Processed Plant-Based Foods for CKD Patients: Good Choice, but Be Aware

Biological properties of vitamin B12

Vitamin B12, cobalamin, is indispensable for humans owing to its participation in two biochemical reactions: the conversion of l-methylmalonyl coenzyme A to succinyl coenzyme A, and the formation of methionine by methylation of homocysteine. Eukaryotes, encompassing plants, fungi, animals and humans, do not synthesise vitamin B12, in contrast to prokaryotes. Humans must consume it in their diet. The most important sources include meat, milk and dairy products, fish, shellfish and eggs. Due to this, vegetarians are at risk to develop a vitamin B12 deficiency and it is recommended that they consume fortified food. Vitamin B12 behaves differently to most vitamins of the B complex in several aspects, e.g. it is more stable, has a very specific mechanism of absorption and is stored in large amounts in the organism. This review summarises all its biological aspects (including its structure and natural sources as well as its stability in food, pharmacokinetics and physiological function) as well as causes, symptoms, diagnosis (with a summary of analytical methods for its measurement), prevention and treatment of its deficiency, and its pharmacological use and potential toxicity.

Plant-based Meat Analogs: Perspectives on Their Meatiness, Nutritional Profile, Environmental Sustainability, Acceptance and Challenges

PURPOSE OF REVIEW

Plant-based meat analogs (PBMAs) have been the subject of interest over the past few years due to consumers' demand for environmentally friendly, healthful, and non-animal-based foods. A better comprehension of the composition, structure, texture, nutrition, and sustainability of these PBMAs is necessary.

RECENT FINDINGS

This review articulates the protein sources and composition of PBMAs and their "meatiness" with respect to texture, structure, and flavor enhancement. The components used in the analogs, such as unsaturated fats, fibers, vitamins, minerals, carbohydrates, and plant-based oils enriching their nutritional profile, are described. The study identifies the environmental and sustainability impact of PBMAs, as crucial to the survival and maintenance of biodiversity. More studies are warranted to scope and underscore the significance of the analogs and comprehend the texture or structure-function relationships. Further product development and testing thereof may ultimately result in quality meat analogs that respect meat taste, health and acceptance of consumers, environmental sustainability, animal welfare, and current challenges.

Advancements in plant based meat analogs enhancing sensory and nutritional attributes

The burgeoning demand for plant-based meat analogs (PBMAs) stems from environmental, health, and ethical concerns, yet replicating the sensory attributes of animal meat remains challenging. This comprehensive review explores recent innovations in PBMA ingredients and methodologies, emphasizing advancements in texture, flavor, and nutritional profiles. It chronicles the transition from soy-based first-generation products to more diversified second- and third-generation PBMAs, showcasing the utilization of various plant proteins and advanced processing techniques to enrich sensory experiences. The review underscores the crucial role of proteins, polysaccharides, and fats in mimicking meat's texture and flavor and emphasizes research on new plant-based sources to improve product quality. Addressing challenges like production costs, taste, texture, and nutritional adequacy is vital for enhancing consumer acceptance and fostering a more sustainable food system.

The Role of Plant-Based Diets in Preventing and Mitigating Chronic Kidney Disease: More Light than Shadows

Chronic kidney disease (CKD) is a non-communicable disease that affects >10% of the general population worldwide; the number of patients affected by CKD is increasing due in part to the rise in risk factors such as obesity, hypertension, and diabetes mellitus. As many studies show, diet can be an important tool for preventing and mitigating the onset of non-communicable diseases. Plant-based diets (PBDs) are those that emphasize the consumption of plant foods and may or may not include small or moderate amounts of animal foods. Recently, these diets have received increasing interest because they have been associated with favourable effects on health and also appear to protect against the development and progression of CKD. PBDs, which are associated with protein restrictions, seem to offer adjunctive advantages in patients with chronic kidney disease, as compared to conventional low-protein diets that include animal proteins. The principal aims of this review are to provide a comprehensive overview of the existing literature regarding the role of plant-based diets and low-protein, plant-based diets in the context of chronic kidney disease. Moreover, we try to clarify the definition of plant-based diets, and then we analyse possible concerns about the use of PBDs in patients with chronic kidney disease (nutritional deficiency and hyperkalaemia risk). Finally, we offer some strategies to increase the nutritional value of plant-based low-protein diets. In the Materials and Methods section, many studies about plant-based diets and low-protein plant-based diets (e.g., the very-low-protein diet and vegan low-protein diet, LPD) in chronic kidney disease were considered. In the Results and Conclusion section, current data, most from observational studies, agree upon the protective effect of plant-based diets on kidney function. Moreover, in patients with advanced CKD, low-protein plant-based options, especially a very-low-protein diet supplemented with heteroanalogues (VLPDs), compared to a conventional LPD appear to offer adjunctive advances in terms of delaying dialysis and mitigating metabolic disturbances. However, further studies are necessary to better investigate the possible metabolic and cardiovascular advantages of plant-based LPDs versus conventional LPDs.

Novel plant-based meat alternatives: future opportunities and health considerations

Present food systems threaten population and environmental health. Evidence suggests reduced meat and increased plant-based food consumption would align with climate change and health promotion priorities. Accelerating this transition requires greater understanding of determinants of plant-based food choice. A thriving plant-based food industry has emerged to meet consumer demand and support dietary shift towards plant-based eating. 'Traditional' plant-based diets are low-energy density, nutrient dense, low in saturated fat and purportedly associated with health benefits. However, fast-paced contemporary lifestyles continue to fuel growing demand for meat-mimicking plant-based convenience foods which are typically ultra-processed. Processing can improve product safety and palatability and enable fortification and enrichment. However, deleterious health consequences have been associated with ultra-processing, though there is a paucity of equivocal evidence regarding the health value of novel plant-based meat alternatives (PBMAs) and their capacity to replicate the nutritional profile of meat-equivalents. Thus, despite the health halo often associated with plant-based eating, there is a strong rationale to improve consumer literacy of PBMAs. Understanding the impact of extensive processing on health effects may help to justify the use of innovative methods designed to maintain health benefits associated with particular foods and ingredients. Furthering knowledge regarding the nutritional value of novel PBMAs will increase consumer awareness and thus support informed choice. Finally, knowledge of factors influencing engagement of target consumer subgroups with such products may facilitate production of desirable, healthier PBMAs. Such evidence-based food manufacturing practice has the potential to positively influence future individual and planetary health.

Novel plant-based meat alternatives: Implications and opportunities for consumer nutrition and health

Against the backdrop of the global protein transition needed to remain within planetary boundaries, there is an influx of plant-based meat alternatives that seek to approximate the texture, flavor and/or nutrient profiles of conventional animal meat. These novel plant-based meat alternatives, enabled by advances in food technology, can be fundamentally different from the whole-plant foods from which they are derived. One of the reasons is the necessity to use food additives on various occasions, since consumers' acceptance of plant-based meat products primarily depends on the organoleptic properties. Consequently, a high degree of heterogeneity in formulation and nutritional profiles exists both within and between product categories of plant-based meat alternatives with unknown effects on several aspects of human health. This is further complicated by the differences in digestibility and bioavailability between proteins from animal and plant sources, which have a profound impact on colonic fermentation, nutritional adequacy and potential health effects. On the other hand, emerging strategies provide opportunities to develop affordable, delicious and nutritious plant-based meat alternatives that align with consumer interests.

Nutritional Profile of Commercialized Plant-Based Meat: An Integrative Review with a Systematic Approach

Given the high cost of production of animal-based meats and the increase in the number of adepts of meatless diets, the need for plant-based meat substitutes is growing. In this prosperously growing market, there is a lack of knowledge about the nutritional value of these meat substitutes and their ingredients. This study aims to review the nutritional composition and ingredients of meat substitutes commercialized worldwide. An integrative review was performed with a systematic literature search in PubMed, EMBASE, Scopus, Science Direct, Web of Science, and 11 studies were selected to compose the sample of this review. Data on meat substitutes' nutritional composition and ingredients from different categories were collected and analyzed. The results showed that meat substitutes commonly present lower energy values and higher amounts of carbohydrates and dietary fiber. Protein values varied according to the meat substitute category, with some showing a higher concentration than others, more specifically in substitutes for bovine meat. Higher values were found in the Pieces category and lower in Seafood substitutes. Unlike animal meat, vegan meat has a proportion of carbohydrates higher than protein in most samples, except for chicken substitutes. Meat substitutes presented similar total and saturated fat content compared to their animal-based counterparts. Higher amounts of fat were found in the "Various" category and lower in "Pieces". Ingredients such as soy, pea, and wheat were the primary protein sources in meat substitutes, and vegetable oils were their primary fat source. Methylcellulose, various gums, and flavorings were the most used food additives. In general, meat substitutes presented high concentrations of sodium, possibly collaborating with an excessive sodium intake, highlighting the need for developing sodium-reduced or sodium-free alternatives. Most of the included samples did not describe the concentration of iron, zinc, and vitamin B12. Further studies are needed to develop meat substitutes with better nutritional composition, fulfilling the need for equivalent substitutes for animal-based meat.

Potassium Bioaccessibility in Uncooked and Cooked Plant Foods: Results from a Static In Vitro Digestion Methodology

Hyperkalemia is a major concern in chronic kidney disease and in end-stage renal disease, representing a predictor of hospitalization and mortality. To prevent and treat hyperkalemia, dietary management is of great clinical interest. Currently, the growing use of plant-based diets causes an increasing concern about potassium load in renal patients. The aim of this study was to assess the bioaccessibility of potassium in vegetables, concerning all aspects of the plants (fruit, flower, root, tuber, leaf and seed) and to what extent different boiling techniques affect potassium content and bioaccessibility of plant-based foods. Bioaccessibility was evaluated by an in vitro digestion methodology, resembling human gastro-intestinal tract. Potassium content was higher in seeds and leaves, despite it not being possible to define a common “rule” according to the type of organ, namely seed, leaf or fruit. Boiling reduced potassium content in all vegetables excluding carrot, zucchini, and cauliflower; boiling starting from cold water contributed to a greater reduction of the potassium content in potato, peas, and beans. Bioaccessibility after in vitro digestion ranged from 12 (peas) to 93% (tomato) regardless of species and organs. Higher bioaccessibility was found in spinach, chicory, zucchini, tomato, kiwi, and cauliflower, and lower bioaccessibility in peas. Potassium from leaf resulted in the highest bioaccessibility after digestion; as a whole potassium bioaccessibility in the fruits and vegetables studied was 67% on average, with differences in relation to the different organs and species. Further, considering the method of boiling to reduce potassium content, these data indicate that the effective potassium load from plant-based foods may be lower than originally expected. This supports the clinical advices to maintain a wide use of plant-based food in the management of renal patients.