Proceedings of the Nutrition Society最新文献

{"title":"The health impact of substituting meat with plant-based meat alternatives: findings from a Systematic Review","authors":"L. Lindberg, R. Reid-McCann, J. Woodside, A. Nugent","doi":"10.1017/s0029665124004373","DOIUrl":"https://doi.org/10.1017/s0029665124004373","url":null,"abstract":"<p>Sales of plant-based meat alternatives (PBMAs) are increasing<span>(1)</span>. While these products are becoming more popular, little is known about their impact on health<span>(2)</span>. Therefore, the aim of this work was to systematically review the evidence on PBMA consumption and associated health outcomes.</p><p>A wider systematic review looking at the environmental impact, ingredient composition, nutritional impact and health outcomes associated with PBMAs was conducted. A search strategy combined terms “meat alternatives” AND “environment” OR “ingredients” OR “nutrition” OR “health.” Five databases were searched, MEDLINE, EMBASE, Web of Science, Scopus and Greenfile, as well as reference lists of relevant articles. All study designs reporting primary data were included, except for animal studies and <span>in vitro</span> studies. Non-English studies and studies published before 2011 were excluded (PROSPERO Registration Number: CRD42021250541).</p><p>2184 papers were identified, 1802 papers remained after duplicates were removed, 1536 were excluded at title and abstract screen stage, 266 full texts were assessed for eligibility and 54 papers were included in the analysis for all outcomes investigated. Ten studies examined the impact of PBMA vs. meat consumption on health outcomes. Three studies measured postprandial response to single test meals<span>(3–5)</span>, four studies were longer-term RCTs<span>(6–8)</span> with two further separate publications reporting on different outcomes for the same RCT<span>(9,10)</span>. One study was a prospective cohort<span>(11)</span> and one a cross-sectional study<span>(12).</span></p><p>Of the single test meal studies, no significant differences were observed for glucose levels in 2/2 studies (100%)<span>(3,5)</span>, PYY and GLP-1 levels in 2/2 studies (100%)<span>(3,4)</span> and self-reported hunger/fullness in 3/3 studies (100%)<span>(3–5)</span>. Significantly lower insulin concentrations and subsequent energy intakes were both reported in 1/2 studies (50%) following consumption of mycoprotein vs. chicken meals<span>(3)</span>.</p><p>Longer-term full and partial replacement of meat with PBMAs resulted in significantly lower body weight (kg) in 2/2 studies (100%)<span>(6,10)</span>, significantly lower saturated fat intakes in 2/2 studies (100%) <span>(6,10)</span>, significantly higher fibre intakes in 2/3 studies (67%)<span>(6,7)</span>, improvements in plasma lipid profile in 2/3 studies (67%)<span>(7,10)</span> and positive changes in gut microbiota in 1/2 studies (50%)<span>(8)</span> compared to meat diet phases/control groups with no restrictions on meat intakes. There were no significant differences in protein intakes in 3/3 studies (100%)<span>(6,7,10)</span>, energy, total fat and carbohydrate intakes in 2/2 studies (100%) <span>(6,7)</span>, blood pressure in 2/2 studies (100%)<span>(6,10)</span>, glucose levels in 2/2 studies (100%) <span>(7,10)</span> and insulin levels in 2/2 ","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"59 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing malnutrition and multimorbidity in primary care: dietary approaches to reduce treatment burden.","authors":"Rebecca J Stratton","doi":"10.1017/S0029665124004695","DOIUrl":"10.1017/S0029665124004695","url":null,"abstract":"<p><p>There are many health and nutrition implications of suffering from multimorbidity, which is a huge challenge facing health and social services. This review focuses on malnutrition, one of the nutritional consequences of multimorbidity. Malnutrition can result from the impact of chronic conditions and their management (polypharmacy) on appetite and nutritional intake, leading to an inability to meet nutritional requirements from food. Malnutrition (undernutrition) is prevalent in primary care and costly, the main cause being disease, accentuated by multiple morbidities. Most of the costs arise from the deleterious effects of malnutrition on individual's function, clinical outcome and recovery leading to a substantially greater burden on treatment and health care resources, costing at least £19·6 billion in England. Routine identification of malnutrition with screening should be part of the management of multimorbidity together with practical, effective ways of treating malnutrition that overcome anorexia where relevant. Nutritional interventions that improve nutritional intake have been shown to significantly reduce mortality in individuals with multimorbidities. In addition to food-based interventions, a more 'medicalised' dietary approach using liquid oral nutritional supplements (ONS) can be effective. ONS typically have little impact on appetite, effectively improve energy, protein and micronutrient intakes and may significantly improve functional measures. Reduced treatment burden can result from effective nutritional intervention with improved clinical outcomes (fewer infections, wounds), reducing health care use and costs. With the right investment in nutrition and dietetic resources, appropriate nutritional management plans can be put in place to optimally support the multimorbid patient benefitting the individual and the wider society.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":" ","pages":"1-9"},"PeriodicalIF":7.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health and multimorbidity: is diet the chicken or the egg?","authors":"Teresa A Marshall, Riva Touger-Decker","doi":"10.1017/S0029665124004683","DOIUrl":"10.1017/S0029665124004683","url":null,"abstract":"<p><p>Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition and oral and systemic diseases that contribute to multimorbidity. Diet- and nutrient-related risk factors for oral diseases include high intakes of free sugars, low intakes of fruits and vegetables and nutrient-poor diets which are similar to diet- and nutrient-related risk factors for systemic diseases. Oral diseases are chronic diseases. Once the disease process is initiated, it persists throughout the lifespan. Pain and tissue loss from oral disease leads to oral dysfunction which contributes to impaired biting, chewing, oral motility and swallowing. Oral dysfunction makes it difficult to eat nutrient-dense whole grains, fruits and vegetables associated with a healthy diet. Early childhood caries (ECC) associated with frequent intake of free sugars is one of the first manifestations of oral disease. The presence of ECC is our 'canary in the coal mine' for diet-related chronic diseases. The dietary sugars causing ECC are not complementary to an Eatwell Guide compliant diet, but rather consistent with a diet high in energy-dense, nutrient-poor foods - typically ultra-processed in nature. This diet generally deteriorates throughout childhood, adolescence and adulthood increasing the risk of diet-related chronic diseases. Recognition of ECC is an opportunity to intervene and disrupt the pathway to multimorbidities. Disruption of this pathway will reduce the risk of multimorbidities and enable individuals to fully engage in society throughout the lifespan.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":" ","pages":"1-8"},"PeriodicalIF":7.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial.","authors":"Oonagh Markey","doi":"10.1017/S0029665124004671","DOIUrl":"10.1017/S0029665124004671","url":null,"abstract":"<p><p>Multimorbidity, the existence of two or more concurrent chronic conditions in a single individual, represents a major global health challenge. The Nutrition Society's 2023 Winter Conference at the Royal Society, London focused on the topic of 'Diet and lifestyle strategies for prevention and management of multimorbidity', with symposia designed to explore pathways for prevention of multimorbidity across the lifecourse, the role of ageing, the gut-brain-heart connection and lifestyle strategies for prevention and management of multimorbidity. It also considered machine learning and precision nutrition approaches for addressing research challenges in multimorbidity. The opening plenary lecture discussed advancing diet and lifestyle research to address the increasing burden and complexity of multimorbidity. The two-day programme concluded with a plenary which addressed the key dietary risk factors and policies in multimorbidity prevention.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":" ","pages":"1-5"},"PeriodicalIF":7.6,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards sustainable diets – interventions and perceptions amongst adolescents: a scoping review","authors":"A. Lanham, J. van der Pols","doi":"10.1017/s0029665124000533","DOIUrl":"https://doi.org/10.1017/s0029665124000533","url":null,"abstract":"&lt;p&gt;Adolescence is an important life-stage during which shifts towards more healthy and sustainable diets can be promoted. Adolescents have increasing influence over their food choices informed by their developing personal knowledge and values, impacting long-term dietary behaviours into adulthood&lt;span&gt;(1)&lt;/span&gt;. We aimed to review the recent literature regarding adolescents’ perceptions of environmentally sustainable diets, and interventions to support adolescents to eat sustainably. We reviewed published literature that focussed on adolescent participants and their perceptions of, or interventions to support, sustainable dietary habits. Five electronic databases were searched to include studies published since 2012 that met the inclusion criteria. The JBI approach and PRISMA-Sc checklist&lt;span&gt;(2)&lt;/span&gt; was used for source screening, data extraction and presentation of data. Data was extracted including study characteristics, methodology and results in relation to each research question. The extracted data was reported, synthesised and discussed in the context of the food system framework&lt;span&gt;(3)&lt;/span&gt; and broader research. Twenty-eight articles were included in the review. Findings suggest that adolescents’ understanding of what constitutes sustainable eating is low. Most adolescents, when asked, were unsure of what constitutes sustainable eating, or a plant-based diet. The environmental impact of the production methods, transport and packaging of foods was most commonly reported when adolescents considered the environmental impact of their foods. The most commonly perceived barrier to consuming sustainable foods mentioned was cost, particularly by adolescents from lower socioeconomic backgrounds. Other barriers include unappealing taste, appearance or smell of ‘sustainable’ food items (particularly those that were vegetarian). Geographical limitations impacting the ability to grow or purchase local and organic products were also mentioned as barriers to consuming sustainable foods. Adolescents reported a lack of understanding of sustainable diets, and distrust of sustainability-related claims from fast-food outlets regarding the quality or source of ingredients, making it difficult to make informed food choices. Additionally, behaviours conflicting with personal and/or group norms were noted as barriers to adopting sustainable dietary habits. Adolescents that had previously received relevant education, valued nature and health, or were from a rural or indigenous community, were more likely to value environmentally sustainable food choices. Interventions which target adolescents’ cognitive understanding and aspiration to make sustainable food choices appear to improve their attitudes towards sustainable food, whereas interventions to increase the availability of sustainable foods improved the environmental sustainability of adolescents’ dietary intake. Multicomponent, tailored and community-based interventions were most effective however the","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"9 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140888645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the potential of meal kits to influence parental food literacy: an application of behaviour change frameworks","authors":"K. Fraser, B.J. Johnson, P. Love, A. Spence, R. Laws, K.J. Campbell","doi":"10.1017/s0029665124000569","DOIUrl":"https://doi.org/10.1017/s0029665124000569","url":null,"abstract":"<p>Cooking at home and eating together provide opportunities to improve family nutrition and promote healthy dietary habits. Commercial meal kit subscription services (MKSSs) (e.g. HelloFresh™, Marley Spoon™, EveryPlate™) may support parents to overcome obstacles to family meal provisioning and facilitate food literacy development. A gap exists in our understanding of how and why meal kits may elicit behaviour change, and opportunities to increase their behaviour change capability. This study aimed to examine the theoretical potential of Australian MKSSs to promote parental food literacy using the Behaviour Change Wheel (BCW)<span>(1)</span> and associated Theoretical Domains Framework (TDF)<span>(1)</span> and Behaviour Change Technique Taxonomy v1 (BCTTv1)<span>(2)</span>. A one-week subscription was purchased for all Australian-based MKSSs (n = 9) and key meal kit components (subscription and meal planning features, meal kit delivery and website content) were coded using the retrospective application of these behaviour change frameworks. Parental food literacy-related behaviours were informed by a Food Literacy framework<span>(3)</span>. Identified BCTs were mapped to the TDF using the Theory and Techniques Tool to identify theoretical mechanisms of action. The key meal kit components identified mapped to eight of the nine BCW intervention functions. These components primarily served the functions of enablement and environmental restructuring to support cooking at home. Thirty-five of the 93 possible BCTs were identified across the nine MKSSs reviewed, ranging from 19 to 29 BCTs per company, and linked to 13 of the 14 TDF domains. The most frequently identified mechanisms of action (TDF) targeted changes in motivation (n = 27) and capability (n = 19) to influence parental food literacy. Australian-based MKSSs incorporate a wide range of BCTs that target mechanisms of action associated with food literacy-related behaviours. These findings provide a strong theoretical evidence-base for the potential of commercial MKSSs to enhance parental food literacy. However, the extent to which these services may influence behaviour change or impact family food intakes is currently unknown. Therefore further research is required to evaluate the healthfulness and effectiveness of MKSSs.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"171 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140888674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing the proportion of plant to animal protein in hospital patient menus: what do stakeholders think?","authors":"G. Stiles, J. Collins, K. Beck","doi":"10.1017/s0029665124000521","DOIUrl":"https://doi.org/10.1017/s0029665124000521","url":null,"abstract":"&lt;p&gt;Replacing dietary animal protein with plant protein has a positive impact on greenhouse gas emissions&lt;span&gt;(1)&lt;/span&gt; and preventing death from chronic disease&lt;span&gt;(2)&lt;/span&gt;. Despite being ideally situated to re-design menus, foodservices in hospitals have not focused on changing protein sources&lt;span&gt;(3)&lt;/span&gt;. Implementation in hospitals requires cooperation from stakeholders across the foodservice system e.g., managers, dietitians, menu planners, purchasers, cooks. A qualitative descriptive study design using semi-structured interviews explored perspectives of hospital foodservice stakeholders on increasing the proportion of plant to animal protein in hospital patient menus and outlined actions required to do this. Interviews were based on participatory backcasting with a “desirable future” defined as hospital patient menus containing, on average, more plant-based protein foods (PBPF) (i.e., legumes, nuts, plant-based meat alternatives) than animal-based protein foods (ABPF) (i.e., beef, lamb, pork, poultry, fish, eggs, dairy) by the year 2050. Analysis was completed using a general inductive approach. Thirty-five stakeholders participated (foodservice dietitians n = 10; foodservice managers, n = 6; dietetic professional leads n = 4; chef/cooks n = 4; information technology n = 4; manager [contracts] n = 4; manager [other] n = 3). Most (n = 25) supported patient menu changes to increase the proportion of plant to animal protein foods, though all described barriers. Common concerns were that patients wouldn’t eat the meals (n = 32), that menu re-design would have a negative impact on protein intake and malnutrition rates (n = 30), and that cost of PBPF was too high making the change unfeasible (n = 25). Benefits were an improvement in the nutrition profile of the menu and subsequent improvement to health (n = 16), lower cost of legumes compared to meat (n = 10), improvements in greenhouse gas emissions (n = 10) and opportunity to use the menu as an education tool (n = 8). We developed a model describing the required actions which began with a trigger for change followed by a cyclical design process, preparation, implementation and monitoring. The cyclical design process included stakeholder consultation, setting a target, choosing a strategy, developing a menu and recipes, finding product, planning the system and operation, and checking it worked. Participants valued gradual changes and maintaining choice during the change process. When prompted about specific strategies, stakeholders were most supportive of replacing ABPF with PBPFs in familiar recipes or replacing entire menu items (n = 21), adding PBPF options (n = 25), and moving PBPFs before ABPF-based items on the menu (n = 22). Hospital foodservices and policy makers wishing to increase the proportion of plant to animal protein in hospital patient menus can use the process and actions identified to plan pathways and communicate these to stakeholders. Future research should explore s","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"35 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of a multidimensional diet quality score for a global sustainable healthy diet based on plant food variety, intake of animal products and dietary contribution of ultra-processed foods (SUSDIET)","authors":"P. Machado, E. Denniss, S.A. McNaughton, K.M. Livingstone, M. Lawrence","doi":"10.1017/s0029665124000211","DOIUrl":"https://doi.org/10.1017/s0029665124000211","url":null,"abstract":"<p>A range of metrics have been developed and used to measure components of dietary patterns (e.g., adequacy, quality, diversity). However, no existing dietary metric simultaneously captures the three key dimensions of sustainable healthy diets recommended by the Food and Agriculture Organization of the United Nations and the World Health Organization: food processing; dietary diversity; and intake of animal products<span>(1)</span>. This study aimed to identify indicators of a global sustainable healthy diet and translate these features into a multidimensional diet quality score (SUSDIET). Informed by our scoping review<span>(1)</span>, a Delphi method was adopted in the form of a three-round online survey of 13 national and international experts in nutritional epidemiology, environmental health, dietary assessment and/or food and nutrition policy. Surveys were conducted between November 2022 and May 2023. Participants were asked about procedures to establish an operational definition for a global sustainable healthy diet. Based on consensus from global experts, we developed the SUSDIET, a food-based diet quality score incorporating variety of plant foods, intake of animal products, and dietary contribution of ultra-processed foods (the ‘dimensions’). Categories and amounts of foods consumed were informed by the Global Diet Quality Score<span>(2)</span>, EAT Lancet Planetary Health<span>(3)</span> and a meta-analysis of the relationship between ultra-processed foods and all-cause mortality<span>(4)</span>. The variety of plant foods is measured based on 12 food groups (citrus fruits, deep orange fruits, other fruits, dark green leafy vegetables, cruciferous vegetables, deep orange vegetables, other vegetables, legumes, deep orange tubers, nuts and seeds, whole grains, white roots and tubers), animal intake based on 5 food groups (egg, dairy, poultry, fish and seafood, red meat), and ultra-processed foods as one food group. Three categories of consumed amounts (in grams per day) are defined for variety of plant foods and animal intake, scoring as 0, 0.5 or 1. Ultra-processed food consumption is scored as 0 or 1 using ≤10% or &gt;10% of total dietary intake as cut-offs. The components of each dimension are weighted so the three dimensions equally range from 0-5. SUSDIET overall score ranges from 0-15 (up to 5 points per dimension), with a higher score indicating a more healthy and sustainable diet. SUSDIET will be of immediate use for research aiming to assess the impact of diets on both health and environmental sustainability outcomes among the general adult population. This multidimensional diet quality score can also be used to inform and assess the effectiveness of policy actions that promote sustainable healthy diets, including the monitoring and surveillance of diets globally.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"2013 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140889944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence and eating experiences differ between participants following a flexitarian or vegetarian diet in a 10-week randomised dietary intervention trial","authors":"N.A. Gillies, A. Worthington, L. Li, T.S. Conner, E.N. Bermingham, S.O. Knowles, D. Cameron-Smith, R. Hannaford, A. Braakhuis","doi":"10.1017/s0029665124000508","DOIUrl":"https://doi.org/10.1017/s0029665124000508","url":null,"abstract":"<p>Flexitarian, vegetarian and vegan diets are increasingly popular, particularly amongst young adults. This is the first randomised dietary intervention to investigate the health, wellbeing, and behavioural implications of consuming a basal vegetarian diet that additionally includes low-to-moderate amounts of red meat compared to one containing plant-based meat alternatives (PBMAs) in young adults (NCT04869163)<span>(1)</span>. The objective for the current analysis is to measure adherence to the intervention, nutrition behaviours, and participants’ experience with their allocated dietary group. Eighty healthy young adults participated in this 10-week dietary intervention as household pairs. Household pairs were randomised to receive approximately three serves of beef and lamb meat (average of 390 g total cooked weight per person per week, flexitarian group) or PBMAs (350–400 g, vegetarian group) on top of a basal vegetarian diet. Participants were supported to adopt healthy eating behaviours, and this intervention was developed and implemented using a behaviour change framework<span>(2)</span>. Diet adherence (eating allocated meat or PBMA, abstaining from animal-based foods not provided by researchers) was monitored daily, with total scores calculated at the end of the 10-week intervention period. Eating experiences were measured by the Positive Eating Scale and a purpose-designed exit survey, and a food frequency questionnaire measured dietary intake. Analyses used mixed effects modelling taking household clustering into account. The average total adherence score was 91.5 (SD = 9.0) out of a possible 100, with participants in the flexitarian group scoring higher (96.1, SD = 4.6, compared to 86.7, SD = 10.0; <span>p</span> &lt; 0.001). Those receiving meat were generally more satisfied with this allocation compared to those receiving the PBMAs, even though a leading motivation for participants joining the study was an opportunity to try plant-based eating (35% expressed that that interest). Participants in both intervention groups had increased vegetable intake (<span>p</span> &lt; 0.001), and reported more positive eating experiences (<span>p</span> = 0.020) and satisfaction with eating (<span>p</span> = 0.021) at the end of the 10-week intervention relative to baseline values. Behavioural methods to encourage engagement with the trial were successful, as participants demonstrated excellent adherence to the intervention. The flexitarian and vegetarian diets elicited different responses in adherence and eating experience. This holds relevance for the inclusion of red meat and PBMAs in healthy, sustainable dietary patterns beyond this study alone.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"23 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140888678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effect of replacing wheat flour with legume flour on ileal amino acid digestibility in healthy adults with an ileostomy","authors":"D. Belobrajdic, H. Brook, G. James-Martin, R. Weerakkody, R. Stockman","doi":"10.1017/s0029665124000673","DOIUrl":"https://doi.org/10.1017/s0029665124000673","url":null,"abstract":"<p>Protein-rich animal foods are highly digestible, high-quality sources or protein, whereas the protein quality of plant-based foods can vary considerably. Given the growing interest in alternative non-animal-based sources of protein, it is important to establish the protein digestibility of these new foods and protein concentrates which have important health implications especially for vulnerable groups who don’t consume sufficient dietary protein. The human ileostomy model is ideal for measuring protein digestibility as it enables protein digestion to be quantified independent of protein degradation in the large intestine. The aim of this study was to determine the protein digestibility and quality of a wheat-based food containing legume flours. This randomised, double-blinded, controlled cross-over intervention was conducted in 4 proctocolectomised adults with conventional and well-functioning permanent ileostomies. The study was conducted over 2 weeks and on each testing day, the participant consumed 2 test muffins (125 g each) or 2 protein-free cookies in the morning (breakfast and morning tea) followed by a standardised low-protein lunch and afternoon tea. Test muffins were made using a standard muffin recipe using wheat flour and for 2 of the test muffins 50% of the flour was substituted with soy or lupin flour. An indigestible marker, titanium dioxide was added to the muffins so that the completeness of muffin recovered in ileal digesta could be calculated. The digestible indispensable amino acid score (DIAAS) was determined by comparing concentrations of true ileal digestible indispensable amino acids to recommended amino acid requirements<span>(1)</span>. Data was reported as mean ± SD and repeated measures ANOVA was used to compare means between treatment groups with significance reported at P &lt; 0.05. Substituting 50% of wheat flour in muffins with soy or lupin flour doubled the protein content of muffins (soy 11.8 g/100g and lupin 10.6 g/100g) compared to muffins that only contained wheat flour (wheat 5.1 g/100g). However, substituting wheat with legume flour did not affect protein digestibility which was similar for all muffin types; wheat (76.8 ± 7.0%), soy (77.9 ± 7.4%) and lupin (81.6 ± 6.9%) (P = 0.181). The DIAAS values for all muffins were below 75% which is classified as the cut off for a good quality protein food. In conclusion, substitution of wheat-based muffins with soy and lupin flour increased the protein content of wheat-based muffins but protein digestibility and overall protein quality was similar.</p>","PeriodicalId":20751,"journal":{"name":"Proceedings of the Nutrition Society","volume":"19 1","pages":""},"PeriodicalIF":7.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140888544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}