Effect of high pressure homogenization on in vitro digestibility and colon fermentability of pea protein-rich bread designed for elderly consumers.

Enrichment of staple foods with proteins can be a solution to tackle protein-energy malnutrition in the elderly. For instance, bread can be enriched with pea proteins that are cheap, sustainable and easily digestible. Non-conventional technologies, such as high pressure homogenization (HPH), can improve the digestibility of plant proteins. To characterize the health functionality of pea-enriched bread, a functional bread tailored to elderly consumers was developed by substituting 5% wheat flour with untreated or HPH-treated pea protein concentrate. Protein digestibility and colon fermentability were assessed by mimicking elderly in vitro gastrointestinal and gut microbiota conditions and compared with adult conditions. Bread reformulation with pea proteins affected physical and chemical properties and produced an increase in hardness, which is one of the key features for the acceptability of bread by the elderly. The highest hardness value was observed for pea protein bread, followed by HPH-treated pea protein bread and wheat bread. In vitro protein digestibility and fermentability were affected by reformulation and by physiological digestive conditions, with lower digestibility under elderly conditions compared to adult ones. The obtained results may contribute to a better understanding of food digestibility under different gastrointestinal conditions and its dependence on physiological and formulation factors, and ultimately would help to design age-tailored foods.

Effects of Replacing Cow's Milk with Plant-Based Beverages on Potential Nutrient Intake in Sustainable Healthy Dietary Patterns: A Case Study.

More consumers are replacing cow's milk (CM) with plant-based drinks (PBD), but data indicating the nutritional impact are limited. This theoretical study aims to assess the effect of substituting CM with PBD sold in Italy on nutrient intake within two dietary patterns: one aligned with the EAT-Lancet Commission reference diet adapted to Italian food habits (EAT-IT) and another one in line with the Italian Dietary Guidelines (IDG). Nutrition information from 368 PBD were collected and categorized according to their descriptive name and their fortification or not with calcium (Ca- and nCa-fortified). The substitution of CM with each PBD category in both dietary patterns was conducted, and an analysis of nutrient content and adequacy was performed. Substituting CM with all PBD resulted in reduced protein intake, except for nCa-fortified soy drinks, decreased saturated fat and vitamins B2 and B12, and increased fiber intake. Replacing CM with nCa-fortified PBD within both diets decreased Ca intake. Following the substitution of CM with Ca-fortified PBD, variations in vitamin D intake depended on the PBD category. The main risk of nutritional inadequacy was observed in Ca and vitamin D levels, which may even be amplified considering the different bioavailability based on the source of nutrients. This study highlighted the important role of CM in meeting calcium requirements and the potential unintended consequences of substituting CM with PBD without considering their nutritional differences.

Compliance and Attitudes towards the Gluten-Free Diet in Celiac Patients in Italy: What Has Changed after a Decade?

This study aims were (i) to describe Italian celiac patients who agreed to participate in the latest web survey and their attitudes toward the GF diet (compliance, perceived limitations, and worries) and (ii) to compare the answers given by the 2011 and 2022 responders. The self-administered questionnaire was distributed through the Italian Coeliac Association channels (link on social media, websites, and newsletters) to all of the celiac patients willing to participate in 2011 and 2022 (2427 and 3529 responders who answered the same questions, respectively). Descriptive analyses and the Pearson's chi-squared test were performed. The responders were 1 to 84 years old and mainly female. The prevalence of adherent patients in 2022 was 91%, with the highest value (94%) in children (≤10 years old) and adolescents (15-17 years old). Overall, young adults were the most worried group. About a decade after the first survey, we observed a decreasing prevalence of transgression events (-5%) and (at least) occasional temptation (-17%), a decreasing prevalence of health-related and general worries, but an increasing prevalence of social life withdrawal. In conclusion, it is important to periodically monitor celiac patients' compliance and attitudes towards the gluten-free diet. As also highlighted in international guidelines, a reorganization of the diagnosis/follow-up visits, including an expert dietary consultation, is needed.

Role of particle size in modulating starch digestibility and textural properties in a rye bread model system.

In cereal products, the use of flour containing clusters of intact cells has been indicated as a potential strategy to decrease starch digestion. Rye possesses more uniform and thicker cell walls than wheat but its protective effect against starch digestion has not been elucidated. In this study, rye flours with three different particle sizes, large (LF) (∼1700 µm), medium (MF) (∼1200 µm), and small (SF) (∼350 µm), were used to produce model bread. The textural properties of these breads were analysed using Textural Profile Analysis (TPA). The starch digestibility of both the flour and the bread was measured using Englyst's method, while the presence of intact cell clusters was examined using Confocal Laser Scanning Microscopy (CLSM). Additionally, the disintegration of bread digesta during simulated digestion was assessed through image analysis. CLSM micrographs revealed that bread made with MF and LF retained clusters of intact cells after processing, whereas bread made with SF showed damaged cell walls. Starch digestibility in LF and MF was lower (p ≤ 0.05) than that in SF. Bread produced with MF and LF exhibited the least (p ≤ 0.05) cohesive and resilient texture, disintegrated more during digestion, and exhibited higher starch digestibility (p ≤ 0.05) than bread made with SF. These results highlight the central role of bread texture on in vitro starch digestibility.

Protein transition: focus on protein quality in sustainable alternative sources.

The current consumption trends, combined with the expected demographic growth in the coming years, call for a protein transition, i.e., the partial substitution of animal protein-rich foods with foods rich in proteins produced in a more sustainable way. Here, we have discussed some of the most common and promising protein sources alternative to animal proteins, namely: legumes, insects, and microorganisms (including microalgae and fungi). The primary objective was to assess their nutritional quality through the collection of digestible indispensable amino acid score (DIAAS) values available in the scientific literature. Protein digestibility corrected amino acid score (PDCAAS) values have been used where DIAAS values were not available. The ecological impact of each protein source, its nutritional quality and the potential applications in traditional foods or novel food concepts like meat analogues are also discussed. The data collected show that DIAAS values for animal proteins are higher than all the other protein sources. Soybean proteins, mycoproteins and proteins of some insects present relatively high DIAAS (or PDCAAS) values and must be considered proteins of good quality. This review also highlights the lack of DIAAS values for many potentially promising protein sources and the variability induced by the way the proteins are processed.

Assessment of Protein Quality and Digestibility in Plant-Based Meat Analogues.

In this first work, commercial steak-like (n = 3) and cured meat (n = 3) analogues with different legume and cereal formulations were studied and compared to their animal-based (n = 3) counterparts. Plant-based products showed lower protein content than meat controls but a good amino acidic profile even though the sum of essential amino acids of plant-cured meats does not fulfill the requirements set by the Food and Agriculture Organization for children. A comparable release of soluble proteins and peptides in the digestates after in vitro digestion was observed in meat analogues as meat products, whereas the digestibility of proteins was lower in plant-based steaks and higher in plant-based cured meats than their counterparts. The overall protein quality and digestibility of products are related to both the use of good blending of protein sources and processes applied to produce them. An adequate substitution of meat with its analogues depends mostly on the quality of raw materials used, which should be communicated to consumers.

Levels of lipid-derived gut microbial metabolites differ among plant matrices in an in vitro model of colon fermentation.

This study explored differences in microbial lipid metabolites among sunflower seeds, soybeans, and walnuts. The matrices were subjected to in vitro digestion and colonic fermentation. Defatted digested materials and fiber/phenolics extracted therefrom were added to sunflower oil (SO) and also fermented. Targeted and untargeted lipidomics were employed to monitor and tentatively identify linoleic acid (LA) metabolites. Walnut fermentation produced the highest free fatty acids (FFAs), LA, and conjugated LAs (CLAs). Defatted digested walnuts added to SO boosted FFAs and CLAs production; the addition of fibre boosted CLAs, whereas the addition of phenolics only increased 9e,11z-CLA and 10e,12z-CLA. Several di-/tri-hydroxy-C18-FAs, reported as microbial LA metabolites for the first time, were annotated. Permutational multivariate analysis of variance indicated significant impacts of food matrix presence and type on lipidomics and C18-FAs. Our findings highlight how the food matrices affect CLA production from dietary lipids, emphasizing the role of food context in microbial lipid metabolism.

Salt content of prepacked cereal-based products and their potential contribution to salt intake of the Italian adult population: Results from a simulation study.

BACKGROUND AND AIMS: High sodium intake is one of the main risk factors for noncommunicable diseases, and its consumption should be reduced. This study aimed to simulate changes in the daily salt intake of the Italian adult population based on consumption scenarios of prepacked cereal-based foods sold in Italy. METHODS AND RESULTS: Information on food packages was retrieved from 2893 cereal-based products. Potential changes in salt intake were simulated based on food consumption scenarios that consider the daily consumption of cereal-based products suggested in the Italian Dietary Guidelines and their current daily consumption by Italian adults. The highest salt content was retrieved in bread (median, 25th-75th percentile: 1.3, 1.1-1.4 g/100 g) and bread substitutes (1.8, 1.0-2.2 g/100 g). If the suggested daily amounts were consumed, bread would contribute to 44% of the 5 g salt/day target, whereas bread substitutes, breakfast cereals, biscuits and sweet snacks would marginally contribute (1-2%). Compared to bread with median salt content, a -44% and +10% salt intake would be observed if products within the first and the last quartile of salt content were chosen, respectively. However, considering the actual intake of Italian consumers, bread would cover 25% and bread substitutes 7% of the daily salt target. CONCLUSION: Food labels have a pivotal role and efforts are required to encourage consumers to use them to make healthy choices. Moreover, these results may contribute to setting sodium benchmarks in cereal-based products and encourage the food industry to reduce the salt content in the products.

Effect of shape, gluten, and mastication effort on in vitro starch digestion and the predicted glycemic index of pasta.

Gluten-containing (GC) and gluten-free (GF) pasta consumption has been growing in recent years. The market offers a wide variety of pasta types, with differences in shape and formulation that influence the mastication process and, consequently, their nutritional behaviors (i.e. starch digestibility and glycemic response). This study investigated the effect of shape, gluten, and structural breakdown on in vitro starch digestibility and predicted the glycemic index (pGI) of GC and GF penne, spaghetti, and risoni. Pasta was cooked and minced to mimic short, intermediate, and long mastication efforts. Short mastication led to a higher number of big particles than intermediate and long mastications for all pasta samples, which was reflected in the different starch digestibility and pGI patterns. Multivariate analysis of variance showed that the three studied factors differently affected the in vitro starch digestion of pasta. Mastication effort, shape, and their interaction mainly affected the starch digestion rate and pGI. Gluten was the major factor in affecting the amount of digested starch. The results suggested that small shapes (i.e. risoni), the presence of gluten, and short mastication effort led to a lower pGI. The findings will be useful for the development of pasta products tailored to fulfill the needs of specific consumers following a rational food design approach.

Lipid complexation reduces rice starch digestibility and boosts short-chain fatty acid production via gut microbiota.

In this study, two rice varieties (RS4 and GZ93) with different amylose and lipid contents were studied, and their starch was used to prepare starch-palmitic acid complexes. The RS4 samples showed a significantly higher lipid content in their flour, starch, and complex samples compared to GZ93. The static in vitro digestion highlighted that RS4 samples had significantly lower digestibility than the GZ93 samples. The C∞ of the starch-lipid complex samples was found to be 17.7% and 18.5% lower than that of the starch samples in GZ93 and RS4, respectively. The INFOGEST undigested fractions were subsequently used for in vitro colonic fermentation. Short-chain fatty acids (SCFAs) concentrations, mainly acetate, and propionate were significantly higher in starch-lipid complexes compared to native flour or starch samples. Starch-lipid complexes produced a distinctive microbial composition, which resulted in different gene functions, mainly related to pyruvate, fructose, and mannose metabolism. Using Model-based Integration of Metabolite Observations and Species Abundances 2 (MIMOSA2), SCFA production was predicted and associated with the gut microbiota. These results indicated that incorporating lipids into rice starch promotes SCFA production by modulating the gut microbiota selectively.

Comparison of protein quality and digestibility between plant-based and meat-based burgers.

Nowadays, consumers are increasingly inclined toward plant-based meat analogues for sake of food security, safety, and sustainability. This growing interest, not only from consumers but also from food companies, brought the offer on the market to be wide and vast. From our previous study it emerged that the market supply, especially the Italian one, is diversified both in terms of protein sources and nutrient content. Although these products are increasingly consumed, for most of the meat analogues today on the market, little is still known about their actual protein quality and digestibility. To fill this gap, in this study different commercial plant-based burgers (2 soy-based and 2 pea-based) were selected and compared to two beef burgers, as controls, in terms of protein quality and digestibility. The findings of this study demonstrated the essential amino acidic profile lacks lysine for almost all burgers (including the meat-based ones) compared to the amino acid scoring pattern set by FAO/WHO (for older children and adults), even if the sum of essential amino acids was within the range of sufficiency. All samples showed good initial protein integrity with low hydrolysis (above 6%) and percentage of D-enantiomers (above 15%). The study of the digestibility, performed by the validated INFOGEST in vitro model, showed better protein solubilisation in the case of meat burgers (63 ± 3% and 61 ± 8%), but a good digestibility also in the case of plant-based ones (from 55% to 40%). The degree of hydrolysis of the solubilised proteins was very high in all samples (from 65% to 40%) indicating a very good protein accessibility to digestive enzymes. The analysis of the peptide fraction of digestates indicated a high prevalence of collagen proteins in beef burgers and of reserve proteins in plant-based burgers. This study showed that the differences between these products are mostly dependent on the quality of the raw materials used, rather than on the vegetal or animal protein source. Therefore, to have a product with a good protein quality and digestibility, independently from the protein origin, the consumer needs to make an accurate choice, carefully reading the ingredient list.

Processing and Nutritional Quality of Breakfast Cereals Sold in Italy: Results from the Food Labelling of Italian Products (FLIP) Study.

This study aimed to compare the level of processing (as assessed by the NOVA classification) and the nutritional quality (as assessed by nutrition values, Nutri-Score and NutrInform battery) of breakfast cereals currently on the Italian market. A total of 349 items were found, mostly belonging to the NOVA 4 group (66.5%) and to Nutri-Score C and A (40% and 30%, respectively). The NOVA 4 products showed the highest energy, total fat, saturates, and sugar content per 100 g and had the highest number of items with Nutri-Score C (49%) and D (22%). Conversely, NOVA 1 products had the highest content of fibre and protein, the lowest amounts of sugars and salt, and 82% of them were Nutri-Score A, while few Nutri-Score B and C were found. Differences were attenuated when products were compared for their NutrInform battery, with NOVA 4 items showing only slightly fuller batteries for saturated fats, sugar, and salt than NOVA 1 and NOVA 3 products. Overall, these results suggest that the NOVA classification partially overlaps with systems based on the nutritional quality of foods. The lower nutritional quality of NOVA 4 foods may at least partially explain the association found between the consumption of ultra-processed foods and the risk of chronic diseases.

Effects of a dietary intervention with Mediterranean vs lacto-ovo vegetarian diets on HDL function: Results from the CARDIVEG study.

BACKGROUND AND AIM: HDL-cholesterol efflux capacity (CEC) has been shown to be a better cardiovascular (CVD) risk marker than serum HDL concentration. Several foods and nutrients have been shown to improve HDL functions, however no effective dietetic nor pharmacological strategy is available to increase CEC. This study aims to evaluate the possible effect of Mediterranean diet (MD) and lacto-ovo-vegetarian diet (VD) on HDL function in a group of clinically healthy subjects at low-to-moderate CVD risk. METHODS AND RESULTS: Thirty apparently healthy subjects with a low-to-moderate cardiovascular risk profile (21 F; mean age: 51.3 ± 9.7 years) were randomly assigned to a 3-month MD or VD diet and then crossed. Participants on VD showed a reduction in total HDL CEC by 8.99% (p < 0.001) as well as a reduction in ABCA1 mediated-CEC by 18.62% (p < 0.001) compared to participants on MD. Regarding CEC mediated by aqueous diffusion, no significant changes were observed after treatment with either diet. Finally, a significant positive association between CEC mediated by the ABCA1 transporter and adiponectin was found (r = 0.462; p = 0.010). CONCLUSION: The results of this study suggest that HDL activity in promoting cholesterol efflux and thereby reducing the concentration of pro-atherogenic lipoproteins was more effective in participants undergoing MD than VD. Based on these findings, the MD could be considered a better therapeutic strategy for cardiovascular prevention than VD. CLINICAL TRIAL REGISTRATION URL: http://www. CLINICALTRIALS: gov. Unique identifier: NCT02641834.

Pre-soaking treatment can improve cooking quality of high-amylose rice while maintaining its low digestibility.

Rice is a staple food for more than half of the world's population and it is regarded as a high glycemic index (GI) food. Breeders developed high amylose rice having low digestibility, but it also has inferior palatability. This study used high-amylose rice (HAR) produced by gamma irradiation and compared the digestion and physicochemical properties related to palatability with those of low-amylose rice (LAR). Pre-soaking and different-pH treatments were adopted to find a way to enhance the palatability of HAR while maintaining its low digestibility. After pre-soaking, HAR had a higher water uptake ratio (4.68 vs. 4.11 g g-1), proportion of leached starch (16.6 vs. 12.6%) and adhesiveness (77 vs. 39), but lower setback (0.092 vs. 0.107 Pa s), hardness (10.1 vs. 12.6 kg) and resilience (0.20 vs. 0.25). The results showed that pre-soaking was able to enhance the quality of the cooked rice mainly by modifying the starch amorphous region while maintaining the low digestibility of HAR. Pre-soaking can be adopted as a practical and effective household cooking method to prepare rice with relatively low digestibility and good palatability.

The Update of the Italian Food Composition Database of Gluten-Free Products and Its Application in Food-Based Dietary Guidelines Menus.

Complete food composition databases (FCDBs) on gluten-free (GF) foods are needed to assess the nutrient intakes of celiac disease patients. The aim of the present work was to update the previously developed version of the Italian GF-FCDB and to apply it to a theoretical GF diet. The updated GF-FCDB includes the composition of 108 GF cereal-based foods, as sold, in terms of energy and macro- and micro-nutrients, imputed using food label information combined with the standard recipe approach. Three scenarios (i.e., refined, mixed, and wholegrain cereals) of the weekly guideline menu for the general Italian population were analyzed for energy and nutrient content in a theoretical dietary assessment using traditional gluten-containing (GC) foods and the corresponding GF substitutes. All GF menus were higher than the corresponding GC menus in polyunsaturated fatty acids, linoleic acid, and vitamin E. Zinc was lower in GF than in GC menus only in the wholegrain-cereal scenario. Thanks to the application of the updated GF-FCDB including a comprehensive list of micronutrients, we observed that it is possible for celiac disease patients to meet nutrient requirements by simply substituting GC with GF cereal-based products following recommendations for the general population.

Consumer Awareness of the Degree of Industrial Food Processing and the Association with Healthiness-A Pilot Study.

Consumption of ultraprocessed foods (UPFs) has been associated with lower diet quality, obesity, and adverse health effects. Not much is known about how consumers evaluate the degree of processing of a food product and how they relate this to healthiness. An online questionnaire was completed by a total of 277 Dutch, 204 Italian, and 181 Brazilian consumers. Consumers were aged 18-65 year, mean 38 ± 13 year, 31% were males, and 71% were highly educated. Pictures of several common food products were evaluated on the degree of industrial processing and healthiness. Thirteen food categories were included, each including one minimally processed food (MPF), one High NS_UPF (Nutri-Score A or B), and one Low NS_UPF (Nutri-Score D or E). Lastly, knowledge and attitude about UPFs were assessed. Ultraprocessing was perceived as unhealthy by the majority of consumers (Dutch, Italian: 55%; Brazilian: 75%) and contributed to weight gain according to: 38% Dutch, 51% Italian, and 70% Brazilian consumers. Low NS_UPFs were correctly rated toward "processed" and "not healthy" in all countries. High NS_UPF were rated as processed but showed large variations in healthiness scores. In conclusion, consumers rated UPFs relatively low in healthiness compared with MPFs with similar Nutri-Scores within the same food category. These preliminary findings suggest that consumers incorporate, to some extent, the degree of industrial processing while assessing the healthiness of food products.

Relationship between front-of-pack labeling and nutritional characteristics of food products: An attempt of an analytical approach.

The adoption of supplementary nutrition information, i.e., front-of-pack labeling (FOPL), on pre-packed food products is advocated as a tool to improve the consumers' knowledge of the nutrient content or the nutritional quality of foods, but also to drive products reformulation by the food industry. Ultimately, FOPL should help people to select foods in order to compose an overall balanced diet, which is essential for health. However, the extent to which the different FOPL systems proposed in the European Union (EU) (interpretative or informative) are effectively able to convey the information useful to improve both food choices and dietary habits of the consumers is still under debate and needs to be analyzed in detail. The use of 3 FOPL schemes proposed within the EU (Nutri-Score, Keyhole and NutrInform Battery) to compare products available on the Italian market within different food categories, highlights some critical issues: (1) different FOPL provide to consumers different kinds of information; (2) systems based on similar theoretical approaches can provide conflicting information; (3) the algorithms on which interpretative FOPL are based can give the same summary information for products differing in nutrient composition, impact on the overall dietary balance and therefore on the health of people with different characteristics, physiological/pathological conditions, and nutritional requirements; (4) on the other hand, products with similar nutrient composition can obtain different interpretative FOPL; (5) informative systems are generally more complex and require greater both attention and knowledge from the consumer; (6) FOPL based on 100 g of product overlook the role of portion (and frequency of consumption) in determining the nutrient intake without informing on the contribution of a single food to the overall diet; (7) FOPL based on scoring systems could promote the reformulation of selected products, especially with a composition very close to the threshold limits; (8) for the portion-based informative FOPL systems, the incentive for reformulation could essentially involve the reduction of portion size. Finally, the importance of nutritional education interventions, which are required to encourage the use by consumers of informative FOPL systems, cannot be neglected to improve the quality of diets regardless of the FOPL used.

Sodium Content in Cereal-Based Products Sold in Italy: How Far Are We from the Global Benchmarks?

Reformulation of food products is one of the measures needed for reducing salt consumption. Accordingly, the World Health Organization (WHO) recently proposed global sodium benchmarks for different food categories to be used for setting national policies. Therefore, the sodium content of cereal-based products currently sold in Italy was compared with the WHO benchmarks, highlighting those categories primarily needing a reformulation. To this aim, the sodium content and several declarations (i.e., nutrition and health claims, organic or gluten free declaration) were retrieved from 2917 cereal-based products sold on the Italian market. All "minimally processed breakfast cereals" had a sodium content below the benchmark, while "flatbreads" and "leavened bread" had the highest percentage of items above the respective sodium benchmarks. Flatbreads and "crackers/savory biscuits" showed the highest median delta values from the respective benchmarks of 360 and 278 mg/100 g, respectively. Large variability in terms of percentage of products with sodium content above the benchmark was observed within the same categories, as well as among products with different declarations. A large number of food products currently sold on the Italian market have a sodium content above the benchmark. This result suggests the need to reformulate many food products currently on the market to achieve the WHO/United Nations (UN) objective of 30% global reduction in sodium intake by 2025.

Monitoring the effect of cell wall integrity in modulating the starch digestibility of durum wheat during different steps of bread making.

Reduction of starch digestibility in starchy foods is beneficial for lowering the risks for major non-communicable diseases. Preserving cell integrity is known to delay starch digestibility in flour but its effect in bread is not clear. In this study, the effect of increasing particle size on in vitro starch digestibility of durum wheat flour, dough, and bread was investigated. Cell integrity was retained during bread processing for medium (1000 µm-1800 µm), and large (>1800 µm) flour, whereas in small one cell walls were mostly damaged (<350 µm). In vitro starch digestibility of flour decreased increasing particle size, but no difference was found in dough. In bread, instead, a modest decrease of starch digestibility for the bread made by large particle was observed, likely due to its dense structure. In conclusion, a high particle size could limit starch digestibility in durum wheat flour but not in bread.

Designing food for the elderly: the critical impact of food structure.

Ageing is an unavoidable progressive process causing many changes of the individual life. However, if faced in an efficient way, living longer in a healthy status could be an opportunity for all. In this context, food consumption and dietary patterns are pivotal factors in promoting active and healthy ageing. The development of food products tailored for the specific needs of the elderly might favour the fulfilment of nutritionally balanced diets, while reducing the consequences of malnutrition. To this aim, the application of a food structure design approach could be particularly profitable, being food structure responsible to the final functionalities of food products. In this narrative review, the physiological changes associated to food consumption occurring during ageing were firstly discussed. Then, the focus shifted to the possible role of food structure in delivering target functionalities, considering food acceptability, digestion of the nutrients, bioactive molecules and probiotic bacteria.