Effects of mycoprotein on glycaemic control and energy intake in humans: a systematic review

Dairy, Plant, and Novel Proteins: Scientific and Technological Aspects

Alternative proteins have gained popularity as consumers look for foods that are healthy, nutritious, and sustainable. Plant proteins, precision fermentation-derived proteins, cell-cultured proteins, algal proteins, and mycoproteins are the major types of alternative proteins that have emerged in recent years. This review addresses the major alternative-protein categories and reviews their definitions, current market statuses, production methods, and regulations in different countries, safety assessments, nutrition statuses, functionalities and applications, and, finally, sensory properties and consumer perception. Knowledge relative to traditional dairy proteins is also addressed. Opportunities and challenges associated with these proteins are also discussed. Future research directions are proposed to better understand these technologies and to develop consumer-acceptable final products.

Mycelium: A Nutrient-Dense Food To Help Address World Hunger, Promote Health, and Support a Regenerative Food System

There is a need for transformational innovation within the existing food system to achieve United Nations Sustainable Development Goal 2 of ending hunger within a sustainable agricultural system by 2030. Mycelium, the vegetative growth form of filamentous fungi, may represent a convergence of several features crucial for the development of food products that are nutritious, desirable, scalable, affordable, and environmentally sustainable. Mycelium has gained interest as technology advances demonstrate its ability to provide scalable biomass for food production delivering good flavor and quality protein, fiber, and essential micronutrients urgently needed to improve public health. We review the potential of mycelium as an environmentally sustainable food to address malnutrition and undernutrition, driven by food insecurity and caloric dense diets with less than optimal macro- and micronutrient density.

Protein intake and type 2 diabetes mellitus: an umbrella review of systematic reviews for the evidence-based guideline for protein intake of the German Nutrition Society

PURPOSE

Protein-rich foods show heterogeneous associations with the risk of type 2 diabetes (T2D) and it remains unclear whether habitual protein intake is related to T2D risk. We carried out an umbrella review of systematic reviews (SR) of randomised trials and/or cohort studies on protein intake in relation to risks of T2D.

METHODS

Following a pre-specified protocol (PROSPERO: CRD42018082395), we retrieved SRs on protein intake and T2D risk published between July 1st 2009 and May 22nd 2022, and assessed the methodological quality and outcome-specific certainty of the evidence using a modified version of AMSTAR 2 and NutriGrade, respectively. The overall certainty of evidence was rated according to predefined criteria.

RESULTS

Eight SRs were identified of which six contained meta-analyses. The majority of SRs on total protein intake had moderate or high methodological quality and moderate outcome-specific certainty of evidence according to NutriGrade, however, the latter was low for the majority of SRs on animal and plant protein. Six of the eight SRs reported risk increases with both total and animal protein. According to one SR, total protein intake in studies was ~ 21 energy percentage (%E) in the highest intake category and 15%E in the lowest intake category. Relative Risks comparing high versus low intake in most recent SRs ranged from 1.09 (two SRs, 95% CIs 1.02-1.15 and 1.06-1.13) to 1.11 (1.05-1.16) for total protein (between 8 and 12 cohort studies included) and from 1.13 (1.08-1.19) to 1.19 (two SRs, 1.11-1.28 and 1.11-1.28) (8-9 cohort studies) for animal protein. However, SRs on RCTs examining major glycaemic traits (HbA1c, fasting glucose, fasting insulin) do not support a clear biological link with T2D risk. For plant protein, some recent SRs pointed towards risk decreases and non-linear associations, however, the majority did not support an association with T2D risk.

CONCLUSION

Higher total protein intake was possibly associated with higher T2D risk, while there is insufficient evidence for a risk increase with higher intakes of animal protein and a risk decrease with plant protein intake. Given that most SRs on plant protein did not indicate an association, there is possibly a lack of an effect.

The effects of substituting red and processed meat for mycoprotein on biomarkers of cardiovascular risk in healthy volunteers: an analysis of secondary endpoints from Mycomeat

PURPOSE

Mycoprotein is a relatively novel food source produced from the biomass of Fusarium venenatum. It has previously been shown to improve CVD risk markers in intervention trials when it is compared against total meat. It has not hitherto been assessed specifically for benefits relative to red and processed meat.

METHODS

We leveraged samples from Mycomeat, an investigator-blind randomised crossover controlled trial in metabolically healthy male adults (n = 20), randomised to consume 240 g/day of red and processed meat for 14 days followed by mycoprotein, or vice versa. Blood biochemical indices were a priori defined secondary endpoints.

RESULTS

Mycoprotein consumption led to a 6.74% reduction in total cholesterol (P = 0.02) and 12.3% reduction in LDL cholesterol (P = 0.02) from baseline values. Change in fasted triglycerides was not significantly different between diets (+ 0.19 ± 0.11 mmol/l with mycoprotein, P = 0.09). There was a small but significant reduction in waist circumference for mycoprotein relative to meat (- 0.95 ± 0.42 cm, P = 0.04). Following the mycoprotein diet, mean systolic (- 2.41 ± 1.89 mmHg, P = 0.23) and diastolic blood pressure (- 0.80 ± 1.23 mmHg, P = 0.43) were reduced from baseline. There were no statistically significant effects of the intervention on urinary sodium, nitrite or TMAO; while urinary potassium (+ 126.12 ± 50.30 mmol/l, P = 0.02) and nitrate (+ 2.12 ± 0.90 mmol/l, P = 0.04) were both significantly higher with mycoprotein relative to meat. The study population comprised metabolically healthy adults, therefore, changes in plasma lipids had little effect on cardiovascular risk scores (- 0.34% FRS for mycoprotein P = 0.24).

CONCLUSIONS

These results confirm potential cardiovascular benefits when displacing red and processed meat with mycoprotein in the diet. Longer trials in higher risk study populations are needed to fully elucidate suggested benefits for blood pressure and body composition.

CLINICALTRIALS

gov Identifier: NCT03944421.

Substituting meat for mycoprotein reduces genotoxicity and increases the abundance of beneficial microbes in the gut: Mycomeat, a randomised crossover control trial

PURPOSE

The high-meat, low-fibre Western diet is strongly associated with colorectal cancer risk. Mycoprotein, produced from Fusarium venanatum, has been sold as a high-fibre alternative to meat for decades. Hitherto, the effects of mycoprotein in the human bowel have not been well considered. Here, we explored the effects of replacing a high red and processed meat intake with mycoprotein on markers of intestinal genotoxicity and gut health.

METHODS

Mycomeat (clinicaltrials.gov NCT03944421) was an investigator-blind, randomised, crossover dietary intervention trial. Twenty healthy male adults were randomised to consume 240 g day^-1 red and processed meat for 2 weeks, with crossover to 2 weeks 240 g day^-1 mycoprotein, separated by a 4-week washout period. Primary end points were faecal genotoxicity and genotoxins, while secondary end points comprised changes in gut microbiome composition and activity.

RESULTS

The meat diet increased faecal genotoxicity and nitroso compound excretion, whereas the weight-matched consumption of mycoprotein decreased faecal genotoxicity and nitroso compounds. In addition, meat intake increased the abundance of Oscillobacter and Alistipes, whereas mycoprotein consumption increased Lactobacilli, Roseburia and Akkermansia, as well as the excretion of short chain fatty acids.

CONCLUSION

Replacing red and processed meat with the Fusarium-based meat alternative, mycoprotein, significantly reduces faecal genotoxicity and genotoxin excretion and increases the abundance of microbial genera with putative health benefits in the gut. This work demonstrates that mycoprotein may be a beneficial alternative to meat within the context of gut health and colorectal cancer prevention.

Alternative Protein Sources and Novel Foods: Benefits, Food Applications and Safety Issues

The increasing size of the human population and the shortage of highly valuable proteinaceous ingredients has prompted the international community to scout for new, sustainable, and natural protein resources from invertebrates (e.g., insects) and underutilized legume crops, unexploited terrestrial and aquatic weeds, and fungi. Insect proteins are known for their nutritional value, being rich in proteins with a good balance of essential amino acids and being a valuable source of essential fatty acids and trace elements. Unconventional legume crops were found rich in nutritional, phytochemical, and therapeutic properties, showing excellent abilities to survive extreme environmental conditions. This review evaluates the recent state of underutilized legume crops, aquatic weeds, fungi, and insects intended as alternative protein sources, from ingredient production to their incorporation in food products, including their food formulations and the functional characteristics of alternative plant-based proteins and edible insect proteins as novel foods. Emphasis is also placed on safety issues due to the presence of anti-nutritional factors and allergenic proteins in insects and/or underutilized legumes. The functional and biological activities of protein hydrolysates from different protein sources are reviewed, along with bioactive peptides displaying antihypertensive, antioxidant, antidiabetic, and/or antimicrobial activity. Due to the healthy properties of these foods for the high abundance of bioactive peptides and phytochemicals, more consumers are expected to turn to vegetarianism or veganism in the future, and the increasing demand for such products will be a challenge for the future.

Alternative dietary protein sources to support healthy and active skeletal muscle aging

To mitigate the age-related decline in skeletal muscle quantity and quality, and the associated negative health outcomes, it has been proposed that dietary protein recommendations for older adults should be increased alongside an active lifestyle and/or structured exercise training. Concomitantly, there are growing environmental concerns associated with the production of animal-based dietary protein sources. The question therefore arises as to where this dietary protein required for meeting the protein demands of the rapidly aging global population should (or could) be obtained. Various non-animal-derived protein sources possess favorable sustainability credentials, though much less is known (compared with animal-derived proteins) about their ability to influence muscle anabolism. It is also likely that the anabolic potential of various alternative protein sources varies markedly, with the majority of options remaining to be investigated. The purpose of this review was to thoroughly assess the current evidence base for the utility of alternative protein sources (plants, fungi, insects, algae, and lab-grown "meat") to support muscle anabolism in (active) older adults. The solid existing data portfolio requires considerable expansion to encompass the strategic evaluation of the various types of dietary protein sources. Such data will ultimately be necessary to support desirable alterations and refinements in nutritional guidelines to support healthy and active aging, while concomitantly securing a sustainable food future.

Nutritional Quality, Techno-Functional Characteristics, and Safety of Biomass Powder and Protein Isolate Produced from Penicillium maximae

This study investigated the suitability of Penicillium maximae biomass powder and protein isolate as a food product or food ingredient. The biomass powder is rich in proteins (34.8%) and insoluble fiber (36.2%) but poor in lipids (3.1%). Strong water hydration (8.3 g/g, 8.5 g/g) and oil holding (6.9 g/g, 16.3 g/g) capacity were observed in the biomass powder and protein isolate, respectively, besides 100% emulsion stability, indicating multiple applications in the food industry. No locomotor impairment was induced in Drosophila melanogaster flies after consuming extracts of P. maximae biomass powder. Furthermore, decreased production of reactive oxygen species and preservation of survival, viability, and fertility parameters were observed in the nematode Caenorhabditis elegans, which reinforces the potential of P. maximae biomass for human and animal consumption. Together, the results show the vast food applicability of P. maximae biomass and protein isolate as protein substitutes with several health and environmental benefits.

Recent Advances in the Allergic Cross-Reactivity between Fungi and Foods

Airborne fungi are one of the most ubiquitous kinds of inhalant allergens which can result in allergic diseases. Fungi tend to grow in warm and humid environments with regional and seasonal variations. Their nomenclature and taxonomy are related to the sensitization of immunoglobulin E (IgE). Allergic cross-reactivity among different fungal species appears to be widely existing. Fungus-related foods, such as edible mushrooms, mycoprotein, and fermented foods by fungi, can often induce to fungus food allergy syndrome (FFAS) by allergic cross-reactivity with airborne fungi. FFAS may involve one or more target organs, including the oral mucosa, the skin, the gastrointestinal and respiratory tracts, and the cardiovascular system, with various allergic symptoms ranging from oral allergy syndrome (OAS) to severe anaphylaxis. This article reviews the current knowledge on the field of allergic cross-reactivity between fungal allergens and related foods, as well as the diagnosis and treatment on FFAS.

Ten decadal advances in fungal biology leading towards human well-being

Fungi are an understudied resource possessing huge potential for developing products that can greatly improve human well-being. In the current paper, we highlight some important discoveries and developments in applied mycology and interdisciplinary Life Science research. These examples concern recently introduced drugs for the treatment of infections and neurological diseases; application of -OMICS techniques and genetic tools in medical mycology and the regulation of mycotoxin production; as well as some highlights of mushroom cultivaton in Asia. Examples for new diagnostic tools in medical mycology and the exploitation of new candidates for therapeutic drugs, are also given. In addition, two entries illustrating the latest developments in the use of fungi for biodegradation and fungal biomaterial production are provided. Some other areas where there have been and/or will be significant developments are also included. It is our hope that this paper will help realise the importance of fungi as a potential industrial resource and see the next two decades bring forward many new fungal and fungus-derived products.

Fungal protein

This chapter reviews the uses of processed fungal cells as protein-rich foods in substitution to meat. Yeasts, mushrooms, and filamentous fungi have long been part of the human diet, improving the nutritional quality and taste of different foods. Recently, because of the populational growth and environmental impact caused by animal farming, the use of animal-derived protein has been raising concerns in public and scientific debates. Fungal biomass represents a nutritious, safe meat alternative that can help society in the reduction of greenhouse gases emissions and improve public health. Additionally, it provides all essential amino acids and has an interesting fatty acid profile. Current research is involved in finding new strains with improved efficiency, the investigation of new substrates (especially agro-industrial wastes) to reduce the environmental impact, and the development of new formulations to use mycoprotein in different dishes.

Fungal-Derived Mycoprotein and Health across the Lifespan: A Narrative Review

Mycoprotein is a filamentous fungal protein that was first identified in the 1960s. A growing number of publications have investigated inter-relationships between mycoprotein intakes and aspects of human health. A narrative review was undertaken focusing on evidence from randomized controlled trials, clinical trials, intervention, and observational studies. Fifteen key publications were identified and undertaken in early/young adulthood, adulthood (mid-life) or older/advanced age. Main findings showed that fungal mycoprotein could contribute to an array of health benefits across the lifespan including improved lipid profiles, glycaemic markers, dietary fibre intakes, satiety effects and muscle/myofibrillar protein synthesis. Continued research is needed which would be worthwhile at both ends of the lifespan spectrum and specific population sub-groups.

The association of mycoprotein-based food consumption with diet quality, energy intake and non-communicable diseases' risk in the UK adult population using the National Diet and Nutrition Survey (NDNS) years 2008/2009-2016/2017: a cross-sectional study

Mycoprotein is a fungal-based ingredient rich in fibre and protein used in meat substitutes called Quorn. Fibre and protein positively regulate glycaemia, lipidaemia and energy intake which are non-communicable diseases' (NCD) markers. We performed a cross-sectional study to investigate the association of mycoprotein intake with diet quality, nutrient, energy intake and NCD risk within 5507 UK free-living adults from the National Diet and Nutrition Survey from years 2008/2009 to 2016/2017. Dietary approaches to stop hypertension (DASH) and healthy diet index (HDI) were calculated to estimate diet quality. Comparison between mycoprotein consumers (>1 % kcal) and non-consumers, and associations between consumers and nutrient intakes, NCD's risk markers and diet quality were investigated using a survey-adjusted general linear model adjusted for sex, age, BMI, ethnicity, socio-economic, smoking status, region of residency, total energy, energy density, HDI and non-mycoprotein fibre intake. Mycoprotein consumers (3·44 % of the cohort) had a higher intake of dietary fibre (+22·18 %, P < 0·001), DASH score (+23·33 %) and HDI (+8·89 %) (P < 0·001, both) and lower BMI (-4·77 %, P = 0·00) v. non-consumers. There was an association (P = 0·00) between mycoprotein consumers and diet quality scores (+0·19 and +0·26), high fibre (+3·17 g), total and food energy (+3·09 and +0·22 kcal), but low energy density intakes (-0·08 kcal/g, P = 0·04). Consumers were negatively associated with fasting blood glucose (-0·31 mmol/l, P = 0·00) and glycated HbA1c (-0·15 %, P = 0·01). In conclusion, mycoprotein intake is associated with lower glycaemic markers and energy density intake, and high fibre, energy intake and diet quality scores.

Alternative protein sources of plant, algal, fungal and insect origins for dietary diversification in search of nutrition and health

This review aimed to compare alternative protein sources in terms of nutritional composition and health benefits with the purpose of disseminating up-to-date knowledge and contribute for diversification of the food marked and consumers decision-making. Plant-based is the most well-established category of alternative proteins, but there is still room for diversification. Less conventional species such as chia seeds are prominent sources of ω-3 (∼60% total lipids), while hempseed and quinoa are notable sources of ω-6 (up to 58% and 61%, respectively). Edible insects and microalgae are alternative foods rich in protein (up to 70%), fibers (∼30%), as well as peptides and polysaccharides with antimicrobial, antioxidant, anti-hypertensive, antidiabetic, antidepressant, antitumor, and immunomodulatory activities. Additionally, lipid contents in insect larvae can be as high as 50%, on a dry weight basis, containing fatty acids with anti-inflammatory and antitumor properties. In contrast, edible fungi have low lipid contents (∼2%), but are rich in carbohydrates (up to 79%) and have balanced amino acid profiles. The results suggest that food formulations combining different alternative protein sources can meet dietary requirements. Further studies on flavoring and texturing processes will help to create meat and dairy analogs, thus helping to broaden acceptance and applicability of alternative protein sources.

Food-Based Dietary Guidelines and Protein Quality Definitions—Time to Move Forward and Encompass Mycoprotein?

Food-Based Dietary Guidelines (FBDG) lack uniformity globally, with the integration of protein food sources being highly variable. Protein guidance tends to be dichotomous, e.g., animal versus plant with other categories such as fungal proteins being overlooked. In 2019 the EAT Lancet Food in the Anthropocene report was a chief driver questioning the need to supply healthy diets from sustainable food systems. Some countries are developing FBDG that integrate these aspects, but these are quite often protracted, too subtle or misaligned with other countries, diluting the effects of meaningful global change. Protein quality metrics also underpin the dissemination of dietary guidance. However, for protein, these remain based on a food’s essential amino acid profile and digestibility scores, thus are nutritionally and physiologically centric. It has been proposed that this definition is becoming increasingly myopic from a wider societal perspective. Updated indices should include contemporary issues such as protein diversity and environmental outcomes. Taken together, there is opportunity for renewed thinking about both FBDG and protein quality definitions, with scope to include both health and environmental outcomes and need to move towards the concept of protein diversification.

Fungal Protein – What Is It and What Is the Health Evidence? A Systematic Review Focusing on Mycoprotein

Mycoprotein is a protein-rich fungal-derived sustainable food source that was first discovered in the early 1960's. Since then, a sizeable body of research has investigated the health benefits of mycelium protein. Given this, the present publication aims to systematically review the effects of mycoprotein on human health. A literature search of human studies was conducted using PubMed Central, ClinicalTrials.Gov, Google Scholar and a manual search. Sixteen controlled trials, totaling 432 participants were included – of these 5 studies reported total cholesterol, 5 reported on energy intake, 7 on insulin levels, 8 on glucose levels and 4 studied protein response. Risk of bias showed that 7 studies were good quality although heterogeneity was apparent between studies. Results showed that acute mycoprotein ingestion was associated with reduced total cholesterol levels, particularly amongst those with hyperlipidemia. Evidence was less conclusive for effects on blood glucose and insulin levels. Mycoprotein also appears to be a promising bioavailable source of essential amino acids that could induce muscle protein synthesis. Overall, given growing interest in sustainable proteins and accruing health evidence for mycoprotein, firmer embedment with food-based dietary guidelines is now worthy of consideration.

Is There Scope for a Novel Mycelium Category of Proteins alongside Animals and Plants?

In the 21st century, we face a troubling trilemma of expanding populations, planetary and public wellbeing. Given this, shifts from animal to plant food protein are gaining momentum and are an important part of reducing carbon emissions and consumptive water use. However, as this fast-pace of change sets in and begins to firmly embed itself within food-based dietary guidelines (FBDG) and food policies we must raise an important question-is now an opportunistic time to include other novel, nutritious and sustainable proteins within FBGD? The current paper describes how food proteins are typically categorised within FBDG and discusses how these could further evolve. Presently, food proteins tend to fall under the umbrella of being 'animal-derived' or 'plant-based' whilst other valuable proteins i.e., fungal-derived appear to be comparatively overlooked. A PubMed search of systematic reviews and meta-analytical studies published over the last 5 years shows an established body of evidence for animal-derived proteins (although some findings were less favourable), plant-based proteins and an expanding body of science for mycelium/fungal-derived proteins. Given this, along with elevated demands for alternative proteins there appears to be scope to introduce a 'third' protein category when compiling FBDG. This could fall under the potential heading of 'fungal' protein, with scope to include mycelium such as mycoprotein within this, for which the evidence-base is accruing.