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This study explores beliefs about protein in dairy and plant-based (PB) alternatives among stakeholders in the US marketplace and whether beliefs are associated with product preferences. Eight thousand and fifty-two unique comments submitted to the US Food and Drug Administration (FDA) in response to a request for public input on the labelling of PB dairy alternatives (FDA-2018-N-3522) were coded. Of these, 383 (4.8%) discussed protein and were analysed for protein-specific themes. Themes were examined in relation to the submitter's product preference. Most comments that discussed protein focused on protein content and/or health outcomes believed to be associated with intake. Only one commenter who preferred dairy demonstrated an inaccurate understanding of protein content in dairy and PB alternatives, although nearly all failed to identify fortified soy beverage as an appropriate protein replacement; meanwhile, 14.2% who preferred PB alternatives demonstrated an inaccurate understanding regarding protein content in dairy and PB products. The results suggest knowledge gaps exist regarding protein in PB dairy alternatives, especially among those who prefer non-dairy options.
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Laticínios , Leite de SojaRESUMO
BACKGROUND: Healthcare professionals are important sources of nutrition and health information for Americans. As plant-based (PB) dairy alternative products increase in popularity, concerns have been raised about their nutritional adequacy, and whether consumers understand nutritional differences to dairy. Healthcare professionals directly advise consumers on dietary choices, therefore we sought to examine their understanding and opinions of PB dairy alternatives. METHODS: We analyzed comments submitted to the U.S. Food and Drug Administration (FDA) by health professionals (n = 191) in 2018-2019 in response to a request for public comment on the nutrition of PB dairy alternatives and the use of dairy terms like "milk", "cheese", and "yogurt" on their labels. Survey data from healthcare professionals (n = 417) was collected in 2020-2021. Comments and survey responses to open-ended questions were coded using template analysis and thematically analyzed. Logistic regression models examined perceptions across health professional characteristics for close-ended survey responses. RESULTS: Three-fourths of health professionals believe consumers are confused about the nutritional differences between dairy and PB dairy alternatives. Over half (53%) do not believe either product is nutritionally superior to the other. Many believe dairy products have higher nutrient value, but also believe PB dairy alternatives can be part of a healthful diet. Compared to other types of health professionals, dietetics professionals demonstrated a more accurate understanding of the nutritional value of both products and were more likely to believe nutrients like protein (OR 2.02; 95% CI 1.22-3.34, p = 0.006) and vitamin D (OR 2.46; 95% CI 1.48-4.09, p = 0.001) may be nutrients of concern for PB dairy alternative consumers. They were also more likely to believe consumers are confused about these products (OR 3.44; 95% CI 1.65-7.21; p = 0.001). Health professionals who submitted comments to the FDA showed stronger opinions in favor of PB dairy alternatives. CONCLUSIONS: Although PB dairy alternatives have nutritional value in certain diets, responses from health professionals suggest that changing their labeling to be different than dairy may reduce confusion. Improved nutrition education among health professionals may also be necessary.
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Objective: To examine the association between health professionals' personal dietary behaviors and their professional nutrition recommendations on dairy and plant-based dairy alternatives. Methods: A cross-sectional survey of 331 U.S. health professionals examined willingness to recommend dairy and/or plant-based dairy alternatives to patients across personal milk preference, and dietary pattern. Results: Plant-based milk preference (OR 4.52; p < 0.001) and following a vegetarian dietary pattern (OR 1.91; p = 0.019) were associated with greater odds of recommending plant-based dairy alternatives to patients. Plant-based milk preference (OR 0.16; p < 0.001), following a vegetarian dietary pattern (OR 0.45; p = 0.009), and considering one's diet to be "plant-based" (OR 0.41; p = 0.005) were associated with lessor odds of recommending dairy to patients. Dietetics professionals were more likely than all other health professionals to recommend both dairy and plant-based dairy alternatives to patients. Conclusion: Health professionals' nutrition recommendations may reflect their personal nutrition choices. Improved nutrition training, focusing on evidence-based recommendations, reducing personal bias in practice, and routinely including registered dietitians on interprofessional healthcare teams may improve the quality of nutrition advice given to U.S. consumers. Innovation: This paper is the first to examine if health professionals' personal health behaviors are associated with their health advice on dairy and/or plant-based dairy alternatives.
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Calcium is a nutrient of public health concern and commonly associated with dairy foods. In recent years, plant-based alternatives to dairy products have grown in popularity. This study examines public understanding of dietary calcium in dairy products and plant-based alternatives and explores whether knowledge is associated with product preference. In 2018, the U.S. Food and Drug Administration (FDA) solicited comments on the labeling of plant-based dairy alternatives (FDA-2018-N-3522), including input on consumer understanding of the nutritional content of dairy foods and plant-based products. All 11,906 submissions were obtained and 8,052 were retained after duplicate and near-duplicate comments were removed. Comments were coded for major nutrition themes and those that mentioned calcium and were analyzed for three calcium-specific themes: knowledge and beliefs about calcium content, calcium bioavailability, and health outcomes associated with intake. Submissions were examined in relation to each commenter's preference for dairy products or plant-based alternatives. 244 unique submissions (3.0%) mentioned calcium. Over half (51.2%) of commenters who mentioned calcium preferred plant-based alternatives. Comments mentioning calcium often reflected preference. Most commenters had an accurate understanding of calcium content in dairy and plant-based products. However, several commenters-especially those who preferred plant-based alternatives-misunderstood calcium metabolism and health outcomes related to calcium. Given declining consumption of fluid dairy milk-a key source of dietary calcium-and increasing consumption of plant-based alternatives, addressing gaps in nutrition knowledge and misunderstanding related to dairy and calcium intake is critical and has implications for nutrition education and policy.
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Copper/zinc superoxide dismutase 1 (SOD1) scavenges free radicals that may otherwise damage brain parenchyma. Impaired SOD1 activity drives Alzheimer's disease (AD) neuropathology in animal models and postmortem AD brains. Yet, it is unknown how cerebrospinal fluid (CSF) SOD1 is related in vivo to AD-relevant cognitive, neuroimaging, and CSF neurotoxic factors, and what potential mechanisms underlie these associations. We found that higher CSF SOD1 correlated with better global cognition scores, yet less gray matter (GM) and glucose metabolism in AD-sensitive parietal and frontal regions. Higher CSF SOD1 was also associated with more CSF total tau and phosphorylated tau-181, but not beta-amyloid 1-42. Through mediation analyses, higher total tau largely mitigated higher CSF SOD1 and better global cognition associations, and it fully accounted for less predicted regional GM but not glucose metabolism. Among participants who developed AD over 2 years or had AD at baseline, higher CSF SOD1 was initially related to more regional GM. This association became nonsignificant with full mediation via higher CSF total tau, through which higher CSF SOD1 predicted more total tau and in turn less GM. Our observations lead to the hypothesis that SOD1 antioxidation reflects tau but not amyloid accumulation, which may lead to pro-oxidant-based neurodegeneration and cognitive dysfunction. Antioxid. Redox Signal. 31, 572-578.
