The cost-effectiveness of food consistency modification with xanthan gum-based Nutilis Clear® in patients with post-stroke dysphagia in Poland.

BACKGROUND: Dysphagia is a well-known stroke complication characterised by difficulty in swallowing. It may affect the majority of stroke patients and increases mortality and morbidity, due to aspiration pneumonia and malnutrition. Food thickening may help patients to feed themselves, and its effectiveness was demonstrated. However, the cost-effectiveness studies are lacking. We evaluate the cost-utility of xanthan gum-based consistency modification therapy (Nutilis Clear®) in adult post-stroke patients from the public payer perspective in Poland. METHODS: Routine clinical practice was used as a comparator, as no alternative specific treatment for dysphagia is available. To verify the robustness of the results against the modelling approach, we built two models: a static (a fixed simple-equations model, 8-week time horizon of dysphagia) and a dynamic one (Markov model, with a possible dysphagia resolution over a 1-year horizon). In both models, the treatment costs, health state utilities, and clinical events (i.e. aspiration, aspiration pneumonia, death) were included. Parameters were estimated jointly for both models, except for the duration of dysphagia and the risk of aspiration pneumonia (specific to the time horizon). We only assumed Nutilis Clear® to prevent aspirations, without affecting dysphagia duration. RESULTS: The average cost of one quality-adjusted life year (i.e. the incremental cost-utility ratios, ICURs) amounted to 21,387 PLN (€1 ≈ 4.5 PLN), and 20,977 PLN in static and dynamic model, respectively; far below the cost-effectiveness threshold in Poland (147,024 PLN). The one-way, scenario, and probabilistic sensitivity analysis confirmed these findings. CONCLUSIONS: Nutilis Clear® is highly cost-effective in Poland from the public payer perspective. Our approach can be used in other countries to study the cost-effectiveness of food thickening in stroke patients.

Mycoprotein: environmental impact and health aspects.

The term mycoprotein refers to the protein-rich food made of filamentous fungal biomass that can be consumed as an alternative to meat. In this paper, the impact caused by the substitution of animal-origin meat in the human diet for mycoprotein on the health and the environment is reviewed. Presently, mycoprotein can be found in the supermarkets of developed countries in several forms (e.g. sausages and patties). Expansion to other markets depends on the reduction of the costs. Although scarce, the results of life cycle analyses of mycoprotein agree that this meat substitute causes an environmental impact similar to chicken and pork. In this context, the use of inexpensive agro-industrial residues as substrate for mycoprotein production has been investigated. This strategy is believed to reduce the costs involved in the fungal cultivation and lower the environmental impact of both the mycoprotein and the food industry. Moreover, several positive effects in health have been associated with the substitution of meat for mycoprotein, including improvements in blood cholesterol concentration and glycemic response. Mycoprotein has found a place in the market, but questions regarding the consumer's experience on the sensory and health aspects are still being investigated.

Application of hydrolases and probiotic Pediococcus acidilactici BaltBio01 strain for cereal by-products conversion to bioproduct for food/feed.

The aim of this study was to apply the enzymatic treatment and fermentation by Pediococcus acidilactici BaltBio01 strain for industrial cereal by-products conversion to food/feed bioproducts with high amount of probiotic lactic acid bacteria (LAB). LAB propagated in potato media and spray-dried remained viable during 12 months (7.0 log10 cfu/g) of storage and was used as a starter for cereal by-products fermentation. The changes of microbial profile, biogenic amines (BAs), mycotoxins, lactic acid (L+/D-), lignans and alkylresorcinols (ARs) contents in fermented cereal by-product were analysed. Cereal by-products enzymatic hydrolysis before fermentation allows to obtain a higher count of LAB during fermentation. Fermentation with P. acidilactici reduce mycotoxins content in fermented cereal by-products. According to our results, P. acidilactici multiplied in potato juice could be used for cereal by-products fermentation, as a potential source to produce safer food/feed bioproduct with high amount of probiotic LAB for industrial production.

Cost-effectiveness analysis of a school-based dental caries prevention program using fluoridated milk in Bangkok, Thailand.

BACKGROUND: This study modelled the cost-effectiveness, from a societal perspective, of a program that used fluoridated milk to prevent dental caries in children who were 6 years old at the beginning of the program, versus non-intervention, after 6 years. METHODS: After 6 years, children in the milk-fluoridation program had a significant (34%) reduction in dental caries experience compared to those in the comparison community (i.e., received school milk without added fluoride) (DMFS: 1.06 vs. 1.60). RESULTS: This improvement was achieved with an investment of Thailand Baht (THB) 5,345,048 over 6 years (or THB 11.88 per child, per year) (1 US$ = THB(2011) 30.0). When comparing the costs of the operation of the program and dental treatment in the test community with those of the comparison community, the program resulted in a net societal savings of THB 8,177,179 (range 18,597,122 to THB 7,920,711) after 6 years. This investment would result in 40,500 DMFS avoided in a community with a childhood population of 75,000 [DMFS avoided: 75,000 x (- 0.54)]. CONCLUSIONS: While the analysis has inherent limitations due to its dependence on a range of assumptions, the results suggest that, from a societal perspective, when compared with the non-intervention group, the Bangkok Metropolitan Administration intervention appeared to be a more cost-efficient option than current standard oral health care.

Shrinking the food-print: A qualitative study into consumer perceptions, experiences and attitudes towards healthy and environmentally friendly food behaviours.

Internationally, there is increasing recognition of the importance of multilevel policies and actions that address healthy and environmentally friendly food behaviours. However it is not yet clear which actions are most suitable to support consumers to adopt both behaviours concurrently. To this end, we undertook a qualitative study to assess consumer perceptions, experiences and attitudes towards healthy and environmentally friendly foods and four target behaviours: reducing overconsumption of food beyond energy needs, reducing consumption of low-nutrient energy dense foods, eating less animal- and more plant-derived foods, and reducing food waste. Online in-depth interviews were held with 29 Australian food shoppers representing different levels of involvement with health and environment in daily food choices. The results indicate that compared to health, the relationship between food and the environment is rarely considered by consumers. The four target food behaviours were primarily associated and motivated by an impact on health, except for not wasting foods. Participants had the most positive attitude and highest motivation for eating less processed and packaged foods, mostly to avoid excessive packaging and 'chemicals' in foods. This was followed by the behaviours reducing food waste and overconsumption. Conversely, there was a predominantly negative attitude towards, and low motivation for, eating less animal-derived products and more plant based foods. Overall, consumers found a joined concept of healthy and environmentally friendly foods an acceptable idea. We recommend that health should remain the overarching principle for policies and actions concerned with shifting consumer behaviours, as this personal benefit appears to have a greater potential to support behaviour change. Future consumer focused work could pay attention to framing behavioural messages, providing intermediate behavioural goals, and a multiple target approach to change habitual behaviours.

Reviewing the Nutrition and Health Claims Regulation (EC) No. 1924/2006: What do we know about its challenges and potential impact on innovation?

Health claims potentially represent an opportunity for firms to engage in product differentiation and thereby induce investment into R&D and innovation in the food sector. The Nutrition and Health Claims Regulation (EC) No. 1924/2006 (NHCR) aims at protecting and promoting innovation as one of its objectives. However, existing studies indicate that this regulation may create several challenges for innovation in the food sector. To this end, we review the challenges related to the NHCR (Article 13.1) and its impact on innovation. Extant literature suggests that companies face challenges related to changing list of ingredients, missing transparency, wording of claims, limited financial resources, limited R&D resources, switching product categories and abandoning the functional foods sector. Moreover, current studies imply that so far the NHCR (in specific Article 13.1) does not seem to encourage innovation in the EU food sector.

Exploring the Nutrition and Health Claims Regulation (EC) No. 1924/2006: What is the impact on innovation in the EU food sector?

Literature suggests that despite its positive aim of promoting innovation, the Nutrition and Health Claims Regulation (EC) No. 1924/2006 (NHCR) may bring along several compliance challenges, which might affect innovation in the EU food sector. This study investigates the challenges faced by companies to comply with the NHCR (specifically Article 13.1) and their impact on innovation. To this end, we conducted an online survey with 105 companies involved in the EU food sector. Results indicate that companies perceive wording of claims, missing transparency and limited financial resources as major challenges to comply with the NHCR (Article 13.1). Companies reported not to have increased their R&D expenditure or innovation activities after the NHCR (Article 13.1) was implemented. Thus, this study highlights specific compliance challenges related to the NHCR (Article 13.1) and indicates that currently, the regulation does not seem to have fostered innovation in the EU food sector.

Glycolipid biosurfactants: main properties and potential applications in agriculture and food industry.

Glycolipids, consisting of a carbohydrate moiety linked to fatty acids, are microbial surface active compounds produced by various microorganisms. They are characterized by high structural diversity and have the ability to decrease the surface and interfacial tension at the surface and interface, respectively. Rhamnolipids, trehalolipids, mannosylerythritol lipids and cellobiose lipids are among the most popular glycolipids. They have received much practical attention as biopesticides for controlling plant diseases and protecting stored products. As a result of their antifungal activity towards phytopathogenic fungi and larvicidal and mosquitocidal potencies, glycolipid biosurfactants permit the preservation of plants and plant crops from pest invasion. Also, as a result of their emulsifying and antibacterial activities, glycolipids have great potential as food additives and food preservatives. Furthermore, the valorization of food byproducts via the production of glycolipid biosurfactant has received much attention because it permits the bioconversion of byproducts on valuable compounds and decreases the cost of production. Generally, the use of glycolipids in many fields requires their retention from fermentation media. Accordingly, different strategies have been developed to extract and purify glycolipids. © 2016 Society of Chemical Industry.

Launching a new food product or dietary supplement in the United States: industrial, regulatory, and nutritional considerations.

Launching a new food/dietary supplement into the US market can be a confusing process to those unfamiliar with the food industry. Industry capability and product specifications are initial determinants of whether a candidate product can be manufactured in a reproducible manner and whether pilot production can be brought up to the market scale. Regulatory issues determine how a product can be produced and marketed; the primary federal institutions involved in regulations are the US Department of Agriculture, the Food and Drug Administration, and the Federal Trade Commission. A primary distinction is made between food and drugs, and no product may enter the food market if it is in part or whole a drug. Product safety is a major concern, and myriad regulations govern the determination of safety. New foods/dietary supplements are often marketed by health claims or structure/function claims, and there are specific regulations pertaining to claims. Not understanding the regulatory issues involved in developing a new product or failing to comply with associated regulations can have legal and financial repercussions.

Effect of the addition of chia's by-product on the composition of fatty acids in hamburgers through chemometric methods.

BACKGROUND: Hamburger is a meat-based food that is easy to prepare and is widely consumed. It can be enriched using different ingredients, such as chia's by-product, which is rich in omega-3. Chemometrics is a very interesting tool to assess the influence of ingredients in the composition of foods. A complete factorial design 2(2) (two factors in two levels) with duplicate was performed to investigate the influence of the factors (1) concentration of textured soy proteins (TSP) and (2) concentration of chia flour partially defatted (CFPD) as a partial replacement for the bovine meat and porcine fat mix in hamburgers. RESULTS: The results of proximal composition, lipid oxidation, fatty acids sums, ratios, and nutritional indexes were used to propose statistical models. The factors TSP and CFPD were significant, and the increased values contributed to improve the composition in fatty acids, crude protein, and ash. Principal components analysis distinguished the samples with a higher content of chia. In desirability analysis, the highest level of TSP and CFPD was described as the optimal region, and it was not necessary to make another experimental point. CONCLUSION: The addition of chia's by-product is an alternative to increase the α-linolenic contents and to obtain nutritionally balanced food.

Chemical composition and flavour characteristics of a liquid extract occurring as waste in crab (Ovalipes punctatus) processing.

BACKGROUND: The crab processing industry has generated a considerable quantity of by-products, and these untapped residues resulted in environmental problem and waste of natural resources. Therefore, the purpose of this research was to evaluate the further usage potential of Ovalipes punctatus extract. The proximate composition, minerals, fatty acids, amino acids, tasty components (free amino acid, flavour 5'-nucleotides, glycine betaine and inorganic ions) and volatile flavour components were studied. RESULTS: O. punctatus extract was found to have a high protein (31.2 g kg⁻¹), but a low fat content (0.13 g kg⁻¹). The protein contained high amounts of arginine (110.2 g kg⁻¹ protein) and glutamic acid (108.9 g kg⁻¹). The fatty acid profiles were dominated by saturated fatty acids, while C20 n-3 and n-6 fatty acids accounted for 85% of its polyunsaturated fatty acids. Arginine, alanine, glycine, glycine betaine, glutamic acid and chloridion (taste active value greater than 1) were primary taste-active components. A total of 77 volatiles were identified, and benzaldehyde and pyrazines were the major flavour contributors to the aroma of O. punctatus extract. Furthermore, sensory evaluation with a five-point hedonic scale showed that the overall flavour of O. punctatus extract had high acceptance. CONCLUSION: Results presented in this study indicated that O. punctatus extract could be utilised to produce nutritious food or value-added products.

The Contribution of Major Food Categories and Companies to Household Purchases of Added Sugar in Australia.

BACKGROUND: The Australian Government will soon be releasing a series of sugar reformulation targets for packaged foods. OBJECTIVE: To estimate the amount of added sugar purchased from packaged food and beverages and the relative contribution that food categories and food companies made to these purchases in 2018. The secondary objective was to examine differences in purchases of added sugar across income levels. DESIGN: Cross-sectional study. PARTICIPANTS/SETTING: We used 1 year of grocery purchase data from a nationally representative panel of Australian households (the NielsenIQ Homescan panel), combined with a packaged food and beverage database (FoodSwitch). MAIN OUTCOME MEASURES: Added sugar purchases (grams per day per capita), purchase-weighted added sugar content (grams per 100 g) and total weight of products (with added sugar) purchased (grams per day per capita). STATISTICAL ANALYSES PERFORMED: Food categories and food companies were ranked according to their contribution to added sugar purchases. Differences in added sugar purchases by income levels were assessed by 1-factor analysis of variance. RESULTS: Added sugar information was available from 7188 households and across 26,291 unique foods and beverages. On average, the amount of added sugar acquired from packaged foods and beverages was (mean ± SE) 35.9 ± 0.01 g/d per capita. Low-income households purchased 11.0 g/d (95% CI: 10.9-11.0 g/d, P < .001) more added sugar from packaged products than high-income households per capita. The top 10 food categories accounted for 82.2% of added sugar purchased, largely due to purchases of chocolate and sweets, soft drinks, and ice cream and edible ices. Out of 994 food companies, the top 10 companies contributed to 62.1% of added sugar purchases. CONCLUSIONS: The Australian Government can strengthen their proposed sugar reduction program by adding further category-specific targets, prioritizing engagement with key food companies and considering a broader range of policies to reduce added sugar intakes across the Australian population.

Effect of olive powder and high hydrostatic pressure on the inactivation of Bacillus cereus spores in a reference medium.

The aim of this work was to study the effect of olive powder combined with high hydrostatic pressure (HHP) on the inactivation of Bacillus cereus spores, to use it as an additional control hurdle in beverages pasteurised by this technology. With this purpose, reference medium prepared at different concentrations of olive powder was inoculated with B. cereus spores and subjected to different pressure treatments. The outgrowth capacity of the treated spores was then determined at 20°C and 32°C. The addition of olive powder was found to slightly reduce the effectiveness of HHP, although in post-treatment storage there was an increased bacteriostatic effect in the samples with 2.5% of olive powder at both temperatures in the samples pressurised at 400 and 500 MPa, and only at 20°C in the samples pressurised at 200 MPa. The addition of olive powder therefore had an additive effect with storage temperature and HHP processing and could act as an additional control hurdle during the shelf-life of products pasteurised by HHP technologies or in the case of cold-chain breakage.

Isolation of pectin-enriched products from red beet (Beta vulgaris L. var. conditiva) wastes: composition and functional properties.

The present work was dedicated to the development of an extraction process for red beet (Beta vulgaris L. var. conditiva) by-products that preserves the high molecular weight of the macromolecules with the primary aim of waste upgrading. Our study concerns the extraction of pectin-enriched products with potential thickening properties for their usage in food formulation, as well as with some healthy physiological effect, by using citrate buffer (pH = 5.2) either alone or with enzymes (hemicellulase or cellulase) active on cell wall polysaccharide networks. Considering that red beet tissue contains ferulic acid, which cross-links pectin macromolecules through arabinose residues to anchor them into the cell wall, an alkaline pretreatment was also evaluated in order to perform polysaccharide hydrolysis in the cell wall network to accomplish higher renderings. Chemical composition and yield, as well as the in vitro glucose retention exerted by the isolated fiber products were finally analyzed.

Extraction of bromelain from pineapple peels.

Large amount of pineapple peels (by-products) is left over after processing and they are a potential source for bromelain extraction. Distilled water (DI), DI containing cysteine and ethylenediaminetetraacetic acid (EDTA) (DI-CE), sodium phosphate buffer pH 7.0 (PB) and PB containing cysteine and EDTA (PB-CE) were used as extractants for bromelain from the pineapple peels. The highest bromelain activity was obtained when it was extracted with PB-CE (867 and 1032 units for Nang Lae and Phu Lae cultv, respectively). The PB could maintain the pH of the extract (pH 5.1-5.7) when compared with others. Under sodium dodecyl sulfate polyacrylamide gel electrophoresis, the extract showed protein bands in the range 24-28 kDa. The protein band with a molecular weight of ∼28 kDa exposed the clear zone on blue background under the casein-substrate gel electrophoresis. The effects of the bromelain extract on the protein patterns of beef, chicken and squid muscles were also determined. Trichloroacetic acid soluble peptide content of all the treated muscles increased when the amount of bromelain extract increased. Decrease in myosin heavy chains and actin was observed in all the muscle types when bromelain extract was used. The best extractant for bromelain from pineapple peels was PB-CE. Moreover, bromelain extract could be used as a muscle food tenderizing agent in food industries.

Distribution and patterns of use of food additives in foods and beverages available in Brazilian supermarkets.

The growing consumption of ultra-processed foods and beverages has drawn attention to the use of different food additives in these products. The use of these additives for different purposes in food products is permitted under specific legislation. The objective of the present study was to assess the distribution and patterns of occurrence of the different categories of food additives present in packaged foods and beverages sold in Brazil. A descriptive cross-sectional study was conducted based on data from lists of ingredients used in foods and beverages sold in supermarkets in Brazil, collected by photographing product labels. The number, technological purpose and proportion of food additives in 9856 items (25 groups) were assessed. Exploratory factor analysis was employed to derive the patterns of food additive categories. Linear regression models were used to assess the association between the patterns and food items analyzed. Only 20.6% of the products analyzed contained no food additives, while 24.8% contained ≥6 additives. The use of food additives was high, particularly cosmetic additives, predominantly flavoring agents, colorings and stabilizers. Five patterns of food additive categories were identified and associated with ultra-processed foods and beverages. The results revealed that food additives are highly prevalent in several types of food items sold in the Brazilian market. Also, the same additive category was common to several different food groups, as were specific food additive combinations. This exposure is potentially harmful to human health, given the known deleterious effects associated with the consumption of these substances.

Harmful Compounds and Willingness to Buy for Reduced-Additives Salami. An Outlook on Italian Consumers.

The consumption pattern of salami has been subjected to relatively widespread attention by academician, but few studies concerning the health implications of salami consumption have been published. Since additives and product origins represent important attributes for salami, the objective of this paper is twofold: (i) to explore the role of two additives, salt and nitrates, in addition to the Italian origin, in relation to consumer attitudes and preferences towards salami, (ii) to segment consumer behaviour by assessing their willingness-to-buy salami, in order to verify whether different purchasing patterns can be identified within the different social groups. The analysis was conducted on two different levels. The first was developed through a conjoint analysis, while the second implemented a frequency analysis based on a bivariate analysis. Results show the price as one of the most important variables in identifying the quality level of salami, in addition, certain socio-economic segments of consumers show a significant propensity to pay an additional price for salami with a low salt content and is nitrate-free.

Citrus medica: nutritional, phytochemical composition and health benefits - a review.

Citrus medica (Citron) is an underutilized fruit plant having various bioactive components in all parts of the plant. The major bioactive compounds present are iso-limonene, citral, limonene, phenolics, flavonones, vitamin C, pectin, linalool, decanal, and nonanal, accounting for several health benefits. Pectin and heteropolysachharides also play a major role as dietary fibers. The potential impact of citron and its bioactive components to prevent or reverse destructive deregulated processes responsible for certain diseases has attracted different researchers' attention. The fruit has numerous nutraceutical benefits, proven by pharmacological studies; for example, anti-catarrhal, capillary protector, anti-hypertensive, diuretic, antibacterial, antifungal, anthelmintic, antimicrobial, analgesic, strong antioxidant, anticancerous, antidiabetic, estrogenic, antiulcer, cardioprotective, and antihyperglycemic. The present review explores new insights into the benefits of citron in various body parts. Throughout the world, citron has been used in making carbonated drinks, alcoholic beverages, syrup, candied peels, jams, marmalade, cordials, and many other value added products, which suggests it is an appropriate raw material to develop healthy processed food. In the present review, the fruit taxonomical classification, beneficial phytochemicals, antioxidant activities, and health benefits are discussed.

Effects of different source additives and wilt conditions on the pH value, aerobic stability, and carbohydrate and protein fractions of alfalfa silage.

To improve the silage quality and reduce the silage additive cost, the present experiment was designed to evaluate the potential of applying the fermented juice of epiphytic lactic acid bacteria (FJLB) as an additive in alfalfa silage. The effects of FJLB on the fermentation quality, carbohydrate and protein fractions, and aerobic stability of alfalfa silage wilted under five different conditions were investigated and compared with commercial lactic acid bacteria (CLAB) and the control. The FJLB application decreased the pH value, the volatile fatty acids and non-protein nitrogen content, and the loss of sugar by 9.9%, 22.9%, 19.6% and 9.6%, respectively; it increased the lactic acid concentration by 29.5% and the aerobic stability by 17 h in comparison to the control. The FJLB application also decreased the pH value (4.44 vs. 4.66) and volatile fatty acid content (38.32 vs. 44.82) and increased the lactic acid concentration (68.99 vs. 63.29) in comparison to the CLAB-treated silage. However, the FJLB treatment had lower aerobic stability (254 h vs. 274 h) than the CLAB treatment. The FJLB application improved silage quality in comparison to the control; in addition, its effect as a fermentation stimulant may be comparable to or even better than CLAB.