Medical foods: Joint efforts are needed on low-protein cereal

The new review calls for the production of a greater variety of cereal-based bakery and snack products - including staples such as bread - that specially formulated to contain low, or no, protein.

Writing in the journal Food Research International​​, researchers from the National University of Ireland noted that while there are some low-protein cereal-based products currently available, and these fulfil their requirements from a medical perspective in that they are safe for consumption by people unable to process specific proteins and/or amino acids - many of these products are not well liked by consumers and could benefit from reformulation.

"The food technologist is facing a huge challenge regarding improvement of these products to increase the palatability, ameliorate the organoleptic characteristics, reduce the cost, and increase the selection of cereal foods available to these consumers,"​ said the research team - led by Professor Elke Arendt.

Arendt and her colleagues suggested that "it is certainly possible to produce a superior range of cereal-based goods with better nutritional, structural, and flavour profiles"​ - adding that production of acceptable low-protein baked goods could help to increase the current poor adherence levels of patients to these foods, particularly amongst the youth and elderly.

Low-protein demand​

The team noted that with current health care costs accounting for greater than 15% of the national expenditure, governments are seeking innovative cost-limiting strategies to aid the management of diseases.

"Medical nutrition therapy (MNT) has proven to be an efficient cost minimising tool whilst concurrently ameliorating the patient's quality of life,"​ the team explained. "These MNTs are defined as specially processed or formulated foods that are used for the dietary management of patients."​

Amongst these medical foods, low-protein and protein-free foods have been shown to improve the physical manifestation of metabolic disorders in patients with amino acid or protein-related diseases, such as Phenylketonuria, Tyrosinaemia type I, as well as chronic kidney, and coeliac, they explained.

Globally, the medical nutritional market is vast. In 2010, the infant medical nutritional market was worth €8.4 billion, the enteral market was worth €6.7 billion, and the parenteral market was worth €2.9 billion.

Cereal solution?​

The team noted that the majority of cereal-based low protein and protein free foods currently marketed are a blend of refined or chemically-based food ingredients "with unpalatable, frequently artificial flavours, having excessive sweetness to mask the chemical tasting ingredients."​

Arendt and her team suggested that this 'drug-like approach​' to the production of low-protein medical foods should be replaced with a 'food-like approach' - but noted that the adoption of this strategy in the production of foods with specific dietary requirements "is a surprisingly complex process."​

"In order to achieve the aim of producing low-protein cereal-based goods which can meet the medical, nutritional, and lifestyle needs of the MNT patient, a joint effort on the part of the food technologist and industry as a whole is essential,"​ they commented - noting that a multi-faceted approach that combines expertise in raw ingredient engineering, enzyme and fermentation technologies, hydrocolloid polymer tools, and flavour modulation chemistry can help to formulate MNT foods that are tastier and more acceptable to patients with medical conditions that mean they require specific diets.

By providing the consumer, particularly parents and carers of young and elderly patients, with convenient ready-to-eat foods, Arendt and her colleagues also suggested that medical professionals can increase patient adherence to these strict dietary regimes.

The Irish scientists also noted that many low-protein medical foods are higher in fat - which improves texture and aroma - than conventionally available foods, which may contribute to overweight and obesity in certain MNT patients who overeat due to social pressures.

"Conversely, older patients typically find it difficult to eat enough food to fulfil their daily nutritional requirements, and the unpalatability of the MNT foods on offer can be inhibitory, thus even leading to malnutrition and sarcopenia,"​ they said.

Source: Food Research International​​
Published online ahead of print, doi: 10.1016/j.foodres.2013.03.001​
"Technological challenges and strategies for developing low-protein/protein-free cereal foods for specific dietary management"​
Authors: Emanuele Zannini, Wilma Kingston, Elke K. Arendt, Deborah M. Waters