMMs) were applied using the lme4 package[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e],with each test parameter serving as the dependent variable. Prior to model fitting, the distribution of all outcome variables was visually assessed using Q-Q plots. Variables not approximately normally distributed were transformed as follows:\u003c/p\u003e\u003cp\u003e\u0026ndash; Log-transformation was applied to Fe, HDL, LDL, OxLDL, LDL/HDL, Trigl, GOT, GGT, CK and LmAnOx.\u003c/p\u003e\u003cp\u003e\u0026ndash; Box-Cox transformation was used for GPT, E2, and MM.\u003c/p\u003e\u003cp\u003eIf assumptions of normality could not be achieved even after transformation, generalized linear mixed models (GLMMs) were fitted using the glmmTMB or lme4 package, assuming a Gamma distribution with a log-link function (or inverse Gaussian if appropriate). This approach was applied to BW, BMI, NLR, PLR, SII, Chol, and P. All models included subject ID as a random intercept to account for repeated measures over time. Fixed effects included Group (Omnivore vs. Vegan), Time (T0\u0026ndash;T3), and their interaction (Group \u0026times; Time). Model diagnostics were performed using the DHARMa package, including residual simulation, tests for dispersion, zero inflation, and outliers. In the case of body weight (BW), a significant under dispersion was observed. Since under dispersion tends to result in conservative estimates and no zero inflation was detected, the Gamma GLMM was retained as a robust and pragmatic model choice. Attempts to fit alternative models (e.g., Tweedie) failed due to convergence issues. Estimated marginal means were calculated using the emmeans package, and pairwise contrasts were FDR-adjusted using the Benjamini\u0026ndash;Hochberg method. Significance was defined as p\u0026thinsp;\u0026lt;\u0026thinsp;.05. To assess multicollinearity, the variable Time was mean-centered, and variance inflation factors (VIF) were computed from equivalent GLMs without random effects. The model comparisons are based on the likelihood function and changes in the Akaike information criterion (\u003cem\u003eAIC\u003c/em\u003e).\u003c/p\u003e\u003c/div\u003e"},{"header":"3 Results","content":"\u003cp\u003eThe characteristics of the participants at the start of the study, including age, height, body weight, and relative maximum strength, are listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. There was no significant difference between the groups at the beginning of the study.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVegan\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOmnivore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (y)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeight (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e170.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e170.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBodyweight (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64.6\u0026thinsp;\u0026plusmn;\u0026thinsp;8.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelative strength (SQ)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eValues displayed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD; SQ, Squat; y, years; n.s., not significant; *#Significance level at p\u0026thinsp;\u0026le;\u0026thinsp;0.05; *\u003c/em\u003e,\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec27\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Nutrition\u003c/h2\u003e\u003cp\u003eSignificant differences in dietary habits were observed throughout the study period. The omnivorous group consumed significantly higher amounts of total energy (p\u0026thinsp;=\u0026thinsp;0.011), relative energy intake per kg BW (p\u0026thinsp;=\u0026thinsp;0.024), protein (p\u0026thinsp;=\u0026thinsp;0.007), relative protein per kg BW (p\u0026thinsp;=\u0026thinsp;0.002) and FFM (p\u0026thinsp;=\u0026thinsp;0.001), essential amino acids (p\u0026thinsp;=\u0026thinsp;0.010) (including L-leucine (p\u0026thinsp;=\u0026thinsp;0.005), relative fat per kg BW (p\u0026thinsp;=\u0026thinsp;0.042) and FFM (p\u0026thinsp;=\u0026thinsp;0.042), cholesterol (\u0026lt;\u0026thinsp;0.001), and had a higher omega-3 to omega-6 (n-3/n-6) fatty acid ratio (p\u0026thinsp;=\u0026thinsp;0.003). In contrast, the vegan group had significantly higher intakes of carbohydrates (p\u0026thinsp;=\u0026thinsp;0.011), sugars (p\u0026thinsp;=\u0026thinsp;0.028), and dietary fiber (p\u0026thinsp;=\u0026thinsp;0.015). No significant differences were found between the groups in relative energy intake per kg FFM, relative carbohydrate per kg BW and FFM, total fat intake, saturated fat acids or L-arginine consumption.\u003c/p\u003e\u003cp\u003eRegarding micronutrients, the omnivorous group had significantly higher intakes of calcium (p\u0026thinsp;=\u0026thinsp;0.002) and vitamin B12 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), whereas the vegan group consumed significantly more iron (p\u0026thinsp;=\u0026thinsp;0.004) and potassium (p\u0026thinsp;=\u0026thinsp;0.013). There were no significant differences between the groups in zinc or iodine intake. The detailed data on the macro- and micronutrient intake are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEnergy intake, Macronutrient and Micronutrient\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMacronutrient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVegan\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOmnivore\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP-values\u003c/p\u003e\u003cp\u003etime\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-values\u003c/p\u003e\u003cp\u003egroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnergy intake (kcal/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1588,27\u0026thinsp;\u0026plusmn;\u0026thinsp;151,33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1739,00\u0026thinsp;\u0026plusmn;\u0026thinsp;183,46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnergy intake (g/kg BW)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25.05\u0026thinsp;\u0026plusmn;\u0026thinsp;4.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29.74\u0026thinsp;\u0026plusmn;\u0026thinsp;3.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.024\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnergy intake (g/kg FFM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35.75\u0026thinsp;\u0026plusmn;\u0026thinsp;3.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41.86\u0026thinsp;\u0026plusmn;\u0026thinsp;5.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCarbohydrates (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e225.26\u0026thinsp;\u0026plusmn;\u0026thinsp;18.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e206,34\u0026thinsp;\u0026plusmn;\u0026thinsp;14,81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCarbohydrates (g/kg BW)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCarbohydrates (g/kg FFM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal sugar (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72.74\u0026thinsp;\u0026plusmn;\u0026thinsp;5.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65.66\u0026thinsp;\u0026plusmn;\u0026thinsp;21.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal Fibre (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28.46\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.96\u0026thinsp;\u0026plusmn;\u0026thinsp;2.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProtein (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.60\u0026thinsp;\u0026plusmn;\u0026thinsp;4.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67.86\u0026thinsp;\u0026plusmn;\u0026thinsp;8.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.007\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProtein (g/kg BW)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProtein (g/kg FFM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.05\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal essential amino acids (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33.13\u0026thinsp;\u0026plusmn;\u0026thinsp;4.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eL-Leucin (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eL-Arginin (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.54\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53.48\u0026thinsp;\u0026plusmn;\u0026thinsp;12.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69.00\u0026thinsp;\u0026plusmn;\u0026thinsp;11.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat (g/kg BW)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.042\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat (g/kg FFM)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.042\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSaturated fatty acids (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.44\u0026thinsp;\u0026plusmn;\u0026thinsp;6.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.46\u0026thinsp;\u0026plusmn;\u0026thinsp;4.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.078\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLinoleic acid (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eO3/O6 Ratio ((O3/O6)/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCholesterol (mg/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.67\u0026thinsp;\u0026plusmn;\u0026thinsp;8.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e267.48\u0026thinsp;\u0026plusmn;\u0026thinsp;110.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIron (mg/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79.38\u0026thinsp;\u0026plusmn;\u0026thinsp;19.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59.69\u0026thinsp;\u0026plusmn;\u0026thinsp;9.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCalcium (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eZinc (mg/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44.56\u0026thinsp;\u0026plusmn;\u0026thinsp;10.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.70\u0026thinsp;\u0026plusmn;\u0026thinsp;6.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIodine (\u0026micro;g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e213.93\u0026thinsp;\u0026plusmn;\u0026thinsp;69.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e349.35\u0026thinsp;\u0026plusmn;\u0026thinsp;103.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePotassium (g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15.25\u0026thinsp;\u0026plusmn;\u0026thinsp;4.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.013\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVitamin B12 (\u0026micro;g/day)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.01\u0026thinsp;\u0026plusmn;\u0026thinsp;4.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eValues displayed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD; n.s., not significant; *Significance level at p\u0026thinsp;\u0026le;\u0026thinsp;0.05\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c6\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec28\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Blood analyses\u003c/h2\u003e\u003cp\u003eNo significant differences between groups were observed in biomarkers related to general health and immune function, with the exception of iron concentrations. A significant time \u0026times; group interaction was identified for iron at T3 (p\u0026thinsp;=\u0026thinsp;0.019). Both groups exhibited a significant increase in oxLDL concentrations at T2 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Additionally, liver enzyme activities (GOT and GGT) increased significantly at T1 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and T2 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with no differences between groups. Significant changes were also observed in lipid profiles at T2: LDL concentrations decreased significantly in both groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), while HDL concentrations increased significantly (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in the omnivorous group only. Detailed data on the biomarkers related to general health and immune function are presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBiomarkers related for general health and immune function\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eT0\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eT1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eT2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eT3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003cp\u003etime\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003cp\u003egroup\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinkinase (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e132.82\u0026thinsp;\u0026plusmn;\u0026thinsp;43.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e115.60\u0026thinsp;\u0026plusmn;\u0026thinsp;42.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e133.80\u0026thinsp;\u0026plusmn;\u0026thinsp;57.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e175.22\u0026thinsp;\u0026plusmn;\u0026thinsp;40.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinkinase (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e121. 90\u0026thinsp;\u0026plusmn;\u0026thinsp;52.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e120.50\u0026thinsp;\u0026plusmn;\u0026thinsp;67.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e148.90\u0026thinsp;\u0026plusmn;\u0026thinsp;105.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e213.50\u0026thinsp;\u0026plusmn;\u0026thinsp;149.79\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMyoglobin (ng/ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003eLOD\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMyoglobin (ng/ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOx LDL (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36.82\u0026thinsp;\u0026plusmn;\u0026thinsp;66.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61.30\u0026thinsp;\u0026plusmn;\u0026thinsp;55.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e92.40\u0026thinsp;\u0026plusmn;\u0026thinsp;54.14*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e45.00\u0026thinsp;\u0026plusmn;\u0026thinsp;70.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOx LDL (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.82\u0026thinsp;\u0026plusmn;\u0026thinsp;21.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43.73\u0026thinsp;\u0026plusmn;\u0026thinsp;26.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e105.60\u0026thinsp;\u0026plusmn;\u0026thinsp;69.41*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e33.73\u0026thinsp;\u0026plusmn;\u0026thinsp;26.45\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLmAn Ox (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e301.36\u0026thinsp;\u0026plusmn;\u0026thinsp;101.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e267.30\u0026thinsp;\u0026plusmn;\u0026thinsp;63.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e220.00\u0026thinsp;\u0026plusmn;\u0026thinsp;35.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e240.67\u0026thinsp;\u0026plusmn;\u0026thinsp;71.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLmAn Ox (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e322.64\u0026thinsp;\u0026plusmn;\u0026thinsp;106.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e361.64\u0026thinsp;\u0026plusmn;\u0026thinsp;106.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e267.00\u0026thinsp;\u0026plusmn;\u0026thinsp;37.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e250.70\u0026thinsp;\u0026plusmn;\u0026thinsp;46.50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGOT (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e24.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.82*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20.20\u0026thinsp;\u0026plusmn;\u0026thinsp;7.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGOT (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.91\u0026thinsp;\u0026plusmn;\u0026thinsp;4.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e22.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e26.64\u0026thinsp;\u0026plusmn;\u0026thinsp;4.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25.36\u0026thinsp;\u0026plusmn;\u0026thinsp;5.85\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGGT (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e11.40\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGGT (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13.91\u0026thinsp;\u0026plusmn;\u0026thinsp;2.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.82\u0026thinsp;\u0026plusmn;\u0026thinsp;3.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e12.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.27*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14.45\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGPT (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.45\u0026thinsp;\u0026plusmn;\u0026thinsp;2.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGPT (U/l)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16.91\u0026thinsp;\u0026plusmn;\u0026thinsp;3.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17.36\u0026thinsp;\u0026plusmn;\u0026thinsp;2.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17.45\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCreatinine (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProgesterone (ng/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e164.45\u0026thinsp;\u0026plusmn;\u0026thinsp;339.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e62.40\u0026thinsp;\u0026plusmn;\u0026thinsp;42.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e76.60\u0026thinsp;\u0026plusmn;\u0026thinsp;47.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e62.44\u0026thinsp;\u0026plusmn;\u0026thinsp;30.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProgesterone (ng/dl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e164.73\u0026thinsp;\u0026plusmn;\u0026thinsp;251.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e212.09\u0026thinsp;\u0026plusmn;\u0026thinsp;417.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e199.73\u0026thinsp;\u0026plusmn;\u0026thinsp;337.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e186.45\u0026thinsp;\u0026plusmn;\u0026thinsp;349.29\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEstradiol (pg/ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e78.00\u0026thinsp;\u0026plusmn;\u0026thinsp;95.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.50\u0026thinsp;\u0026plusmn;\u0026thinsp;79.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e61.60\u0026thinsp;\u0026plusmn;\u0026thinsp;63.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e54.67\u0026thinsp;\u0026plusmn;\u0026thinsp;64.06*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.037\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEstradiol (pg/ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.55\u0026thinsp;\u0026plusmn;\u0026thinsp;50.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e108.55\u0026thinsp;\u0026plusmn;\u0026thinsp;87.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e92.55\u0026thinsp;\u0026plusmn;\u0026thinsp;70.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e75.91\u0026thinsp;\u0026plusmn;\u0026thinsp;54.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCholesterol (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e172.27\u0026thinsp;\u0026plusmn;\u0026thinsp;30.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e182.80\u0026thinsp;\u0026plusmn;\u0026thinsp;49.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e160.00\u0026thinsp;\u0026plusmn;\u0026thinsp;30.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e174.44\u0026thinsp;\u0026plusmn;\u0026thinsp;34.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCholesterol (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e155.91\u0026thinsp;\u0026plusmn;\u0026thinsp;48.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e170.27\u0026thinsp;\u0026plusmn;\u0026thinsp;20.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e149.27\u0026thinsp;\u0026plusmn;\u0026thinsp;36.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e171.45\u0026thinsp;\u0026plusmn;\u0026thinsp;26.58\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e97.91\u0026thinsp;\u0026plusmn;\u0026thinsp;22.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e102.60\u0026thinsp;\u0026plusmn;\u0026thinsp;37.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e80.30\u0026thinsp;\u0026plusmn;\u0026thinsp;26.00*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e97.89\u0026thinsp;\u0026plusmn;\u0026thinsp;26.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e94.36\u0026thinsp;\u0026plusmn;\u0026thinsp;15.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e92.36\u0026thinsp;\u0026plusmn;\u0026thinsp;14.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e80.64\u0026thinsp;\u0026plusmn;\u0026thinsp;14.11*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e96.36\u0026thinsp;\u0026plusmn;\u0026thinsp;18.79\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHDL (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55.91\u0026thinsp;\u0026plusmn;\u0026thinsp;9.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.10\u0026thinsp;\u0026plusmn;\u0026thinsp;8.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e62.70\u0026thinsp;\u0026plusmn;\u0026thinsp;11.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e57.78\u0026thinsp;\u0026plusmn;\u0026thinsp;11.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHDL (mg/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.82\u0026thinsp;\u0026plusmn;\u0026thinsp;8.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e58.64\u0026thinsp;\u0026plusmn;\u0026thinsp;7.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e64.40\u0026thinsp;\u0026plusmn;\u0026thinsp;8.33*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e57.64\u0026thinsp;\u0026plusmn;\u0026thinsp;6.48\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTriglyceride\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e116.82\u0026thinsp;\u0026plusmn;\u0026thinsp;52.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e187.00\u0026thinsp;\u0026plusmn;\u0026thinsp;165.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e148.90\u0026thinsp;\u0026plusmn;\u0026thinsp;135.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e116.56\u0026thinsp;\u0026plusmn;\u0026thinsp;43.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTriglyceride\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106.36\u0026thinsp;\u0026plusmn;\u0026thinsp;52.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e110.18\u0026thinsp;\u0026plusmn;\u0026thinsp;43.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e113.36\u0026thinsp;\u0026plusmn;\u0026thinsp;50.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e100.09\u0026thinsp;\u0026plusmn;\u0026thinsp;46.80\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIron (ug/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e88.00\u0026thinsp;\u0026plusmn;\u0026thinsp;34.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85.60\u0026thinsp;\u0026plusmn;\u0026thinsp;30.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e90.60\u0026thinsp;\u0026plusmn;\u0026thinsp;41.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e67.00\u0026thinsp;\u0026plusmn;\u0026thinsp;21.31#\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.019\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIron (ug/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59.54\u0026thinsp;\u0026plusmn;\u0026thinsp;29.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59.27\u0026thinsp;\u0026plusmn;\u0026thinsp;28.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e68.00\u0026thinsp;\u0026plusmn;\u0026thinsp;29.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e77.37\u0026thinsp;\u0026plusmn;\u0026thinsp;27.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHaemoglobin (g/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHaemoglobin (g/dl)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNLR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNLR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.17\u0026thinsp;\u0026plusmn;\u0026thinsp;1.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.47\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePLR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePLR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSII\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e444.44\u0026thinsp;\u0026plusmn;\u0026thinsp;138.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e370.78\u0026thinsp;\u0026plusmn;\u0026thinsp;196.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e426.85\u0026thinsp;\u0026plusmn;\u0026thinsp;172.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e338.32\u0026thinsp;\u0026plusmn;\u0026thinsp;138.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSII\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e805.15\u0026thinsp;\u0026plusmn;\u0026thinsp;605.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1199.86\u0026thinsp;\u0026plusmn;\u0026thinsp;1688.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e954.67\u0026thinsp;\u0026plusmn;\u0026thinsp;1222.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e741.93\u0026thinsp;\u0026plusmn;\u0026thinsp;384.94\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eValues displayed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD; LOD; below the limit of detection; n.s., not significant; *#Significance level at p\u0026thinsp;\u0026le;\u0026thinsp;0.05; *, indicates a significant time effect; #, indicates a significant interaction effect;\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec29\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Body composition\u003c/h2\u003e\u003cp\u003eA significant reduction in bodyweight (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and BMI (p\u0026thinsp;=\u0026thinsp;0.004) was observed over time in the vegan group, with a significant time-by-group interaction favoring the vegan group over the omnivorous group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; p\u0026thinsp;=\u0026thinsp;0.004). Both groups demonstrated significant increases in fat-free mass (p\u0026thinsp;=\u0026thinsp;0.025) and muscle mass (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) over time; however, no significant differences between the groups were detected. A significant change over time was also observed in TBW (p\u0026thinsp;=\u0026thinsp;0.031). No significant changes were found in fat mass, either overtime or between groups. Detailed data for body composition are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBody composition\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eT0\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eT1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eT2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eT3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003cp\u003etime\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003cp\u003egroup\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBody height (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e170.27\u0026thinsp;\u0026plusmn;\u0026thinsp;5.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e170.27\u0026thinsp;\u0026plusmn;\u0026thinsp;5.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e170.27\u0026thinsp;\u0026plusmn;\u0026thinsp;5.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e170.27\u0026thinsp;\u0026plusmn;\u0026thinsp;5.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBody height (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e170.18\u0026thinsp;\u0026plusmn;\u0026thinsp;5.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e170.18\u0026thinsp;\u0026plusmn;\u0026thinsp;5.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e170.18\u0026thinsp;\u0026plusmn;\u0026thinsp;5.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e170.18\u0026thinsp;\u0026plusmn;\u0026thinsp;5.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBodyweight (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e64.64\u0026thinsp;\u0026plusmn;\u0026thinsp;8.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e64.64\u0026thinsp;\u0026plusmn;\u0026thinsp;8.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e64.08\u0026thinsp;\u0026plusmn;\u0026thinsp;7.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e62.47\u0026thinsp;\u0026plusmn;\u0026thinsp;7.24*#\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBodyweight (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59.64\u0026thinsp;\u0026plusmn;\u0026thinsp;3.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59.64\u0026thinsp;\u0026plusmn;\u0026thinsp;3.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e60.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e59.78\u0026thinsp;\u0026plusmn;\u0026thinsp;3.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.711\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat free mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44.26\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e44.29\u0026thinsp;\u0026plusmn;\u0026thinsp;3.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e45.12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e45.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.76*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.025\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat free mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.61\u0026thinsp;\u0026plusmn;\u0026thinsp;2.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43.23\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e44.08\u0026thinsp;\u0026plusmn;\u0026thinsp;3.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e43.85\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.37\u0026thinsp;\u0026plusmn;\u0026thinsp;6.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.35\u0026thinsp;\u0026plusmn;\u0026thinsp;6.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18.96\u0026thinsp;\u0026plusmn;\u0026thinsp;5.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18.61\u0026thinsp;\u0026plusmn;\u0026thinsp;7.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFat mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.03\u0026thinsp;\u0026plusmn;\u0026thinsp;2.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15.94\u0026thinsp;\u0026plusmn;\u0026thinsp;2.28\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkeletal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.37\u0026thinsp;\u0026plusmn;\u0026thinsp;3.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e29.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e29.70\u0026thinsp;\u0026plusmn;\u0026thinsp;4.09*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSkeletal muscle mass (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.95\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e28.92\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e29.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.38*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal body water (L)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.41\u0026thinsp;\u0026plusmn;\u0026thinsp;2.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e33.01\u0026thinsp;\u0026plusmn;\u0026thinsp;1.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e32.94\u0026thinsp;\u0026plusmn;\u0026thinsp;2.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.031\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal body water (L)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31.16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.71\u0026thinsp;\u0026plusmn;\u0026thinsp;1.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e31.96\u0026thinsp;\u0026plusmn;\u0026thinsp;1.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e31.99\u0026thinsp;\u0026plusmn;\u0026thinsp;2.06\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e22.25\u0026thinsp;\u0026plusmn;\u0026thinsp;2.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e21.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e21.87\u0026thinsp;\u0026plusmn;\u0026thinsp;2.39*#\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e20.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.792\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eValues displayed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD; n.s., not significant; *#Significance level at p\u0026thinsp;\u0026le;\u0026thinsp;0.05; *, indicates a significant time effect; #, indicates a significant interaction effect;\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec30\" class=\"Section2\"\u003e\u003ch2\u003e3.4. Performance\u003c/h2\u003e\u003cp\u003eRegarding performance outcomes, the vegan group exhibited a significant reduction in absolute maximal squat strength over time (p\u0026thinsp;=\u0026thinsp;0.031). Additionally, significant time-by-group interaction effects were observed at time points T1 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and T2 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), favouring the omnivorous group (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003eA). Relative squat strength also demonstrated significant interaction effects at T1 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and T2 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), although no significant main effect of time was observed (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003eB). In the SJ, a significant time-by-group interaction effect was found at T1 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05); however, no significant changes over time were detected in either group (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003eC). For the CMJ and DJ, no significant main effects of time or time-by-group interactions were observed. In the 30\u0026thinsp;\u0026minus;\u0026thinsp;15 IFT, both groups showed a significant decline in endurance performance over time (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with no significant differences between groups. The detailed data for performance are presented in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePerformance\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParameter\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroup\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eT0\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eT1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eT2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eT3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003cp\u003etime\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003ep-values\u003c/p\u003e\u003cp\u003egroup\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1RM SQ (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e75.00\u0026thinsp;\u0026plusmn;\u0026thinsp;14.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e70.45\u0026thinsp;\u0026plusmn;\u0026thinsp;11.39#\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e69.00\u0026thinsp;\u0026plusmn;\u0026thinsp;10.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e70.25\u0026thinsp;\u0026plusmn;\u0026thinsp;10.63*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.031\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1RM SQ (kg)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65.45\u0026thinsp;\u0026plusmn;\u0026thinsp;9.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e67.00\u0026thinsp;\u0026plusmn;\u0026thinsp;8.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e68.44\u0026thinsp;\u0026plusmn;\u0026thinsp;9.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e63.25\u0026thinsp;\u0026plusmn;\u0026thinsp;12.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003e0.547\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelative SQ (Kg/BW)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15#\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.15#*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelative SQ (Kg/BW)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.13\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;0.25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSquat Jump (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.61\u0026thinsp;\u0026plusmn;\u0026thinsp;3.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e27.64\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44#\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e27.98\u0026thinsp;\u0026plusmn;\u0026thinsp;3.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28.61\u0026thinsp;\u0026plusmn;\u0026thinsp;3.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSquat Jump (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.99\u0026thinsp;\u0026plusmn;\u0026thinsp;4.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.23\u0026thinsp;\u0026plusmn;\u0026thinsp;4.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e29.44\u0026thinsp;\u0026plusmn;\u0026thinsp;4.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29.11\u0026thinsp;\u0026plusmn;\u0026thinsp;4.83\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCMJ (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.52\u0026thinsp;\u0026plusmn;\u0026thinsp;4.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.81\u0026thinsp;\u0026plusmn;\u0026thinsp;3.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28.37\u0026thinsp;\u0026plusmn;\u0026thinsp;4.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28.69\u0026thinsp;\u0026plusmn;\u0026thinsp;4.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCMJ (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.77\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.09\u0026thinsp;\u0026plusmn;\u0026thinsp;5.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e28.90\u0026thinsp;\u0026plusmn;\u0026thinsp;5.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28.90\u0026thinsp;\u0026plusmn;\u0026thinsp;5.09\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDrop Jump (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.40\u0026thinsp;\u0026plusmn;\u0026thinsp;5.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.08\u0026thinsp;\u0026plusmn;\u0026thinsp;4.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e27.80\u0026thinsp;\u0026plusmn;\u0026thinsp;5.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDrop Jump (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26.94\u0026thinsp;\u0026plusmn;\u0026thinsp;4.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.04\u0026thinsp;\u0026plusmn;\u0026thinsp;3.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e27.56\u0026thinsp;\u0026plusmn;\u0026thinsp;5.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.65\u0026thinsp;\u0026plusmn;\u0026thinsp;4.50\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIFT 30\u0026thinsp;\u0026minus;\u0026thinsp;15 (Km/h)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eVegan\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.18\u0026thinsp;\u0026plusmn;\u0026thinsp;1.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e17.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.96*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e17.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.72*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e16.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.06*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c10\" namest=\"c9\" rowspan=\"2\"\u003e\u003cp\u003en.s.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIFT 30\u0026thinsp;\u0026minus;\u0026thinsp;15 (Km/h)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eOmnivore\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.14\u0026thinsp;\u0026plusmn;\u0026thinsp;1.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e17.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e16.50\u0026thinsp;\u0026plusmn;\u0026thinsp;1.27*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cem\u003eValues displayed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD; SQ\u0026thinsp;=\u0026thinsp;Squat; CMJ\u0026thinsp;=\u0026thinsp;Countermovement Jump; IFT\u0026thinsp;=\u0026thinsp;Intermittent Fitness Test; n.s., not significant; *#Significance level at p\u0026thinsp;\u0026le;\u0026thinsp;0.05; *, indicates a significant time effect; #, indicates a significant interaction effect;\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to investigate the effects of a non-matched vegan diet versus an omnivorous diet on general health markers, body composition, and performance in young female athletes. Despite ongoing supervision by a qualified nutritionist, significant differences emerged between the two dietary strategies. Concerning health markers, a significant reduction in serum iron concentration was observed in the vegan group, while no significant differences were found in lipid profiles, liver and kidney function, oxidative stress levels, or immune-related parameters such as the NLR, PLR, and SII. Regarding body composition, reductions in body weight and BMI were observed exclusively in the vegan group. In contrast, declines in strength and jump performance were also significant only within the vegan group.\u003c/p\u003e\u003cp\u003eIt is well known that the energy intake and macronutrient distribution of a non-matched vegan diet differ from those of an omnivorous dietary pattern [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Generally, vegan diets are characterized by lower total energy intake and protein intake [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. These differences were also evident in the present cohort of young female athletes. Self-reported dietary records indicated that the vegan group had a significantly lower energy intake (absolute and per kg BW) compared to the omnivorous group. When additionally considering energy intake per kg of FFM (kcal/kg FFM)), both groups demonstrated reduced energy availability [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], falling below the recommended threshold of 45 kcal/kg FFM [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Nevertheless, the results suggest that a non-matched vegan diet may further increase the risk of reduced energy availability in athletes, particularly if adequate energy intake is not carefully monitored. Furthermore, both absolute and relative (BW and FFM) protein intake, as well as the intake of essential amino acids, particularly L-leucine, were significantly reduced in the vegan group. Despite protein and essential amino acid intakes falling below current recommendations for female athletes [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], no adverse effects were observed on FFM or SMM. Consistent with previous findings, absolute carbohydrate intake, including total sugar consumption, was significantly higher in the vegan group compared to the omnivorous group [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In contrast, when considering relative carbohydrate (BW and FFM) intake, no differences were observed between the two dietary strategies. However, the relative carbohydrate intake in both groups appears to be too low for competitive athletes and aligns more closely with the recommendations for recreational athletes (3\u0026ndash;5 g/kg BW) rather than with those for high-performance athletes (\u0026ge;\u0026thinsp;5 g/kg BW) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. No significant difference was observed in total fat intake between the two groups, but for relative fat intake (BW and FFM). Nevertheless, the relative fat intake per kg BW in both groups are in line with current recommendations [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Regarding dietary fiber, micronutrients, and vitamin intake, the vegan group demonstrated a significantly lower intake of vitamin B12 and calcium, consistent with previous findings [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In contrast, iron and potassium intake were significantly higher in the vegan group compared to the omnivorous group.\u003c/p\u003e\u003cp\u003eEliminating animal products and reducing the intake of animal-based, particularly saturated, fats typically leads to a lower overall energy intake and is associated with a reduced risk of cardiovascular disease [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. However, in the present study, no significant differences were observed at any time between the vegan and omnivorous groups in key health markers, including lipid profiles, liver and kidney function. This lack of difference may be attributed to the generally high baseline health status of the female athletes, who consistently exceeded physical activity recommendations due to their intensive training and competition schedules [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. As such, the adoption of a vegan diet did not appear to confer additional benefits to general health in this population. Moreover, no potential pre-regenerative effects were observed, as indicated by unchanged concentration of muscle damage markers (CK and myoglobin) and oxidative stress indicators (e.g., oxLDL or LmAnOx). These findings suggest that a vegan diet does not exert a pro-regenerative effect in young female athletes. Interestingly, a significant reduction in serum iron concentration over time was observed exclusively in the vegan group, despite their reported dietary iron intake being higher throughout the study period. This finding aligns with previous research indicating that, although plant-based foods may contain substantial amounts of iron, their bioavailability is considerably lower compared to animal-derived sources [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. It is well established that women are generally at higher risk for iron deficiency and should therefore monitor their iron status more closely [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Iron deficiency is associated with a range of adverse symptoms, including fatigue, weakness, and shortness of breath [\u003cspan additionalcitationids=\"CR41 CR42\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. However, these observations should be interpreted with caution, as serum iron concentration does not directly reflect iron stores (ferritin concentration). To clearly identify iron deficiency, it would have been necessary to assess haemoglobin and ferritin levels in addition to serum iron concentration [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. When considering haemoglobin concentrations over time in both groups, no significant differences were observed, suggesting that there is no clear indication of iron deficiency associated with a vegan diet. Nevertheless, regular monitoring of iron status (ferritin, haemoglobin and iron concentration) is particularly recommended for female athletes, with iron supplementation advised when deficiencies are detected [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eConcerning body composition, a significant reduction in BW and BMI was observed exclusively in the vegan group. This finding is consistent with previous studies conducted in other populations [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Interestingly, no significant change in FM was detected. However, when considering FFM and SMM, the results suggest that the reduction in body weight was primarily attributable to a decrease in FM, as no significant reductions were observed in either FFM or SMM. In contrast to previous studies [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], no significant differences in SMM were observed between the vegan and omnivorous groups. Despite a significant difference in protein intake between the groups and with both groups falling below the recommended protein intake per kg of BW [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], no significant decline in SMM was detected. On the contrary, both groups showed an increase in SMM over time. Two plausible explanations may account for the observed findings. First, although the overall training regimen, including both sport-specific and strength-oriented components, was systematically periodized by the coaching staff, it is conceivable that modifications within the resistance training program contributed to increases in FFM or SMM. However, this interpretation appears incongruent with the observed changes in maximal strength capacity, which did not reflect corresponding improvements. This discrepancy suggests that hypertrophic adaptations alone are insufficient to explain the findings. An alternative explanation concerns the potential inaccuracy of dietary reporting. It is possible that actual protein intake exceeded the values documented, due either to underreporting or incomplete dietary records. Such limitations are well-recognized in applied sports nutrition research, where both the implementation of individualized nutritional strategies and the rigorous documentation of dietary intake pose substantial methodological challenges [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Furthermore, empirical evidence consistently demonstrates a decline in adherence to dietary protocols, as well as a reduction in the accuracy of self-reported intake, with increasing duration of nutritional interventions [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhen examining performance capacity, a significant reduction in maximal squat performance was observed in the vegan group, as well as a significant interaction effect between time points T1 and T2. This decline was also evident in relative strength measures and confirmed in the SJ at T1. The significant decrease in performance in both exercises may be attributable to the markedly lower energy intake observed in the vegan group and is associated with fatigue and reduced energy availability [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], which could plausibly explain the observed performance impairments. When energy and protein intake are appropriately matched, current evidence indicates that there are no statistically significant differences in either strength performance or alterations in body composition between individuals adhering to a vegan diet and those following an omnivorous diet, irrespective of training status [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In contrast, no significant decline in performance was observed in the CMJ or DJ. This may be attributed to differences in movement execution compared to the SJ. Both the CMJ and DJ involve a dynamic stretch-shortening cycle, whereas the SJ is initiated from a static position following an isometric preload [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. In the 30\u0026thinsp;\u0026minus;\u0026thinsp;15 IFT, however, a significant decline in performance was observed in both groups, in contrast to the power-based tests. This reduction may be explained by cumulative fatigue throughout the competitive season. It is well established that general performance metrics tend to decline as the season progresses [\u003cspan additionalcitationids=\"CR50 CR51\" citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e], which suggests that the observed impairment in the IFT is likely attributable to seasonal fatigue rather than to any specific dietary strategy.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eDespite the novel and meaningful contributions of the present investigation, several methodological limitations must be acknowledged. Foremost among these is the relatively small sample size, as only 22 female athletes successfully completed the study. Given that all participants were concurrently engaged in competitive sport during the intervention period, the likelihood of participant attrition was inherently elevated compared to more controlled experimental designs. Nevertheless, this study represents the first to exclusively investigate a cohort of young female elite athletes, thereby filling a critical gap in the current literature. Another limitation concerns the lack of experimental control over training stimuli. Throughout the intervention period, all training was planned, coordinated, and implemented solely by the team\u0026rsquo;s coaching staff. As such, any potential influence of training variation on performance outcomes must be interpreted with caution. However, since all participants were recruited from the same club and subjected to a uniform training program, a degree of standardization in training exposure was preserved. Additionally, the reliability of dietary intake data warrants careful consideration. The potential for incomplete or inaccurate dietary documentation exists in both intervention groups, particularly given the extended duration of the study and the inherent challenges associated with integrating prescribed nutritional strategies and meticulous dietary recording into the daily routines of high-performance athletes. While such factors may have introduced reporting bias, it is important to note that all participants were exposed to similar conditions and constraints, thereby partially mitigating the impact of this limitation.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, the present investigation revealed that a non-matched vegan diet, despite supervision by a qualified nutritionist, resulted in a statistically significant reduction in both energy and protein intake. Furthermore, although dietary iron intake increased over the course of the intervention, a concomitant significant decline in circulating blood iron concentrations was observed in the vegan cohort. However, reduced iron concentration alone does not allow for a definitive diagnosis of iron deficiency. The reduced energy intake of the vegan group may have adversely impacted neuromuscular performance, as evidenced by diminished 1RM squat performance and squat jump capabilities. Notably, no measurable improvements in general health biomarkers or immune function attributable to the vegan dietary regimen were detected among the athletes. It is imperative to interpret these findings with caution, given potential limitations in the completeness and accuracy of dietary intake documentation. Nonetheless, the data underscore the necessity for more stringent, tailored nutritional protocols within vegan populations, even under professional guidance, to mitigate the risk of nutrient insufficiencies and to optimize athletic performance outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eThe authors would like to thank all participants and the medical staff for taking part in and conducting the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Open Access:\u003c/strong\u003e funding provided by IST University of Applied Sciences\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e No sources of funding were used to assist in the preparation of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u003c/strong\u003e All authors have no conflicts of interest that are relevant to the content of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval:\u003c/strong\u003e\u0026nbsp; This study was approved by the Ethics Committee of the German Sport University (125/2021) and registered in the German register for clinical studies (DRKS00031633).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate:\u003c/strong\u003e\u0026nbsp; All participants were informed about the study design and objectives and signed a consent form before the start of the intervention. The study was conducted voluntarily by all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e all authors agree with the submitted version of the manuscript. There is also no conflict of interest with a third party.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e: Anonymised data can be requested from the first author or the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u003c/strong\u003e AL, JD, EI conceived the idea for this intervention. data collection: AL and JS. nutrition data analyses: SV and SF; blood analyses: SB, PZ and PD, statistical analyses: JS, UF and JD; supervision and preparation of study design: SG and EI; original manuscript: JD, JS and EI; proof reading: SG, PZ, PD.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLeitzmann, C. 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Seasonal Variation and the Effect of the Transition Period on Physical Fitness Parameters in Youth Female Soccer Players. \u003cem\u003eSports (Basel, Switzerland) \u003c/em\u003e\u003cstrong\u003e12 \u003c/strong\u003e(2024).\u003c/li\u003e\n\u003cli\u003ePapaevangelou, E.\u003cem\u003e et al. \u003c/em\u003eChanges in Cardiorespiratory Fitness during a Season in Elite Female Soccer, Basketball, and Handball Players. \u003cem\u003eApplied Sciences \u003c/em\u003e\u003cstrong\u003e13, \u003c/strong\u003e9593 (2023).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"vegan diet, female athletes, performance, risks, body composition, health","lastPublishedDoi":"10.21203/rs.3.rs-7319305/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7319305/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA vegan diet is frequently associated with a health-conscious lifestyle and has become increasingly adopted by athletes. However, empirical evidence regarding its impact on athletic performance and health—particularly in young female athletes—remains limited. This study aimed to investigate the effects of a vegan dietary pattern on health markers, immune function, body composition, and physical performance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn a 12-week randomized controlled two-arm trial, 22 young female athletes were assigned to follow either a vegan or an omnivorous diet. Blood samples, body composition, and performance metrics were assessed at baseline and at four-week intervals. A certified nutritionist and medical personnel supervised the intervention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSignificant between-group differences were found in total energy intake, macronutrient distribution, and micronutrient consumption. The vegan group consumed significantly less energy (p = 0.011), protein (p = 0.007), essential amino acids (p = 0.010) including L-leucine (p = 0.005), calcium (p = 0.002), and vitamin B12 (p \u0026lt; 0.001), but had higher intakes of carbohydrates (p = 0.011), sugar (p = 0.028), and iron (p = 0.004). While no significant differences were observed in lipid profile, liver and kidney function, or sex hormones, a significant group difference was observed for iron concentration after 12 weeks (p = 0.019). In terms of body composition, the vegan group showed a significant reduction in body weight (p \u0026lt; 0.001) and BMI (p = 0.004), with no differences in fat-free mass, skeletal muscle mass, or fat mass. Performance measures revealed a significant decrease in 1-RM squat performance in the vegan group (p = 0.031), along with group differences at weeks 4 (p \u0026lt; 0.05 and 8 (p \u0026lt; 0.05) in relative squat performance. A significant difference in squat jump performance was also noted at week 4 (p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA non-matched vegan diet may impair strength-related performance and reduce iron status in young female athletes, underscoring the need for carefully structured nutritional planning to ensure adequate energy as well as macro- and micronutrient intake.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGerman Clinical Trials Register\u003c/strong\u003e (DRKS00031633)\u003c/p\u003e","manuscriptTitle":"Potential risks of a non-matched vegan diet on biomarkers of health status, body composition and performance in young female athletes – a 12-week randomized controlled trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-28 08:02:05","doi":"10.21203/rs.3.rs-7319305/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"84949049-3b51-47ff-ac3e-8925ea518d8e","owner":[],"postedDate":"August 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-05T02:58:50+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-28 08:02:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7319305","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7319305","identity":"rs-7319305","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}