Are plant-based alternatives healthier? A two-dimensional evaluation from nutritional and processing standpoints

Fifteen Years of NOVA Food-Processing Classification: "Friend or Foe" Among Sustainable Diet Indicators? A Scoping Review

It has been 15 years since the introduction of the NOVA food-processing classification. While it was designed to identify ultra-processed foods linked to noncommunicable diseases, the NOVA system has a holistic concept that fits with sustainable nutrition. However, NOVA's connection to other sustainable diet indicators has not been thoroughly explored. The aim was to summarize the research and methodological context of using the NOVA system with other sustainable diet indicators and to investigate NOVA's synergies and discordance with them. A scoping review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR). Studies published between 2009 and 2023 were collected from the Web of Science, Scopus, and PubMed databases. 1612 studies were initially screened; in the selected studies (n = 77), the NOVA system was applied in addition to other sustainable diet indicator(s). The studies were analyzed within a qualitative data analysis framework. 77 studies were analyzed in which healthiness (n = 66), environmental pressure (n = 9), affordability (n = 11), other processing classifications (n = 6), and other sustainable diet indicators (n = 10) were applied with NOVA. Among them, the identified relationships between the NOVA system and other healthfulness indicators were synergistic in the majority of studies (n = 70/93). For environmental pressure indicators, a mixed picture was observed; the NOVA classification was predominantly synergistic with greenhouse gas emissions (n = 8/13), while it was mostly discordant with fresh water use (n = 8/12). Economic affordability was also found to be discordant with the NOVA classification in the majority of studies (n = 10/16). To complete the NOVA classification with nutrient profiling would be beneficial to identify healthy diets. In the case of the integration of NOVA into sustainable nutrition research, environmental pressure and economic affordability indicators should be controlled to reach optimal trade-offs for more sustainable diets. The application of NOVA is gaining relevance; thus, its methodological adaptation to sustainable nutrition research is necessary.

Availability, price and nutritional assessment of plant-based meat alternatives in hypermarkets and supermarkets in Petaling, the most populated district in Malaysia

This study investigated the availability, price, nutritional composition, and quality of plant-based meat alternatives (PBMAs) in supermarkets and hypermarkets in Petaling, the most populated district in Malaysia. The survey covered 85 stores through on-site visits, identifying 251 unique PBMA products from 42 brands. The PBMAs were categorized into nine groups: Burgers/Patties, Coated Meat, Luncheon Meat, Minced Meat, Pastries, Pieces/Chunks/Fillets/Strips, Prepacked Cooked Meals, Sausages, and Seafood Balls/Cakes/Meatballs. The survey indicated widespread availability of PBMAs in Petaling, with premium supermarkets offering the most extensive selection. The median prices of PBMAs across categories were below MYR 7 (~USD 1.6) per 100 grams, with Pieces/Chunks/Fillets/Strips being the most affordable. Nutritionally, PBMAs exhibited lower energy, total fat, saturated fat, sodium, and protein levels than meat equivalents, while showing higher carbohydrate content. Nutri-Score profiling revealed generally favourable scores (Grade A to C), indicating moderate to good nutritional quality. These findings suggest that PBMAs offer a viable alternative for consumers in Malaysia seeking healthier and more sustainable food options, particularly for those aiming to reduce their intake of fat and sodium. However, PBMAs may not be recommended for individuals seeking a higher protein and lower carbohydrate diet. Further research is recommended to explore micronutrient profiles to enhance dietary decision-making.

Future perspectives: Current trends and controversies of meat alternatives classified as ultra-processed foods

This study reviewed the current state of meat alternatives including plant-based or cell-based ingredients and discussed the contentious factor surrounding the classification of meat alternatives as ultra-processed foods (UPFs). The term UPFs refers to foods undergoing extensive industrial processing and containing additives such as flavors, colors, emulsifiers, and preservatives. There is growing concern regarding the potential adverse effects of UPF consumption on health, nutrition, and sociodemographic factors. Additionally, this study examined the market potential, drivers, and barriers associated with different types of meat alternatives. In light of barriers focused on UPFs, meat alternatives can be disputed in that they undergo extensive processing and are highly processed, including numerous ingredients, while meat alternatives offer potential solutions to the environmental, ethical, and health issues associated with animal meat consumption. Consequently, it is important to distinguish them from other UPFs, which are known to have detrimental effects on health. Therefore, this paper proposed a reassessment of the UPF classification system, the establishment of uniform nutritional profiles for meat alternatives, and the dissemination of their beneficial impacts. These measures are necessary to validate the exclusion of meat alternatives from the UPF category and to promote their development and adoption.

Microbiological Safety and Functional Properties of a Fermented Nut-Based Product

Fermented nut-based products, obtained after soaking and fermentation, are gaining increasing interest as animal food substitutes because of ethical, environmental and health reasons. In these products, Lactic Acid Bacteria (LAB) perform the fermentation, leading to matrix acidification and contributing to controlling spoilage and pathogenic microbiota. In this work, LAB strains isolated from an artisanal product and combined with a commercial strain were added as starter cultures during nut soaking to produce a cheese-like fermented plant-based product. Three different LAB consortia were used in challenge tests at laboratory scale against Listeria monocytogenes, Escherichia coli or Salmonella Enteritidis, inoculated in nuts at 5 log CFU/g, and monitored for pathogen survival and matrix acidification. The combination of Lactiplantibacillus plantarum 82 and Leuc. carnosum 4010 resulted in faster acidification (pH value < 4.4 after 18 h instead of 48 h) and the reduction of target pathogens; L. monocytogenes was already absent after seven days from production, and the counts of E. coli or S. Enteritidis were lower with respect to other samples. Thus, this microbial consortium was used for a pilot-scale production in which, beyond safety, the fermented plant-based product was also characterized for aroma profile and phenolic compounds, parameters that are known to be affected by LAB fermentation. The results showed an enhancement of the aroma profile, with an accumulation of molecules able to confer cheese-like notes (i.e., acetoin and diacetyl) and higher phenolic content, as well as the presence of compounds (i.e., phenyllactic acid and hydroxyphenyllactic acid) that could exert antimicrobial activity. This study allowed us to set up a guided fermentation for a cheese-like vegan product, guaranteeing safety and improving aromatic and functional features.

A novel multiple plant-based milk alternative containing various preprocessed grains achieves better performance in protein digestibility and free amino acid profile via in vitro gastrointestinal digestion analysis

Plant-based milk alternatives are sustainable, hypoallergenic, and nutrient-rich, but challenges related to their lower bioavailability compared with animal-based milk still exist. In this study, we developed a multiple plant-based milk alternative using germinated soybeans and fermented cereals, and compared the protein digestible behaviors with commercial soy and bovine milk via in vitro gastrointestinal digestion. The multiple plant-based milk alternative possessed a higher level of essential amino acids and amino acid scores than the soy milk and a smaller percentage of low-molecular-weight peptides than the bovine milk. It displayed better protein-digestible responses with no apparent gastric coagulation. Moreover, the relatively larger particles in the multiple plant-based milk alternative had few effects on protein digestibility, with the highest proteolytic degree and a better free amino acid profile. The findings suggest that the multiple plant-based milk alternative presents higher protein digestibility behavior, and it could be a promising industrial plant-based product.

Dietary and Lifestyle Strategies for Obesity

The prevalence of obesity globally has tripled over the last half century, and currently affects around 650 million adults and 340 million children and adolescents (ages 5-19 years). Obesity contributes towards >50 co-morbidities and premature mortality. Obesity is a highly stigmatised condition that is associated with much mental and emotional distress and dysfunction. Thus, obesity is a major contributor to healthcare expenditure globally. Traditionally, the management of obesity stratifies into three major groups that include metabolic (bariatric) surgery, pharmacotherapies, and lifestyle (primarily dietary) strategies. Although listed as a separate category, dietary strategies for obesity remain a central component of any management plan, and often complement other surgical and pharmacotherapeutic options. Indeed, the effectiveness of any management approach for obesity relies upon successful behavioural changes, particularly relating to eating behaviours. In this concise review, we explore the foundational pillars of dietary strategies for obesity: sleep, listening, routine, de-stressing and optimisation of social conditions. We then discuss the importance of balancing dietary macronutrients (including dietary fibre, carbohydrates, protein and ultra-processed foods [UPFs]) as a key dietary strategy for obesity. Although we focus on general principles, we should provide bespoke dietary strategies for our patients, tailored to their individual needs. Rather than judging the utility of a diet based simply on its associated magnitude of weight loss, we should adopt a more holistic perspective in which a dietary strategy is valued for its overall health benefits, including the nurturing of our gut microbiota, to enable them to nurture and protect us.

Nutrition classification schemes for plant-based meat analogues: Drivers to assess nutritional quality and identity profile

Changes in dietary patterns promoted by the emergence of alternative food systems are becoming increasingly common. The decrease in the consumption of animal-derived products promoted exponential growth in plant-based product demand and, consequently, the availability of several meat analogues for this consumer market. Plant-based meat analogues (PBMAs) were developed to mimic the physical and sensory characteristics of meats and their derivatives. Therefore, the composition of these products has been studied in some countries as an attempt to evaluate their nutritional quality in comparison with that of traditional meat products. The main aim of this study was to employ different Nutrition Classification Schemes (NCSs) to assess the nutritional quality of plant-based meat and to discuss the application of one or more NCSs in defining the identity and quality profile of these foods. Five NCSs were used: three nutrient-based (Nutri-Score; Nutrient Profiling Model (NPM) from Brazil; NPM from PAHO); one food-based (NOVA classification); and one hybrid (Plant-Based Nutrient Profile Model). The nutritional composition and ingredients were collected from labels of 349 PBMAs; 117 were classified as burgers, and 182 products employed soy as the main protein ingredient. The use of different NCSs is strategic for PBMAs' nutritional quality evaluation, and the Nutri-Score was able to show the effectiveness of differentiating products as having poor nutritional quality. In this way, the employment of NPM from Brazil is recommended as a driver for PBMAs choices, especially due to the excellent agreement between the Nutri-Score and NPM from Brazil for burgers.

Investigation into the Sensory Properties of Plant-Based Eggs, as Well as Acceptance, Emotional Response, and Use

Consumers have become interested in plant-based alternatives to animal-based products. One of the under-studied alternatives is plant-based eggs (PBEs). This research investigated PBEs relative to conventional eggs and tofu scramble-another plant-based alternative. Firstly, participants (n = 93) completed a word association task asking them about PBEs. Participants then evaluated the different food samples using hedonic scales, check-all-that-apply (CATA), and temporal check-all-that-apply (TCATA), as well as identified their emotional response and proposed use for PBEs. Participants were interested in plant-based alternatives, including PBEs, but they were concerned about the sensory properties. When they evaluated the different samples, the flavour and texture of the PBEs were disliked in comparison to the eggs. This result may be due to the beany, bitterness, and off-flavour attributes associated with the PBEs. Participants also associated the PBEs with negative emotions. The liking of tofu scramble was not significantly different from the eggs, and the eggs and tofu scramble were mainly associated with positive emotions. During the TCATA evaluation, the participants focused on the flavour attributes of PBEs, while their evaluation of the eggs was dominated by the textural attributes. Whether following a plant-based diet or not, consumers are interested in PBEs, but the sensory properties of PBEs need to be improved before they are willing to adopt them into their diet. This study is one of the first to evaluate the sensory properties of PBEs, as well as consumers' emotional response to them and their attitudes about PBEs.

Complementarity between the updated version of the front-of-pack nutrition label Nutri-Score and the food-processing NOVA classification

OBJECTIVE

To compare the initial and the updated versions of the front-of-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level.

DESIGN

Using the OpenFoodFacts database - 129,950 food products - we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used.

SETTINGS

The food offer in France.

PARTICIPANTS

Not applicable.

RESULTS

With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77·9 % and 87·5 % of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3·8 percentage points (-5·2 %) rated A or B and +1·3 percentage points (+12·9 %) rated D or E) and ultra-processed foods the most impacted (-9·8 percentage points (-43·4 %) rated A or B and +7·8 percentage points (+14·1 %) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially sweetened beverages, sweetened plant-based drinks and bread products were the most penalised categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected.

CONCLUSION

These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.

Reproducibility and relative validity of a semi-quantitative food and beverage frequency questionnaire for Spanish children aged 3 to 11 years: the COME-Kids F&B-FQ

A reliable food and beverage frequency questionnaire (F&B-FQ) to measure dietary intakes for children across Spain is currently unavailable. Thus, we designed and assessed the reproducibility and relative validity of a new F&B-FQ in 210 Spanish children aged 3-11 years. COME-Kids F&B-FQ contained 125 items to assess the usual diet intake in the past year among children. To explore the reproducibility, caregivers answered COME-Kids F&B-FQ twice over a 15-day period (± 1 week). To evaluate the relative validity, estimates from a third COME-Kids F&B-FQ administered at 1 year of follow-up were compared with the mean estimates from 3-day dietary records (3d-DR) collected at baseline, 6 months, and after 1 year of follow-up. Reproducibility and relative validity of the COME-Kids F&B-FQ in estimating food groups and nutrients were assessed using Pearson (r) and intra-class (ICC) correlation coefficients. We used the kappa index to evaluate the agreement in repeat administrations or with the 3d-DR. We used Bland-Altman plots to identify bias across levels of intake. A total of 195 children (105 boys, 90 girls) completed the study. The reproducibility of data estimated from COME-Kids F&B-FQ was substantial with mean r and ICC being 0.65 and 0.64 for food groups and 0.63 and 0.62 for nutrients, respectively. Validation assessments comparing the FFQ and 3d-DRs showed r = 0.36 and ICC = 0.30 for food groups and r = 0.29 and ICC = 0.24 for nutrients. The mean agreement for food group reproducibility and relative validity was 86% and 65%, respectively. These estimates were 85% for reproducibility and 64% for relative validity in the case of nutrients. For reproducibility and relative validity, the overall mean kappa index was 63% and 37% for all food groups and 52% and 27% for nutrients, respectively. Bland-Altman plots showed no specific bias relating to the level of intake of nutrients and several food groups.

CONCLUSION

COME-Kids F&B-FQ showed substantial reproducibility and acceptable relative validity to assess food and beverage intake in Spanish children aged 3 to 11 years. Most children were correctly classified in relation to the intake of food groups and nutrients, and misclassification was unlikely with reference to 3d-DR.

WHAT IS KNOWN

• The estimation of dietary intake in children is complex, especially in large cohorts. • The food frequency questionnaire is a well-recognized and the most frequently used method for assessing food consumption.

WHAT IS NEW

• A new food and beverage frequency questionnaire including a beverage section and novel plant-based food items has been validated in Spanish children aged 3-11 years.

Nutritional and health benefits and risks of plant-based substitute foods

Plant-based substitutes (PBS) are seen as a convenient way to transition to a more plant-based diet, but their potential health benefits and nutritional concerns remain debated. Based on a review of the literature, it is concluded here that the primary risk of insufficient nutrient intake with PBS concerns iron and calcium, which are critical to the nutritional value of PBS. Other risks were identified but these would depend on the characteristics of the overall diet, as is the case for iodine in a diet containing no seafood or dairy, and vitamin B12 in a vegetarian/vegan diet. Conversely, the use of PBS is also expected to confer some benefits for long-term health because it would result in higher fibre intakes (in the case of meat PBS) and lower SFA intakes (but higher PUFA/MUFA intakes), but attention should be paid to a potential increase in sodium intake with PBS of meat products. In fact, a recurring finding in this review was that PBS is a very heterogeneous food category involving considerable variations in ingredient and nutrient composition, and whose design could be improved in order to foster nutritional and health benefits. The latter also depend on the animal food that is being replaced and are only deemed likely when PBS replace red meat. The fortification of PBS with key nutrients such as iron and calcium may constitute an actionable public health solution to further shift the balance in favour of PBS in the context of the current dietary transition in western countries.

How does the updated Nutri-Score discriminate and classify the nutritional quality of foods in a Norwegian setting?

BACKGROUND

The Nutri-Score is a candidate for the harmonized mandatory front-of-pack nutrition label enabling consumers in the European Union to make healthier food choices. Nutri-Score classifies foods (including beverages) from A (high nutritional quality) to E (low nutritional quality) based on the foods' qualifying and disqualifying components. We aimed to evaluate the updated Nutri-Score for foods (2022) and beverages (2023) in a Norwegian setting by exploring its ability to discriminate the nutritional quality of foods within categories. Additionally, we assessed Nutri-Scores' ability to classify foods in accordance with the Norwegian food-based dietary guidelines (FBDGs).

METHODS

The updated Nutri-Score was calculated for 1,782 foods in a Norwegian food database. The discriminatory ability of the updated Nutri-Score was considered by exploring the distribution of Nutri-Score within categories of foods using boxplots and frequency tables, and by examining which qualifying and disqualifying components that contributed most to the Nutri-Score class. Accordance with the Norwegian FBDGs was assessed by exploring Nutri-Score for foods specifically mentioned in the guidelines.

RESULTS

Overall, the updated Nutri-Score seemed to discriminate the nutritional quality of foods within categories, in a Norwegian setting. The foods' content of salt and the beverages' content of sugar were components contributing the most to Nutri-Scores' discriminatory ability. Furthermore, in most cases the updated Nutri-Score classified foods in accordance with the Norwegian FBDGs. However, there were minor inconsistencies in how Nutri-Score classified certain foods, such as the inabilities to discriminate between full-fat and low-fat/leaner cheeses, cremes and processed meats (sausages), and between whole grain and refined pasta/rice.

CONCLUSIONS

We observed an overall acceptable discriminatory performance of the updated Nutri-Score in a Norwegian setting and in most cases the updated Nutri-Score classified foods in accordance with the Norwegian FBDGs. However, minor inconsistencies were observed. Together with the FBDGs, the updated Nutri-Score could be a useful tool in guiding consumers towards healthier food choices in Norway, but consumer evaluations are warranted to fully assess the performance of the updated Nutri-Score in a Norwegian context.

Updates on Plant-Based Protein Products as an Alternative to Animal Protein: Technology, Properties, and Their Health Benefits

Plant-based protein products, represented by "plant meat", are gaining more and more popularity as an alternative to animal proteins. In the present review, we aimed to update the current status of research and industrial growth of plant-based protein products, including plant-based meat, plant-based eggs, plant-based dairy products, and plant-based protein emulsion foods. Moreover, the common processing technology of plant-based protein products and its principles, as well as the emerging strategies, are given equal importance. The knowledge gap between the use of plant proteins and animal proteins is also described, such as poor functional properties, insufficient texture, low protein biomass, allergens, and off-flavors, etc. Furthermore, the nutritional and health benefits of plant-based protein products are highlighted. Lately, researchers are committed to exploring novel plant protein resources and high-quality proteins with enhanced properties through the latest scientific and technological interventions, including physical, chemical, enzyme, fermentation, germination, and protein interaction technology.