Plant-Based Diets Are Not Enough? Understanding the Consumption of Plant-Based Meat Alternatives Along Ultra-processed Foods in Different Dietary Patterns in Germany

Nutritional Considerations of Plant-Based Diets for People With Food Allergy

Plant-based diets (PBD) have been reported throughout history, but are increasingly common in current times, likely in part due to considerable emphasis on climate change and human health and wellness. Many dietary organisations around the world endorse well-planned, nutritionally adequate PBD, which exclude some or all forms of animal-based foods. However, special attention must be given to patients who follow PBD and also have food allergy (FA), as avoidance may increase the risk of developing nutritional deficiencies, including poor growth in children, weight loss in adults and vitamin and mineral deficiencies. Given the increasing prevalence of both PBD and food allergen avoidance diets, healthcare providers are likely to counsel patients with FA who also follow a PBD. In this review, an overview of PBD in patients with FA is provided, including recent trends, macro- and micronutrient needs, and growth for children and weight gain considerations for adults. With regard to a PBD, special attention should be given to ensure adequate fat and protein intake and improving the bioavailability of several minerals such as iron, zinc, iodine, calcium and magnesium, and vitamins such as A, B2, B12 and D. Although the collective data on growth amongst children following a PBD are varied in outcome and may be influenced in part by the type of PBD, growth must be regularly monitored and in adults weight gain assessed as part of any clinical assessment in those people with FA.

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.

Revealed preferences on meat substitute consumption and political attitudes - Testing the left-right and environmental concerns framework

The promotion of meat substitutes to reduce meat intake is a promising way to reduce the environmental and public health externalities of meat consumption while preserving the important role of taste and texture in meat products. However, the market for meat substitutes is developing more slowly than expected. Therefore, we analyze the factors associated with the heterogeneity in meat substitute consumption in Germany, a country where meat traditionally plays an important role. We use revealed preference data on meat substitute sales from 1025 individual retailers, sociodemographic data, and election results from 92 regions in Germany over the period 2017-2021, to analyze whether differences in meat substitute consumption are associated with consumers' political orientation (liberal/left or conservative/right) and socio-demographic variables. We also investigate whether election results for parties with stronger climate protection goals are associated with meat substitute consumption. Our results show that meat substitute consumption varies significantly across Germany and that this is related to differences in socio-demographic characteristics and voting behavior across regions. Voting for the Green Party and parties with strong climate protection ambitions is positively related to the market share of meat substitutes. In contrast, voting for Germany's most conservative party, which has the lowest ambitions in terms of climate protection targets, is associated with lower meat substitute consumption. Therefore, manufacturers could develop tailored marketing strategies that specifically target these voter groups in order to increase the market share of meat substitutes as alternatives to meat products.

Comparison of nutritional profile between plant-based meat analogues and real meat: A review focusing on ingredients, nutrient contents, bioavailability, and health impacts

In order to fully understand the nutritional heterogeneity of plant-based meat analogues and real meat, this review summarized their similarities and differences in terms of ingredients, nutrient contents, bioavailability and health impacts. Plant-based meat analogues have some similarities to real meat. However, plant-based meat analogues are lower in protein, cholesterol and VB12 but higher in dietary fiber, carbohydrates, sugar, salt and various food additives than real meat. Moreover, some nutrients in plant-based meat analogues, such as protein and iron, are less bioavailable. There is insufficient evidence that plant-based meat analogues are healthier, which may be related to the specific attributes of these products such as formulation and degree of processing. As things stand, it is necessary to provide comprehensive nutrition information on plant-based meat products so that consumers can make informed choices based on their nutritional needs.

Industrially Produced Plant-Based Food Products: Nutritional Value and Degree of Processing

The plant-based food market is rapidly growing, offering innovative options to meet consumer expectations. However, a comprehensive analysis of the nutritional quality of these foods is lacking. We aimed to characterize industrial plant-based food products' nutritional value and degree of processing. A cross-sectional study was conducted on two market-leading Portuguese food retail chains by assessing the nutritional composition of all the available pre-packaged plant-based food products (n = 407). These products were categorized into meal alternatives, dairy alternatives, and other products containing dairy/meat alternative ingredients including ready meals and desserts. The products' nutritional quality was assessed according to the cut-offs established by the Portuguese Directorate General of Health [DGS] on total fat, saturated fat, sugar, and salt, and considering the degree of processing using NOVA classification. One-tenth of the products were classified as having a high total fat, saturated fat, sugars, or salt content. In some sub-categories, half of foods were classified as high in saturated fat, and over two-thirds were considered high salt products. Less than one-third exhibit a good nutritional profile based on the national cut-offs. A total of 84.3% of plant-based food products were ultra-processed. These findings emphasize the need to improve the nutritional profile of plant-based options.

What factors influence sustainable and healthy diet consumption? A review and synthesis of literature within the university setting and beyond

Globally, typical dietary patterns are neither healthy nor sustainable. Recognizing the key role of dietary change in reducing noncommunicable disease risk and addressing environmental degradation, it is crucial to understand how to shift individuals toward a sustainable and healthy diet (SHD). In this literature review, we introduced the concept of a SHD and outlined the dietary behaviors necessary to transition toward SHD consumption; we reviewed the literature on factors that may influence sustainable (and unsustainable) dietary behaviors in adults; and we developed a novel scoring system to rank factors by priority for targeting in future research. Given the significant potential to promote a sustainable and healthy dietary transition on the university campus-where factors that may impact dietary behaviors can be targeted at all levels of influence (i.e., individual, interpersonal, environmental, policy)-we narrowed our focus to this setting throughout. Aided by our novel scoring system, we identified conscious habitual eating, product price, food availability/accessibility, product convenience, self-regulation skills, knowledge of animal ethics/welfare, food promotion, and eating norms as important modifiable factors that may influence university students' dietary behaviors. When scored without consideration for the university population, these factors were also ranked as highest priority, as was modified portion sizes. Our findings offer insight into factors that may warrant attention in future research aimed at promoting SHDs. In particular, the high-priority factors identified from our synthesis of the literature could help guide the development of more personalized dietary behavioral interventions within the university setting and beyond.

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

BACKGROUND

Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors.

METHODS

MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed.

RESULTS

A sample of 1485 participants (median (IQR) age 21.0 (19.0-22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen.

CONCLUSIONS

Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

Sociodemographic and behavioural differences between frequent and non-frequent users of convenience food in Germany

Introduction

Convenience foods are a double-edged sword in that they provide quick and easy nutrition but may promote non-communicable diseases related to excess intakes of sugar, fat, and salt. To inform the German national reduction and innovation strategy for less sugar, fat, and salt in processed foods, the present study sought to analyse the consumption frequency of selected convenience foods and to determine sociodemographic and behavioural factors that characterise frequent users.

Methods

In a representative computer-assisted telephone interview survey in the adult German population (N = 3,997) conducted in 2018, consumption frequency of 21 convenience foods was assessed. To characterise frequent in contrast to non-frequent users, data on sociodemographics and behavioural aspects were compared. Statistical analyses comprised chi-square tests with Bonferroni correction as well as Spearman's rank correlation. Cramer's V was used to determine the strength of an association.

Results

Overall and among frequent users (7.7% of the sample) sweet convenience foods and savoury cooking aids were consumed most frequently. Around 75% of the participants indicated little-to-no consumption of 19 of the 21 convenience foods. Male gender (p < 0.001), younger age (p < 0.001), and not having a high level of education (p = 0.017) were identified as key characteristics of frequent users. Furthermore, frequent users were more likely than non-frequent users to live in a family household (p = 0.003) or without a partner (p < 0.001), and to work in shifts (p = 0.002). Additionally, they showed significantly lower cooking skills (p < 0.001).

Conclusion

Public health interventions to limit excess intakes of sugar, fat, and salt from convenience food in Germany should target people of male gender, younger age, and having a lower level of education. On the behavioural side, developing the skills to cook from scratch emerged as major point of focus. Simultaneously, reformulation of the food offer should continue in order to help transition to a more health-promoting food environment.

Adherence to Healthy or Unhealthy Pro-Vegetarian Plant-Based Diets Have Different Impact on Prostate Cancer Severity: Preliminary Findings

Prostate cancer (PCa) is a prevalent malignancy affecting men worldwide, and plant-based diets have been widely advocated for their health benefits. The aim of this study was to test the association between general, healthy, and unhealthy pro-vegetarian plant-based diets and PCa severity on 118 consecutive patients undergoing prostatectomy in a university hospital in Italy. Food frequency questionnaires were used to calculate scores for dietary patterns. Multivariate logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to test the associations. A general plant-based diet was not associated with cancer severity, while patients reporting a higher adherence to a healthy plant-based diet were less likely to have a more severe PCa (for medium/high vs. low-risk PCa, OR = 0.27, 95% CI: 0.08, 0.88; for high vs. medium/low-risk PCa, OR = 0.09, 95% CI: 0.02, 0.39). Patients resulting in higher adherence to an unhealthy plant-based diet were more likely to be diagnosed with more severe PCa (OR = 6.15, 95% CI: 1.70, 22.24). In conclusion, plant-based dietary patterns may have a different impact on PCa severity depending on the quality of the foods included.

The association of highly processed food consumption with food choice values and food literacy in Japanese adults: a nationwide cross-sectional study

BACKGROUND

Highly processed food (HPF) consumption is increasing globally and has become a prominent public health concern. However, the relationship between HPF consumption and food choice values and food literacy is unknown. This study aimed to examine the association of HPF consumption with food choice values and food literacy.

METHODS

This cross-sectional study used data from a nationwide questionnaire survey conducted in 2018 among 2232 Japanese adults aged 18-80 years. We assessed eight food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort, and safety) using a 25-item scale, and food literacy characterised by nutrition knowledge (using a validated 143-item questionnaire), cooking and food skills (using 14- and 19-item scales, respectively), and eight eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness, and slowness in eating, using the 35-item Adult Eating Behavior Questionnaire). HPF consumption was estimated using a validated brief diet history questionnaire. The associations between HPF consumption and age, body mass index, energy intake, and each score on food choice values and food literacy were evaluated by multiple linear regression.

RESULTS

In males, one standard deviation increase in scores for cooking skill and satiety responsiveness was associated with an increase in HPF consumption by 22.1 g/4184 kJ (95% confidence interval (CI): 6.6 to 37.5) and 15.4 g/4184 kJ (95% CI: 6.0 to 24.7), respectively. In females, one standard deviation increase in age and scores for safety and nutrition knowledge corresponded to a decrease in HPF consumption by - 16.4 g/4184 kJ (95% CI: - 23.4 to - 9.3), - 9.9 g/4184 kJ (95% CI: - 19.1 to - 0.7), and - 11.1 g/4184 kJ (95% CI: - 17.0 to - 5.3), whereas one standard deviation increase in the satiety responsiveness score corresponded to an increase in HPF consumption by 13.1 g/4184 kJ (95% CI: 6.8 to 19.4).

CONCLUSIONS

This cross-sectional study suggests that several aspects of food choice values and food literacy were associated with HPF consumption in Japanese adults. Further studies are needed to confirm our findings in a broader context.

Ultra-processing markers are more prevalent in plant-based meat products as compared to their meat-based counterparts in a German food market analysis

OBJECTIVE

To compare ultra-processing markers and nutrient composition in plant-based meat products (PBMP) with equivalent meat-based products (MBP).

DESIGN

A total of 282 PBMP and 149 MBP within 18 product categories were assessed. Based on the NOVA classification, 33 ultra-processing markers were identified and six ultra-processing bullet categories were defined, that is flavour, flavour enhancer, sweetener, colour, other cosmetic additives and non-culinary ingredients. The ingredient lists were analysed concerning these ultra-processing markers and ultra-processing bullet categories, as well as nutrient composition, for all PBMP and MBP. Differences between PBMP and MBP were assessed using chi-square and Mann-Whitney U tests, respectively.

SETTING

Cross-sectional analysis.

PARTICIPANTS

282 PBMP and 149 MBP.

RESULTS

The percentage of ultra-processed food (UPF) items was significantly higher in PBMP (88 %) as compared to MBP (52 %) (P < 0·0001). The proportion of UPF items was numerically higher in 15 out of 18 product categories with differences in six categories reaching statistical significance (P < 0·05). Flavour, flavour enhancer, colour, other cosmetic additives and non-culinary ingredients were significantly more prevalent in PBMP as compared to MBP (P < 0·0001). Concerning nutrient composition, median energy, total fat, saturated fat and protein content were significantly lower, whereas the amounts of carbohydrate, sugar, fibre and salt were significantly higher in PBMP (P < 0·05).

CONCLUSIONS

Ultra-processing markers are significantly more prevalent in PBMP as compared to MBP. Since UPF intake has been convincingly linked to metabolic and CVD, substituting MBP with PBMP might have negative net health effects.

Vegan diet: nutritional components, implementation, and effects on adults' health

Vegan diet has emerged as a popular dietary choice for people worldwide in recent times, due to concerns such as health issues, animal rights and welfare, and the sustainability of the environment. The purpose of this literature review was to explain how a vegan diet may affect the health of adults and to point out beneficial components found in it as well as any difficulties associated with its implementation. Evidence supports that a vegan diet can reduce the risk of chronic diseases, such as type 2 diabetes, hypertension, and certain types of cancer. A well-planned vegan diet must include adequate calories and nutrients, as well as the necessary supplements, such as vitamin B12, vitamin D and EPA/DHA. Given the current growing interest in plant-based diets among the general population, it is crucial to understand both the barriers, risks, and benefits of the vegan diet among physicians, policy makers, and the general population.

Plant-based foods as meat and fat substitutes

Animal proteins have in the past been used in food production due to their functional properties that range from gelation and emulsification to foaming ability and stability. However, animal husbandry has been shown to be a major contributor to global warming and climate change. Consequently, there has been a drive toward the use of alternative proteins, for example, proteins from plant sources which are perceived to be cheaper, healthier, and sustainable. The use of trans and saturated fatty acids in the food industry has been associated with various health issues that include an increased risk of metabolic disorders. This has resulted in an increased search for fat substitutes that are healthier and sustainable. To contribute toward a reduction in the consumption of meats from animal sources and the consumption of trans and saturated fatty acids, the formulation of plant-based meat and fat analogs/substitutes has been carried out. However, there has been a lower acceptance of these meat or fat substitutes which was attributed to their sensorial and textural properties that fail to mimic or resemble real fat or meat. Therefore, this review aims to discuss the advances that have been made when it comes to plant-based meat and fat substitutes. Additionally, consumer perception and acceptance of these products will be reviewed as well as future markets will be discussed and the opportunities and challenges that exist in the formulation of these products will be explored.

Personality traits and meat consumption: The mediating role of animal-related ethical concerns

Prior research suggests that personality traits are associated with meat consumption. However, this association is not uniform across all types of meat. For instance, Big Five personality traits such as openness and agreeableness are negatively associated with red meat consumption but positively associated with fish. Using a large sample of Chilean university students (N = 1,149), we examined whether these differential meat consumption patterns can be explained by an intermediary variable of animal-related ethical values. Structural equation modeling was employed to test the hypothesized associations. The results suggest that animal-related ethical values mediate the effect of certain personality traits on the consumption of beef and poultry.

Prospects for Plant-Based Meat: Current Standing, Consumer Perceptions, and Shifting Trends

Dietary habits have a substantial influence on both planet and individual health. High intake of animal products has significant negative effects on the environment and on human health; hence, a reduction in meat consumption is necessary. The transition towards plant-based meat (PBM) is one of the potential solutions for environmental and health issues. To achieve this goal, it is important to understand the dietary habits and demands of consumers. This review was designed with a focus on PBM alternatives, dietary shifts during the COVID-19 pandemic, the drivers of consumers' perceptions in various countries, and the measures that can promote the shift towards PBM. The PBM market is predicted to grow with rising awareness, familiarity, and knowledge in the coming years. Companies must focus on the categories of anticipated benefits to aid consumers in making the switch to a diet higher in PBM alternatives if they want to win over the target market.

Emerging trends in the agri-food sector: Digitalisation and shift to plant-based diets

Our planet is currently facing unprecedented interconnected environmental, societal, and economic dilemmas due to climate change, the outbreak of pandemics and wars, among others. These global challenges pose direct threats to food security and safety and clearly show the urgent need for innovative scientific solutions and technological approaches. Backed by the current alarming situation, many food-related trends have emerged in recent years in response to these global issues. This review looks at two megatrends in agriculture and the food industry; the shift to vegetable diets and the digital transformation in food production and consumption patterns. On one side, several innovative technologies and protein sources have been associated with more sustainable food systems and enhanced nutritional quality and safety. On the other side, many digital advanced technologies (e.g., artificial intelligence, big data, the Internet of Things, blockchain, and 3D printing) have been increasingly applied in smart farms and smart food factories to improve food system outcomes. Increasing adoption of vegetal innovations and harnessing Industry 4.0 technologies along the food supply chain have the potential to enable efficient digital and ecological transitions.

Plant-Based Only: Investigating Consumers' Sensory Perception, Motivation, and Knowledge of Different Plant-Based Alternative Products on the Market

Consumer acceptance and product development of sustainable, healthy, and tasty plant-based alternative products (PBAPs) are closely interlinked. However, information on consumer perceptions of the sensory profile of plant-based meat, cheese, and milk remains scarce. The study aimed to investigate German consumers’ (1) sensory evaluation of PBAPs and (2) consumers´ motivations and knowledge underlying the purchase of such products. This was analyzed in relation to different dietary styles of consumers (omnivore, flexitarian, vegetarian, vegan). A sample of 159 adults completed two tasks: first, a sensory test in which participants tasted and rated three different PBAPs in two consecutive sessions, and second, a questionnaire on consumption behavior, motivation, and knowledge. Results show few differences between nutrition styles in sensory evaluation of individual product attributes. However, overall liking was rated significantly higher by vegans than by omnivores. All dietary styles reported animal welfare and environmental aspects as the main motivations for consuming PBAPs. Most participants acknowledged that meat and cheese alternatives are highly processed foods and not a fad but are not automatically healthier or more environmentally friendly than their animal-based counterparts. Future research should focus on emerging product segments such as plant-based cheeses to better understand how consumers evaluate PBAPs.

Dietary Patterns and Dietary Recommendations Achievement From Latin American College Students During the COVID-19 Pandemic Lockdown

This study aimed to compare the diet quality of different dietary patterns among college students from Latin American countries, including vegetarians, vegans, and omnivores during the COVID-19 pandemic. A cross-sectional, observational, multicenter study was conducted including a non- probabilistic sample of university students from 10 countries. University students were invited to participate in the study through social network platforms. Participants were self-reported to have followed a specific dietary pattern; either the Prudent diet, Western diet, Ovo-dairy-vegetarian diet, Fish-vegetarian diet, Strict vegetarian diet (vegan) or other. The last three patterns (vegetarians and vegans) were grouped as following a plant-based diet. A self-assessment survey was used to evaluate healthy eating habits using a questionnaire with values between 1 (do not consume) and 5 (consume) for a total of 9–45 points (higher values represent better eating habits). Unhealthy habits were assessed with nine questions. A total of 4,809 students filled out the questionnaire, and the majority of them were females (73.7%). A high percentage have been in lockdown for more than 5 months and were in lockdown when the survey was released. 74.3% were self-reported to follow a prudent diet, while 11.4% reported following a western dietary pattern and 8.8% a plant-based diet. When compliance with healthy and unhealthy dietary habits was analyzed, although all groups had low compliance, the plant-based diet group (56.09 ± 6.11) performed better than the Western diet group (48.03 ± 5.99). The total diet quality score was significantly higher for plant-based diet followers, who also tended to better achieve the recommendations than omnivorous students, especially the ones following a western diet. These results present evidence that young adults such as college-aged students have unhealthy dietary habits. However, the ones who follow a plant-based diet such as vegetarians and vegans exhibit better scores and healthier dietary conducts.

Plant and Animal Protein Intakes Largely Explain the Nutritional Quality and Health Value of Diets Higher in Plants: A Path Analysis in French Adults

Diets higher in plants are associated with lower risks of chronic diseases. However, animal foods, which are rich in protein, are also rich in some important minerals and vitamins. Using data from a representative survey in France (INCA3, n = 1,125), we used path analyses as a mediation-like approach to decipher the importance of plant and animal proteins in the relationship between the plant-based diet index (PDI) and diet quality. We used three types of diet quality scores, namely, nutrient security, positive nutrient adequacy, and long-term mortality risk of four diet-related diseases (i.e., coronary heart disease, stroke, type 2 diabetes, and colorectal cancer). We identified positive and negative mediations, i.e., changes in plant/animal protein intake that are associated with changes in PDI, and favor or limit the association with the diet quality score. The PDI was positively associated with the risk of long-term mortality but not significantly with nutrient adequacy or nutrient security. A positive mediation by plant protein was found for all diet quality scores (specific indirect effects (SIEs) ranging from 0.04 to 0.10 SD). Conversely, the association between PDI and nutrient adequacy (but not nutrient security) was negatively mediated by animal protein intake (SIE: −0.06 SD). In further detailed models, the association between PDI and diet quality was mainly positively mediated by protein foods from the fruit-vegetables-legumes group (0.01 SD for the nutrient security and 0.02 SD for the nutrient adequacy) and whole grains (0.02 SD for the nutrient adequacy). Our data suggest that the positive impact of plant-based diets on diet quality is largely driven by higher intakes of plant protein foods, especially from fruits-vegetables-legumes and whole grains. Conversely, lower animal protein intake tends to limit the positive impact of plant-based diets on overall positive nutrient adequacy but not security. Protein sources appear critical to healthy plant-based diets.