Food Quality: Balancing Health and Disease
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Food Quality: Balancing Health and Disease, Volume Thirteen in the Handbook of Food Bioengineering series, provides essential information for researchers, scientists and students on the relationship between the quality of foods and disease at the biological level. It presents different technological approaches to detect food properties and their capabilities for balancing health and disease to deliver high-quality products to consumers. This volume explores the dynamic potential of how food bioengineering can improve traditional foods through modern methods to make a positive impact on human health and foster innovation.
- Provides information on how bioavailability of nutrients and food formulation can be used to prevent or improve disease
- Includes the most recent research methods of metabolomics and genomics to detect best outcomes
- Includes innovative applications for anti-aging effects and curative properties in foods
- Presents research examples on how both human gut microbiota and food components control the way certain organisms develop and react in different environmental conditions
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Food Quality - Alexandru Mihai Grumezescu
Food Quality: Balancing Health and Disease
Handbook of Food Bioengineering, Volume 13
Edited by
Alina Maria Holban
Alexandru Mihai Grumezescu
Table of Contents
Cover
Title page
Copyright
List of Contributors
Foreword
Series Preface
Preface for Volume 13: Food Quality: Balancing Health and Disease
Chapter 1: Improvement of the Functional and Healthy Properties of Meat Products
Abstract
1. Introduction
2. Improvement of Nutritional and Healthy Properties of Meat Products
3. Production of Functional Meat Products
4. Current Status on the Consumer Acceptance for Functional Meats
5. Future Trends
Chapter 2: Biogenic Amines as Food Quality Index and Chemical Risk for Human Consumption
Abstract
1. Introduction
2. Composition, Nature, and Function of Biogenic Amines
3. Biogenic Amines in Foods of Animal Origin
4. Risks to Human Health and Legislation
5. Biogenic Amines Analysis
6. Biogenic Amines as Quality Index
7. Conclusions
Acknowledgments
Chapter 3: Marine-Based Toxins and Their Health Risk
Abstract
1. Introduction
2. Seafood Poisoning
3. Other Marine Biotoxins
4. Health Risk
5. Treatments of Marine-Based Food Poisoning
6. Prevention Aspects of Marine Toxin for Humans
7. Conclusions
Abbreviations
Chapter 4: Olive Oil Antioxidants and Aging
Abstract
1. Introduction
2. Nutraceuticals and Olive Oil
3. Oleic Acid: A Monounsaturated Fatty Acid with Antiaging Effect
4. Olive Oil’s Minor Components and Antiaging Effects
5. Tocopherols
6. Conclusions
Chapter 5: Heavy Metal Levels in Fish, Molluscs, and Crustacea From Turkish Seas and Potential Risk of Human Health
Abstract
1. Background
2. Fate of Heavy Metals in Marine Ecosystems
3. Risk Assessment of Heavy Metals in Human
4. Importance of Seafood in Turkey
5. Investigation of the Public Health Hazard
6. Selection of Heavy Metals and Their Toxicity
7. Estimation of Dietary Exposure to Heavy Metals
8. Intake Levels Calculation
9. The Mediterranean Sea
10. Aegean Sea
11. Sea of Marmara
12. Black Sea
13. Heavy Metal Levels in Fish Species
14. Heavy Metals in Crustaceans
15. Heavy Metals in Mollusc
16. Health-Risk Assessment for Fish and Other Seafood Consumption
17. Conclusions
18. List of Elements Names and Their Symbols
19. List of Species’ Latin, English, and Turkish Names and Their New Names
Abbreviations
Chapter 6: Trace and Major Elements Content of Cereals and Proteinaceous Feeds in Greece Analyzed by Inductively Coupled Plasma Mass Spectrometry
Abstract
1. Introduction
2. Research Data and Methodology
3. Results
4. Analytical Methodology on Minerals or Isotopes, and Their Implications for Characterization of Products With Specific Identity
5. Mineral or Trace Element Content of Feedstuffs or Foods After Genetic Modifications of Plants
6. Conclusions
Chapter 7: The Bioavailability of Nutrients That Have a Health-Promoting Effect on Nervous System Function
Abstract
1. Introduction
2. Healthy Lifestyle
3. Bioavailability of Food Products—Physiological Aspect
4. Processes and Bioavailability
5. Conclusions
Chapter 8: Agroindustrial By-Products and Animal Products: A Great Alternative for Improving Food-Quality Characteristics and Preserving Human Health
Abstract
1. Oxidation Processes and Antioxidants
2. Utilization of Agroindustrial By-Products in Livestock Diets
3. Conclusions
Chapter 9: Development of a Functional Food Security for Parents for Transgenerational Epigenetic Health Promotion and Disease Prevention Among Offspring
Abstract
1. Introduction
2. Family History and Epigenetic Inheritance
3. Nutritional Factors in Transgenerational Epigenetic Inheritance
4. Effects of Micronutrient Supplementation in Parents on Offspring
5. Development of a Micronutrient-Added Functional Food
6. Effects of High-Fat Diets in Parents on Offspring
7. Development of Functional Food Package for Parents
8. Development of a Blend of Oils That is Rich in Protective Nutrients
9. Fruits, Vegetables, Nuts, and Whole Grains, Including Legumes andMillets
10. Healthy Eating Patterns
11. Conclusions
Acknowledgments
Chapter 10: Heated Oil and Its Effect on Health
Abstract
1. Introduction
2. Thermal Oxidation of Cooking Oil
3. Oxidative Stress and Cardiovascular Disease
4. Role of Inflammation in Cardiovascular Disease
5. Heated Oil and Its Effect on Cardiovascular Risk Factors
6. Heated Oil and the Liver
7. Heated Oil and the Kidneys
8. Heated Oil and Bone
9. Discussion
Acknowledgments
Chapter 11: Contribution of Infant Formula and Tea on Daily Fluoride Intake and Prevalence of Fluorosis Among Infants and Children
Abstract
1. Introduction
2. Daily Fluoride Intake of Infants
3. Tea Consumption and Fluoride Intake in Children
4. Collection and Analysis of Infant Formula and Tea for Fluoride
5. Assessment of Fluoride Intake Through Infant Formula and Tea
6. Epidemiological Survey and Assessment of Prevalence of Dental Fluorosis
7. Influence of Infant Formula and Tea on Daily Fluoride Intake
8. Prevalence of Fluorosis, Habit, and Frequency of Tea Drinking
9. Habit and Frequency of Tea Drinking by Children in Study Villages
10. Recommendations
Chapter 12: Preventive and Therapeutic Effects of Dietary Fibers Against Cardiovascular Diseases
Abstract
1. Introduction
2. Incidence of Cardiovascular Diseases
3. Diet and CVD
4. Dietary Fiber and Its Role on Health
5. Effect of Dietary Fiber on Major CVD Risk Factors
6. Dietary Fiber, Gastrointestinal Health, and CVD
7. Physiological and Molecular Mechanism in CVD
8. Conclusions
Chapter 13: The Role of High Salt Intake in the Development and Progression of Diverse Diseases
Abstract
1. Introduction
2. High Salt Diet and Hypertension
3. High Salt Diet and Cardiovascular Diseases
4. High Salt Diet and Chronic Kidney Disease
5. High Salt Diet and Diabetes
6. Two Faces of Salt Intake Reduction
7. Understanding the Need of and Ways to Limit Salt Overingestion
8. Conclusions
Chapter 14: Spices and Herbs as Therapeutic Foods
Abstract
1. Introduction
2. Therapeutic Potential of Herbs and Spices
3. The Nutraceutical Potential of Herbs and Spices
4. Spices as Functional Foods
Chapter 15: Vitamin D Deficiency in Children: Health Consequences and Prevention
Abstract
1. Introduction
2. History
3. Characteristics of Vitamin D
4. Prevention of Vitamin D Deficiency
5. Conclusions
Index
Copyright
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List of Contributors
Padma Ambalam, Department of Biotechnology, Christ College, Christ Campus, Vidya Niketan, Saurashtra University, Rajkot, Gujarat, India
Elif Arici, Sinop University, Sinop, Turkey
Levent Bat, Sinop University, Sinop, Turkey
María J. Beriain, Research Institute on Innovation and Sustainable Development in Food Chain (ISFOOD), Universidad Pública de Navarra, Pamplona, Spain
Eleftherios Bonos, Research Institute of Animal Science, Pella, Macedonia, Greece
Anil K. Chauhan, Center of Food Science and Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Efterpi Christaki, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
Carlos A. Conte-Junior, Department of Food Technology, Federal Fluminense University, Rio de Janeiro, Brazil
Marion P. Costa, Department of Preventive Veterinary Medicine and Animal Production, Federal University of Bahia, Ondina, Salvador, Brazil
Fabien De Meester, The Tsim Tsoum Institute, Krakow, Poland
Stelios G. Deligeorgis, Agricultural University of Athens, Athens, Greece
Irene Dini, Pharmacy Department, University of Naples Federico II
, Naples, Italy
Mukesh Doble, Bioengineering and Drug Design Lab, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
Anna Fabisiak, Warsaw School of Tourism and Hospitality Management, Vistula Group of Universities, Warsaw, Poland
Jan Fedacko, Pavol Jozef Safarik University, Kosice, Slovakia
Panagiota Florou-Paneri, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
Beatriz S. Frasao, Department of Food Technology, Federal Fluminense University, Rio de Janeiro, Brazil
Ilias Giannenas, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
Inmaculada Gómez, Research Institute on Innovation and Sustainable Development in Food Chain (ISFOOD), Universidad Pública de Navarra, Pamplona, Spain
Anna Gvozdjakova, Comenius University in Bratislava, Bratislava, Slovakia
Imen Hamed, Biotechnology Research and Application Centre, Cukurova University, Adana, Turkey
Krasimira Hristova, National Heart Hospital, Sofia, Bulgaria
Francisco C. Ibáñez, Research Institute on Innovation and Sustainable Development in Food Chain (ISFOOD), Universidad Pública de Navarra, Pamplona, Spain
Arunporn Itharat
Ubon Ratchathani University, Ubon Ratchathani
Department of Applied Thai Traditional Medicine, Faculty of Medicine, Thammasat University Center of Excellence in Applied Thai Traditional Medicine Research (CEATMR), Thammasat University, Bangkok, Thailand
Kamsiah Jaarin
UKM Medical Center, Universiti Kebangsaan Malaysia
Faculty of Medicine, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
Mariusz Jaworski
Warsaw School of Tourism and Hospitality Management, Vistula Group of Universities
Department of Teaching and Outcomes of Education, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
Indrani Kalkan, Istanbul Aydin University, Istanbul, Turkey
Yusof Kamisah, UKM Medical Center, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Elżbieta Kompanowska-Jezierska, Department of Renal and Body Fluid Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
Norliana Masbah, UKM Medical Center, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Sanjay Mishra, IFTM University, Moradabad, Uttar Pradesh, India
Pavlos Nisianakis, Centre of Biological Research for the Armed Forces, Penteli, Athens, Greece
Krzysztof H. Olszyński, Behavior and Metabolism Research Laboratory, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
Ekasit Onsaard, Ubon Ratchathani University, Ubon Ratchathani, Thailand
Ana I. Ordóñez, Research Institute on Innovation and Sustainable Development in Food Chain (ISFOOD), Universidad Pública de Navarra, Pamplona, Spain
Fatih Özogul, Department of Seafood Processing Technology, Faculty of Fisheries, Cukurova University, Adana, Turkey
Enzo Perri, CREA-OLI Research Centre for Olive Growing and Olive Oil Industry, Città Sant’Angelo, Pescara, Italy
Maya Raman, Bioengineering and Drug Design Lab, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
Bruna L. Rodrigues, Department of Food Technology, Federal Fluminense University, Rio de Janeiro, Brazil
Domenico Rongai, CREA-OLI Research Centre for Olive Growing and Olive Oil Industry, Città Sant’Angelo, Pescara, Italy
Nadia Sabatini, CREA-OLI Research Centre for Olive Growing and Olive Oil Industry, Città Sant’Angelo, Pescara, Italy
Ioannis Sarakatsianos, Third Military Veterinary Hospital, Thermi, Thessaloniki, Macedonia, Greece
M. Victoria Sarriés, Research Institute on Innovation and Sustainable Development in Food Chain (ISFOOD), Universidad Pública de Navarra, Pamplona, Spain
Panagiotis E. Simitzis, Agricultural University of Athens, Athens, Greece
Meenakshi Singh, Council of Scientific and Industrial Research, New Delhi, Delhi, India
Ram B. Singh, Halberg Hospital and Research Institute, Moradabad, Uttar Pradesh, India
Ravi P. Singh, Center of Food Science and Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Ayşe Sonay Türkmen, Karamanoğ lu Mehmetbey University, Karaman, Turkey
Toru Takahashi, Graduate School of Human Environmental Medicine, Fukuoka, Japan
Gopalan Viswanathan, Bannari Amman Institute of Technology, Sathyamangalam, Tamil Nadu, India
Douglas W. Wilson, Centre for Ageing and Dementia Research, Swanssea, Wales, United Kingdom
Foreword
In the last 50years an increasing number of modified and alternative foods have been developed using various tools of science, engineering, and biotechnology. The result is that today most of the available commercial food is somehow modified and improved, and made to look better, taste different, and be commercially attractive. These food products have entered in the domestic first and then the international markets, currently representing a great industry in most countries. Sometimes these products are considered as life-supporting alternatives, neither good nor bad, and sometimes they are just seen as luxury foods. In the context of a permanently growing population, changing climate, and strong anthropological influence, food resources became limited in large parts of the Earth. Obtaining a better and more resistant crop quickly and with improved nutritional value would represent the Holy Grail for the food industry. However, such a crop could pose negative effects on the environment and consumer health, as most of the current approaches involve the use of powerful and broad-spectrum pesticides, genetic engineered plants and animals, or bioelements with unknown and difficult-to-predict effects. Numerous questions have emerged with the introduction of engineered foods, many of them pertaining to their safe use for human consumption and ecosystems, long-term expectations, benefits, challenges associated with their use, and most important, their economic impact.
The progress made in the food industry by the development of applicative engineering and biotechnologies is impressive and many of the advances are oriented to solve the world food crisis in a constantly increasing population: from genetic engineering to improved preservatives and advanced materials for innovative food quality control and packaging. In the present era, innovative technologies and state-of-the-art research progress has allowed the development of a new and rapidly changing food industry, able to bottom-up all known and accepted facts in the traditional food management. The huge amount of available information, many times is difficult to validate, and the variety of approaches, which could seem overwhelming and lead to misunderstandings, is yet a valuable resource of manipulation for the population as a whole.
The series entitled Handbook of Food Bioengineering brings together a comprehensive collection of volumes to reveal the most current progress and perspectives in the field of food engineering. The editors have selected the most interesting and intriguing topics, and have dissected them in 20 thematic volumes, allowing readers to find the description of basic processes and also the up-to-date innovations in the field. Although the series is mainly dedicated to the engineering, research, and biotechnological sectors, a wide audience could benefit from this impressive and updated information on the food industry. This is because of the overall style of the book, outstanding authors of the chapters, numerous illustrations, images, and well-structured chapters, which are easy to understand. Nonetheless, the most novel approaches and technologies could be of a great relevance for researchers and engineers working in the field of bioengineering.
Current approaches, regulations, safety issues, and the perspective of innovative applications are highlighted and thoroughly dissected in this series. This work comes as a useful tool to understand where we are and where we are heading to in the food industry, while being amazed by the great variety of approaches and innovations, which constantly changes the idea of the food of the future.
Anton Ficai PhD (Eng)
Department Science and Engineering of Oxide Materials and Nanomaterials,
Faculty of Applied Chemistry and Materials Science, Politehnica University of Bucharest,
Bucharest, Romania
Series Preface
The food sector represents one of the most important industries in terms of extent, investment, and diversity. In a permanently changing society, dietary needs and preferences are widely variable. Along with offering a great technological support for innovative and appreciated products, the current food industry should also cover the basic needs of an ever-increasing population. In this context, engineering, research, and technology have been combined to offer sustainable solutions in the food industry for a healthy and satisfied population.
Massive progress is constantly being made in this dynamic field, but most of the recent information remains poorly revealed to the large population. This series emerged out of our need, and that of many others, to bring together the most relevant and innovative available approaches in the intriguing field of food bioengineering. In this work we present relevant aspects in a pertinent and easy-to-understand sequence, beginning with the basic aspects of food production and concluding with the most novel technologies and approaches for processing, preservation, and packaging. Hot topics, such as genetically modified foods, food additives, and foodborne diseases, are thoroughly dissected in dedicated volumes, which reveal the newest trends, current products, and applicable regulations.
While health and well-being are key drivers of the food industry, market forces strive for innovation throughout the complete food chain, including raw material/ingredient sourcing, food processing, quality control of finished products, and packaging. Scientists and industry stakeholders have already identified potential uses of new and highly investigated concepts, such as nanotechnology, in virtually every segment of the food industry, from agriculture (i.e., pesticide production and processing, fertilizer or vaccine delivery, animal and plant pathogen detection, and targeted genetic engineering) to food production and processing (i.e., encapsulation of flavor or odor enhancers, food textural or quality improvement, and new gelation- or viscosity-enhancing agents), food packaging (i.e., pathogen, physicochemical, and mechanical agents sensors; anticounterfeiting devices; UV protection; and the design of stronger, more impermeable polymer films), and nutrient supplements (i.e., nutraceuticals, higher stability and bioavailability of food bioactives, etc.).
The series entitled Handbook of Food Bioengineering comprises 20 thematic volumes; each volume presenting focused information on a particular topic discussed in 15 chapters each. The volumes and approached topics of this multivolume series are:
Volume 1: Food Biosynthesis
Volume 2: Food Bioconversion
Volume 3: Soft Chemistry and Food Fermentation
Volume 4: Ingredients Extraction by Physicochemical Methods in Food
Volume 5: Microbial Production of Food Ingredients and Additives
Volume 6: Genetically Engineered Foods
Volume 7: Natural and Artificial Flavoring Agents and Food Dyes
Volume 8: Therapeutic Foods
Volume 9: Food Packaging and Preservation
Volume 10: Microbial Contamination and Food Degradation
Volume 11: Diet, Microbiome and Health
Volume 12: Impact of Nanoscience in the Food Industry
Volume 13: Food Quality: Balancing Health and Disease
Volume 14: Advances in Biotechnology for Food Industry
Volume 15: Foodborne Diseases
Volume 16: Food Control and Biosecurity
Volume 17: Alternative and Replacement Foods
Volume 18: Food Processing for Increased Quality and Consumption
Volume 19: Role of Materials Science in Food Bioengineering
Volume 20: Biopolymers for Food Design
The series begins with a volume on Food Biosynthesis, which reveals the concept of food production through biological processes and also the main bioelements that could be involved in food production and processing. The second volume, Food Bioconversion, highlights aspects related to food modification in a biological manner. A key aspect of this volume is represented by waste bioconversion as a supportive approach in the current waste crisis and massive pollution of the planet Earth. In the third volume, Soft Chemistry and Food Fermentation, we aim to discuss several aspects regarding not only to the varieties and impacts of fermentative processes, but also the range of chemical processes that mimic some biological processes in the context of the current and future biofood industry. Volume 4, Ingredients Extraction by Physicochemical Methods in Food, brings the readers into the world of ingredients and the methods that can be applied for their extraction and purification. Both traditional and most of the modern techniques can be found in dedicated chapters of this volume. On the other hand, in volume 5, Microbial Production of Food Ingredients and Additives, biological methods of ingredient production, emphasizing microbial processes, are revealed and discussed. In volume 6, Genetically Engineered Foods, the delicate subject of genetically engineered plants and animals to develop modified foods is thoroughly dissected. Further, in volume 7, Natural and Artificial Flavoring Agents and Food Dyes, another hot topic in food industry—flavoring and dyes—is scientifically commented and valuable examples of natural and artificial compounds are generously offered. Volume 8, Therapeutic Foods, reveals the most utilized and investigated foods with therapeutic values. Moreover, basic and future approaches for traditional and alternative medicine, utilizing medicinal foods, are presented here. In volume 9, Food Packaging and Preservation, the most recent, innovative, and interesting technologies and advances in food packaging, novel preservatives, and preservation methods are presented. On the other hand, important aspects in the field of Microbial Contamination and Food Degradation are shown in volume 10. Highly debated topics in modern society: Diet, Microbiome and Health are significantly discussed in volume 11. Volume 12 highlights the Impact of Nanoscience in the Food Industry, presenting the most recent advances in the field of applicative nanotechnology with great impacts on the food industry. Additionally, volume 13 entitled Food Quality: Balancing Health and Disease reveals the current knowledge and concerns regarding the influence of food quality on the overall health of population and potential food-related diseases. In volume 14, Advances in Biotechnology for Food Industry, up-to-date information regarding the progress of biotechnology in the construction of the future food industry is revealed. Improved technologies, new concepts, and perspectives are highlighted in this work. The topic of Foodborne Diseases is also well documented within this series in volume 15. Moreover, Food Control and Biosecurity aspects, as well as current regulations and food safety concerns are discussed in the volume 16. In volume 17, Alternative and Replacement Foods, another broad-interest concept is reviewed. The use and research of traditional food alternatives currently gain increasing terrain and this quick emerging trend has a significant impact on the food industry. Another related hot topic, Food Processing for Increased Quality and Consumption, is considered in volume 18. The final two volumes rely on the massive progress made in material science and the great applicative impacts of this progress on the food industry. Volume 19, Role of Materials Science in Food Bioengineering, offers a perspective and a scientific introduction in the science of engineered materials, with important applications in food research and technology. Finally, in volume 20, Biopolymers for Food Design, we discuss the advantages and challenges related to the development of improved and smart biopolymers for the food industry.
All 20 volumes of this comprehensive collection were carefully composed not only to offer basic knowledge for facilitating understanding of nonspecialist readers, but also to offer valuable information regarding the newest trends and advances in food engineering, which is useful for researchers and specialized readers. Each volume could be treated individually as a useful source of knowledge for a particular topic in the extensive field of food engineering or as a dedicated and explicit part of the whole series.
This series is primarily dedicated to scientists, academicians, engineers, industrial representatives, innovative technology representatives, medical doctors, and also to any nonspecialist reader willing to learn about the recent innovations and future perspectives in the dynamic field of food bioengineering.
Alina M. Holban
University of Bucharest, Bucharest, Romania
Alexandru M. Grumezescu
Politehnica University of Bucharest, Bucharest, Romania
Preface for Volume 13: Food Quality: Balancing Health and Disease
Food intake represents one of the major factors to control our well-being and health. Depending on the quality and quantity of ingested foods, the health condition can be changed. This aspect may impact on the development of various diseases or to control the progression and prognostic of other health conditions. In our era, a great attention is given to the dietary input in all age groups (children, adults, and elders), as their nutritional requests have been proved to be slightly different. In recent years, industrial companies have made impressive progress in developing faster production methods; better processing technologies; and more sensitive detection techniques for food quality. This progress could be quantified by the currently imposed standards in food production and processing. This led to the development of personalized formulations to fulfill nutritional requirements of a particular group of individuals, in terms of age or clinical condition. These food formulations have brought important advantages in life quality of many individuals and have the potential to balance health and disease. Despite the huge technological progress and the obtained benefits for particular categories of individuals, the current trend in food industry seems to reduce the naturalness in processed foods and to reduce the availability of traditional products. Nowadays, traditional and small producers fight to maintain authentic foods on a highly industrialized market.
In this context, the purpose of this book was to reveal new achievements in food industry to control and increase food quality, while promoting a positive impact on human health. Also, health-related risks, which may be associated with the consumption of various natural or processed foods, are discussed here.
The volume contains 15 chapters prepared by outstanding authors from Turkey, Italy, Poland, India, Malaysia, United Kingdom, Bulgaria, Japan, Slovakia, Thailand, Greece, Brazil, and Spain.
In Chapter1, Improvement of the Functional and Healthy Properties of Meat Products, Beriain etal. provide an updated and critical review regarding the impact of meat quality (beef, pig, foal, and lamb) on consumers health.
Chapter2, Biogenic Amines as Food Quality Index and Chemical Risk for Human Consumption, prepared by Costa etal., discusses about the biological properties of biogenic amines (BAs), which could be found in foods. The BAs analyses are very important as they are considered indicators of food quality and safety, being applied as quality index for meat, fish, and dairy products.
Chapter3, Marine-Based Toxins and Their Health Risk, prepared by Özogul and Hamed, describes main marine toxins and their health effects upon ingestion. Also, the molecular and biochemical roles and modulated pathways within host cells and organs are dissected.
Chapter4, Olive Oil Antioxidants and Aging, prepared by Sabatini etal., gives an overview of most recent studies together with molecular mechanisms concerning the antiaging, antioxidant, and nutraceutical properties of virgin olive oil and each of its major and minor compounds.
Chapter5, entitled Heavy Metal Levels in Fish, Molluscs, and Crustacea From Turkish Seas and Potential Risk of Human Health, prepared by Bat and Arici, discusses about current regulations and procedures to control pollutants levels and heavy metals in edible sea organisms in countries with a great fish and seafood industry, such as Turkey. Authors are also highlighting major pollution sources and health effects of such pollutants.
Chapter6, Trace and Major Elements Content of Cereals and Proteinaceous Feeds in Greece Analyzed by Inductively Coupled Plasma Mass Spectrometry, prepared by Giannenas etal., dissects the impact of multivariate analysis of trace or major elements to be applied as a useful tool for feed differentiation, focusing on the characterization of feed, or food products certified as protected designation of origin or protected geographical indication.
Chapter7, The Bioavailability of Nutrients That Have a Health-Promoting Effect on Nervous System Function, prepared by Jaworski and Fabisiak, highlights the impact of the current lifestyle, stress, and improper diet that may affect the quality of life on one hand, and psychological functioning on other hand. The chapter summarizes current research findings on relationship between nutrition and neurological functioning in the context of changing their bioavailability during technological processes.
In Chapter8, Agroindustrial By-Products and Animal Products: A Great Alternative for Improving Food-Quality Characteristics and Preserving Human Health, Simitzis and Deligeorgis empathize on uncovering the causes associated with the etiology of several diseases affecting human health, while utilizing enriched foods. Enrichment of foods with bioactive compounds, such as polyunsaturated fatty acids (PUFAs), conjugated linoleic acid (CLA), or antioxidant agents (vitamins, polyphenols, flavonoids, etc.) appear to improve quality characteristics and protect consumer health against oxidation effects, while other by-products may trigger hazardous effects.
Chapter9, Development of a Functional Food Security for Parents for Transgenerational Epigenetic Health Promotion and Disease Prevention Among Offspring, prepared by Chauhan etal., discusses about noncommunicable diseases (NCDs), which have become a worldwide problem due to food security and lack of physical activity. The rapid increase may be due to interaction of genes/memes and environment, having adverse effects on the epigenome. Recent researches indicate Mediterranean-style foods and multiple micronutrients, being inversely associated with risk of NCDs; cardiovascular diseases (CVDs), type 2 diabetes, and obesity in adult life.
Chapter10, Heated Oil and Its Effect on Health, prepared by Jaarin etal., describes the detrimental effects of repeatedly heated oil on human health. Heating produces harmful products of lipid peroxidation, which have been proved to be responsible for the pathogenesis of many diseases, such as cardiovascular disease and cancer.
In Chapter11, Contribution of Infant Formula and Tea on Daily Fluoride Intake and Prevalence of Fluorosis Among Infants and Children, Viswanathan talks about the chronic intake of fluoride rich water and food and early risk of fluorosis, and dissect the potential contribution of infant formula and tea on daily fluoride intake for finding ways to reduce and optimize the daily fluoride intake. Excess fluoride intake can cause adverse effects on the developing brain; thereby reduction in intelligence of children and affects the thyroid gland and kidney functions.
In Chapter12, Preventive and Therapeutic Effects of Dietary Fibers Against Cardiovascular Diseases, Raman etal. emphasize on the therapeutic role of dietary fibers and major components in the prevention of cardiovascular and other relevant diseases. Importance is given to in-vitro, in-vivo, and clinical studies to bring forth the significance of dietary fibers as a nutraceutical food.
Chapter13, The Role of High Salt Intake in the Development and Progression of Diverse Diseases, prepared by Kompanowska-Jezierska and Olszyński, discusses about how the course and outcome of multiple diseases is worsened by high salt intake, often but not always via elevation of arterial blood pressure. Recent findings indicate an urgent need for reduction of worldwide salt consumption, agreeing upon the idea that this would substantially reduce mortality in cardiovascular diseases and also help alleviate progression of many other diseases, such as heart failure, chronic kidney disease, and diabetes.
Chapter14, Spices and Herbs as Therapeutic Foods, written by Dini, discusses how spices and herbs may be used for the prevention of various deficiencies and against diseases. Some herbs and spices may be classed as a functional food, with a range of health benefits beyond basic nutrition, such as reduction of the risks of heart diseases, diabetes, obesity, cancer, and Alzheimer.
In Chapter15, Vitamin D Deficiency in Children: Health Consequences and Prevention, Türkmen and Kalkan review the most common health issues associated with vitamin D deficiency in children, health consequences, and prevention.
Alina M. Holban
University of Bucharest, Bucharest, Romania
Alexandru M. Grumezescu
Politehnica University of Bucharest, Bucharest, Romania
Chapter 1
Improvement of the Functional and Healthy Properties of Meat Products
María J. Beriain
Inmaculada Gómez
Francisco C. Ibáñez
M. Victoria Sarriés
Ana I. Ordóñez Research Institute on Innovation and Sustainable Development in Food Chain (ISFOOD), Universidad Pública de Navarra, Pamplona, Spain
Abstract
Over the last decade, the consumer demands meat and meat products with enhanced composition. Reductions in contents of fat, cholesterol, salt and nitrite, as well as improvement in fatty acid profile and incorporation of bioactive compounds are increasing worldwide. The food industry basically has two strategies to provide meat products adapted to such demand, on the one hand, production of raw material with healthy ingredients, and on the other, reformulation of the finished products. For the first option, modification of diet and supplementation would be an effective approach to enhance animal breeding, carcass yield, and meat quality. For the second option, novel processing methods are based in redefinition of meat products replacing animal fat with vegetable and fish oils and adding ingredients as dietary fibers, vitamins, minerals, and others. The latter ones included polyphenols, natural antioxidants that, in addition to its functional properties, have biological activities to provide beneficial effects for the human health. However, changes in formulation have had an impact on the quality and palatability of the new meat products that should be taken into consideration. Elaboration of cooked meat products with selected nutrients and ingredients (polyunsaturated fatty acids, soluble fiber, polyphenols, etc.) would have a positive impact on consumers’ health and likely affect product choice by the consumer. Moreover, the introduction of the modified meat product improves the nutritional status of the subjects with special needs and equalizes their population characteristics and leads to health benefits for the elderly population. This chapter provides an updated and critical review based in the experience of authors on meat products (beef, pig, foal, and lamb) and consumers.
Keywords
meat
functional property
healthy property
bioactive compound
consumer
acceptability
1. Introduction
Meat is referred to as edible parts of the terrestrial animals, including muscle and byproducts as viscera and blood. Marine mammals also are included as meat in some cultures inhabitants next to the seas. In any case, it is required that food products be considered suitable and safe for human consumption (FAO, 2005). Meat products are products resulting from the processing of muscle and fat as main ingredients. Along with the main ingredients, a wide range of nonmeat substances is used to obtain processed meat products. Some of them are necessary (salt and seasonings) and others are specific for products. The type of technological treatment (grounding, drying, heating, curing, or fermenting) provided a variety of semiprocessed or processed meat products.
In anthropological terms, the human diet has varied among time periods. It can be assumed that the pattern of meat consumption during humankind history evolved in four periods: the first period could be characterized as a scavenger and opportunist hunter; the second one, as a systematic hunter; the third one, humans started to domesticate animals for local consumption; during the fourth and last period men exploited intensively livestock farming. Overall, this dietary change resulted in a reduced consumption of meat and increased domesticated grains. Concomitantly, a lifestyle based in progressive sedentary lifestyle and overfeeding is accompanied by an increase in civilization diseases
(Larsen, 2003).
The register of animal species for human consumption is relatively large, both wild and domesticated species. Beef, buffalo, horses, pigs, poultry, sheep, goats, ostriches, and game animals are eaten as meat. The majority of meat production worldwide in 2013 was porcine (112.7 · 10⁶ tonnes), chicken (95.5 · 10⁶ tonnes), bovine (63.7 · 10⁶ tonnes), ovine (8.6 · 10⁶ tonnes), turkey (5.5 · 10⁶ tonnes), caprine (5.4 · 10⁶ tonnes), and equine (0.8 · 10⁶ tonnes). Asia, Europe, and Northern America basically are large meat producers. By contrast, Africa, Central America, and Oceania have the lowest production (Table 1.1). In this chapter domestic animals are only considered as meat source.
Table 1.1
Data are expressed as tonnes of meat (FAO, 2015).
1.1. Current Pattern in Meat Consumption
After a subsistence economy stage, the dietary transition is characterized by quantitative growth in consumption of plant foods. Then a nutritional transition came and it was characterized by a radical change in dietary pattern. The greater the incomes, the higher intake of animal based foods. Indeed, over the last 50 years, meat consumption rose worldwide from 23.1 kg per person per year in 1961 to 42.20 kg per person per year in 2011 (Sans and Combris, 2015). That is, the increase in revenues is accompanied by an increase in meat protein consumption. Meanwhile, Mathijs (2015) evaluated the relationship between meat intake and incomes worldwide, showing no clear relation between both. However, it was revealed the existence of a set of high-income countries in which meat consumption is relatively low. More detail reveals that in some cases the relationship between income and meat consumption is not as expected by nutrition transition theory. For example, high-meat consumption (>10% of energy intake) is observed in low-income countries (Uganda, Guinea, or Tanzania). Conversely, some high-income countries (Germany, Japan, or Belgium) have low-meat intake. So, the consumption of meat is a two-sided story: in developing countries, consuming meat means positive effects for health, while in developed countries consuming too much meat has negative health impacts.
Meat consumption also has been influenced by the crises linked to food safety. The crisis series started with the so-called mad-cow crisis (bovine spongiform encephalopathy disease, BSE) in 1986 in the United Kingdom. The incident spread in later years to Belgium (1993), Netherlands (1997), Denmark (2000), France (2000), Germany (2000), Portugal, Switzerland, Spain (2000), Italy (2001), and Canada (2003). BSE was related to Creutzfeldt–Jakob disease, so consumers developed a fear of beef and meat consumption dropped drastically. In 1999 a stock of animal feed was contaminated accidentally with dioxin in Belgium. The result was the contamination of poultry and pig farms. It was known as the Belgian dioxin crisis. The chicken and pork consumption decreased more than 50%. Other crises that have affected meat consumption are the avian influenza originated in 1997 in Asia and the Irish pork crisis of 2008 by dioxin contamination. As a result consumers became concerned about certain food substances and they started to fear of certain foods (Bánáti, 2011). For all the aforementioned, meat consumption is influenced both by health and safety factors.
1.2. Meat and Nutritional Value
According to the process treatment, meat products can be classified into fresh meat and processed meats. To obtain fresh meat from muscle, previously a tenderization process in carcass from some species is required. Chemical composition of fresh meat can vary substantially, depending on factors, such as species, race, age, feeding management, and retail cuts. Water is the major component (>60% of raw weight) and carbohydrates as glycogen are reduced (except in liver). The protein content ranged from 17% to 22% (Table 1.2). It is also important to note that meat proteins have been distinguished by their essential amino acids content and their high digestibility. The digestibility is also determined by collagen content, about 5% of protein (Barron-Hoyos et al., 2013).
Table 1.2
Data are expressed on raw product (United States Department of Agriculture, 2015).
Fat content differs significantly not only between species, but also from individuals of the same species (Table 1.1). It depends also on the anatomical site. The loin is the leanest portion in both beef and pork while the breast is generally the leanest part in poultry meat. When the fat content is less than 10% it is considered lean meat or low-fat meat. Age and sex are the major factors that change profile of FAs of beef meat. Generally, C18:0 (stearic acid) is higher in bulls and steers than heifers and cows. A relevant data with regard to this FA is that no significant effects have been detected for C18:0 on biomarkers of cardiovascular risk (Hammad et al., 2016). Several studies have shown that the FA profile of meat can be significantly influenced by feed. Significant differences were found between pasture and grain-fed animal’s FA composition with higher polyunsaturated FA concentrations in pasture fed groups (Venkata Reddy et al., 2015). Contrary to popular assumption, saturated fatty acids (SFA) are not predominant in pork meats. The most abundant FAs in pork are C18:1 (oleic acid), C16:0 (palmitic acid), and C18:2n−6 (linoleic acid, LA) (Ros-Freixedes and Estany, 2014). In Mediterranean lamb SFA reaches 47.5% of total proportion. However, C18:1 is the most abundant, followed by C16:0 and C18:0 (Kaić et al., 2016).
It is also possible to find trans FAs in meat that are derived mainly from bacterial isomerization of polyunsaturated fatty acids (PUFA) in the rumen. They consist of a mixture of FAs that are known as conjugated linoleic acid (CLA). CLA is a group of isomers with double bonds in configurations trans (t) and cis (c). A wide spectrum of isomers with variations in positions and geometry exists, but the most common are t7,c9; t8,c10; c9,t11; t10,c12; and c11,t13. In meat about 80% of the CLA is the c9,t11 isomer (rumenic acid, RA). The highest CLA concentrations were found in lamb (4.3–19.0 mg/g lipid), beef (1.2–10.0 mg/g lipid) and turkey (2–2.5 mg/g lipid). The CLA content of pork, chicken, and horses is usually lower than 1 mg/g lipid (Schmid et al., 2006).
Meat color is linked to the content of myoglobin, a hemoprotein that provides typical reddish color. Generally, beef, lamb, and horse have more myoglobin in their muscles (8–10 mg/g tissue) than pork, turkey, and chicken (0.5–4 mg/g tissue) (Keeton and Eddy, 2004; Miller, 2002). The first ones are classified as red meats and the second ones as white meats. On the other hand, heme-iron in beef, horse, and lamb ranged from 72% to 87% of total iron. Pork has about 62% of total iron, while chicken and turkey has less than 40% (Lombardi-Boccia et al., 2002). Keep in mind that absorption of heme-iron is estimated at 15%–35% of intake (Hurrell and Egli, 2010). In by-products, liver is a good source for iron (Table 1.3).
Other mineral element content in meats is zinc. Together nuts, legumes, and whole-grain items, provide more than 1 mg of zinc per 100 g of edible serving (Solomons, 2001).
Livers from ruminant animals contain the largest amounts of vitamin B12, and red meat is another excellent source (Table 1.3). For raw meat the higher vitamin B12 concentrations are for beef and lamb (0.7–5.2 mg/100 g) and the lower for pork, goat, chicken, and turkey (0.4–3.0 mg/100 g) (Gille and Schmid, 2015).
Unlike vegetal products, animal products contain both carotenoids as retinoids, while the former are provitamins, the latter are vitamin A. Both compounds are stored in adipose tissues, but mainly in liver (Table 1.3).
Table 1.3
Data are expressed on raw product (United States Department of Agriculture, 2015).
Regarding vitamin D, meat content (up to 10 μg/kg) is lower than fish content (up to 477 μg/kg). Variations between species and meat cuts are seen (Schmid and Walther, 2013).
It must also be borne in mind that meat, with the exception of chicken thigh (1.2 mg α-tocopherol/100 g), is not an important supplier of vitamin E, not even from animals fed a vitamin E enriched diet (Leonhardt et al., 1997).
It is important to consider the influence of cooking techniques on micronutrient contents considering that humans rarely eat raw meat. Some studies have shown that cooking in general produces significant losses of B1 vitamin. Thiamin is more sensitive to heat. Higher losses of thiamin occurred during roasting, braising, and deep-frying (50%–70%), while boiling and microwave cooking resulted in lower losses (<40%). Meanwhile, niacin is the most stable water-soluble vitamin (Lešková et al., 2006). Regarding the iron, an effect of cooking methods or doneness level on the heme-iron content of meat was not observed (Cross et al., 2012).
1.3. Meat and Chronic Diseases
When the linkage between food and health is researched, it is compulsory to ensure that the data are scientifically valid. For that purpose, several types of experimental methods exist. Basically, two types of studies are relevant in the area of health sciences: experimental and observational studies. While experimental studies are used to establish cause–effect relationships, observational studies are useful to identify associations. Experimental studies can be performed in vitro or in vivo (animal or human trials). Randomized controlled trials provide the strongest evidence due to the fact that they remove the bias. Observational studies can be divided in descriptive studies (time-series studies) and analytical studies (cohort, cross-sectional, and case-control studies). Both experimental and observational studies are primary sources of scientific evidences. Secondary sources are the systematic reviews and metaanalysis. Systematic reviews—based on experimental data, as well as observational studies—provide a summary of scientific studies on a specific question. Metaanalyses assess the statistical results of these combined studies (Sargeant et al., 2014). According to the scientific weight of evidences, the study methods are ranked from low to high quality (Fig. 1.1).
Figure 1.1 Types and Hierarchy of Studies in Health Sciences and Their Evidence Quality.
Although meat is a more nutrient-dense food than most plant foods, there is concern raised by many studies that intake of red and/or processed meat intake is associated with chronic diseases, such as obesity, type 2 diabetes (DM2), cardiovascular disease (CVD), and a variety of cancers. As a result of such studies, many health agencies have recommended restriction of red and/or processed meat intake (Klurfeld, 2015). The following sections describe and analyze these links.
The first metaanalysis to probe the association between meat intake and incidence of DM2 was published in 2009 (Aune et al., 2009). The mechanisms by which intake of red meat increases the risk of DM2 still remain speculative. Putative factors are enhanced intracellular lipid storage, elevated body iron stores or increased biomarkers of inflammation (Barnard et al., 2014). Observational studies have shown that processed red meat is associated with higher fasting glucose for each additional 50 g serving (Fretts et al., 2015). Instead, the contribution of unprocessed meat to DM2 remains inconclusive (Kouvari et al., 2016). These findings should be interpreted with caution, because few studies take into account the lifestyle (as sedentary behaviors) or previous conditions (as overweight before being included in the study).
Observational studies have shown a higher incidence of CVD mortality in Western countries as meat intake increases (Snowdon, 1988; Thelle, 1985). An increase of 50 g/d in meat products intake was found to be positively associated to CVD mortality, while an increment of 100 g/d in red meat consumption was found to be positively associated to CVD mortality. These findings indicate that processed meat consumption could increase the risk of mortality from CVD, while red meat consumption is positively but weakly associated with CVD mortality. These results should be interpreted with caution due to the high heterogeneity observed in most of the studies (Abete et al., 2014).
Associations between specific red meat subtypes and risk of colorectal cancer (CRC) have been investigated in a number of observational studies from past century (Reddy et al., 1977). A systematic review of prospective studies concludes that beef and lamb consumption was associated to an increased risk of CRC. No association was observed for pork or poultry (Carr et al., 2016). The mechanistic evidence suggests that meat processing, such as curing and smoking, can result in formation of carcinogenic chemicals, including N-nitroso-compounds and polycyclic aromatic hydrocarbons (Bouvard et al., 2015). Also, heme-iron has been involved as a risk factor for colon cancers mainly due to its prooxidant activity, which can lead to oxidative damage on DNA (Fonseca-Nunes et al., 2014).
The information of the effects of the amount and source of dietary protein on health remains a main issue. Studies on the relation of dietary protein and mortality are inconclusive. In this context, Song et al. (2016) performed a metaanalysis using data from two cohort studies to prospectively examine animal protein versus plant protein in relation to the risk for all-cause and cause-specific mortality. Sources of animal protein included processed and unprocessed red meat, poultry, dairy products, fish, and egg. Deaths due to CVD, cancer, and other causes we assessed. Risk factors, such as low-physical activity, smoking, obesity, hypertension, and heavy alcohol intake were considered. After adjusting for risk factors, animal protein intake was weakly associated with higher mortality, particularly cardiovascular mortality, whereas plant protein was associated with lower mortality. These associations were confined to participants with at least one unhealthy risk factor. The authors concluded that high-animal protein intake (>18% of total energy) was positively associated with mortality and high-plant protein intake (>6% of total energy) was inversely associated with mortality, especially among individuals with at least one lifestyle risk factor. However, the conclusion should be another. If lifestyle is healthy, moderate intake of animal protein (12%–15% of total energy) carries no special health risk. Instead, consumption of vegetable protein should be increased on an unhealthy lifestyle.
Finally, most of the systematic reviews and metaanalysis performed for determining the relationship between meat and diseases are based in heterogeneous observational studies. In any case, they prove a strong association for meat and any adverse health outcomes, not a cause–effect relationship (Klurfeld, 2015).
2. Improvement of Nutritional and Healthy Properties of Meat Products
All foods provide some level of physiological function beyond nutritional effects. The association between food and disease is scientifically recognized as the bedrock of preventive nutrition. In this context the concept of functional food
arises. Functional food is essentially a marketing term and widely used in scientific literature; however, it is not explicitly recognized by law (Henry, 2010). There is no consensus among scientific bodies, so several definitions for functional foods exist. The term functional foods
is defined by Academy of Nutrition and Dietetics of USA as whole foods along with fortified, enriched, or enhanced foods that have a potentially beneficial effect on health when consumed as part of a varied diet on a regular basis at effective levels based on significant standards of evidence. However, all food is essentially functional at some level as it provides energy and nutrients needed to sustain life (Crowe and Francis, 2013).
To add confusion to this scenario, the concept of functional ingredient
is also used in food science and technology. Certain ingredients, together with additives, are used with technological purpose during food processing to modify or enhance their physical and chemical properties. Carbohydrates (starches, maltodextrins, pectins, alginates, gums, etc.), proteins (from soy, milk, and egg) and lipids [hydrogenated fats, phospholipids (PLs), etc.] are added as functional ingredients. In meat systems, the functional properties as water holding, emulsification, emulsion stabilization, gelation, and texturization are of interest. The substances used in these technological processes are functional ingredients
properly. By contrast, the substances used to modify or improve the health properties of foods should be called biologically active compounds
or bioactive compounds.
With regard to meat and processed meats, the negative consumer opinions are associated with their unhealthy profile including high contents of energy, fats, SFA, cholesterol, and salt. In order to offset this association different strategies have been proposed to provide products of modified composition. The strategies have focused on the product reformulation by reduction of fat, cholesterol, and NaCl or inclusion of oils, dietary fiber, bioactive compounds, and others (Grasso et al., 2014). The rationale for such strategies is reviewed in the next section.
2.1. Lipid Enhancing
2.1.1. Fat reduction
During the 20th century, the population began to gain proportionally more weight than height, to the point where the cognitive and attitudinal factors of overweight and obesity has become not only epidemic, but even pandemic. Excess adiposity in obesity is linked with the increased risk of a diversity noncommunicable diseases, including hypertension, CVD, DM2, and some cancers, although this association becomes much weaker when physical activity is measured. The risk factors of this problem are still debated: excess energy intake, lack of physical activity, specific changes to micro- and macronutrients. In the 1970s, there was increasing concern that high-dietary fat, and especially saturated fat, intake was causing considerable increases in CVD. Consequently, government health agencies have developed guidance on a healthy diet based on reducing fat intake (Shook et al., 2014). Although a metaanalysis confirms that reduction in dietary total fat led a loss in body weight (Hooper et al., 2012a), the effect is very small (<2 kg). With regard to reduction in cardiovascular risk, another metaanalysis suggested that there is no effect in reducing dietary total fat (Hooper et al., 2012b).
Dietary campaigns to reduce fat urged consumers to demand low-fat products. For that reason, the food industry is focused on developing and marketing low-fat, reduced-fat, fat-free products. In the particular case of the meat industry, reduced-fat meat products have been formulated with a variety of fat replacers—protein-, fat-, or carbohydrate-based substances—(Brewer, 2012) and their beneficial effects on cardiovascular risk biomarkers (LDL cholesterol, oxidized LDL, and tumor necrosis factor α) have been evidenced by controlled trials (Celada et al., 2016; Delgado-Pando et al., 2014). However, such effects cannot be attributed to the fat reduction, but the lipid profile modification.
2.1.2. Cholesterol reduction
The dietary guidelines of the Committee on Nutrition of American Heart Association included in 1968 the restriction of dietary cholesterol to <300 mg/d and the consumption of no more than three whole eggs per week. Both recommendations were unjustified for a healthy population. A semantic relationship between dietary cholesterol and serum cholesterol was established: cholesterol in food equals cholesterol in the blood
(McNamara, 2014). Certainly, high-plasma cholesterol is an independent risk factor for CVD, but serum cholesterol is derived from two sources: endogenous cholesterol from synthesis, and exogenous cholesterol derived from intestinal absorption of dietary cholesterol. In healthy adults, dietary cholesterol is absorbed approximately 50% from intestine. In the animal model, dietary cholesterol suppresses the cholesterol synthesis, while a high-fat diet increases cholesterol synthesis without affecting whole body synthesis (Van der Wulp et al., 2013).
Absorption of dietary cholesterol can be reduced by food components as phytosterols, phytostanols, and soluble dietary fiber. Phytosterols and phytostanols are present in vegetable oils, nuts, seeds, and cereals. Intake in Western diet is about 300 mg/d for phytosterols and about 30 mg/d for phytostanols. The intestinal absorption of phytosterols is <2%, and for phytostanols is <0.2%. Daily ingestion of 1.5–3.0 g of phytosterols and phytostanols interferes with intestinal cholesterol absorption. Consequently, cholesterol uptake by the liver is reduced and LDL levels are low. Also, a reduction of serum carotene concentration is observed, although serum vitamin A levels are unaffected (Gylling et al., 2014). Tapola et al. (2004) investigated the effect of frankfurter sausages enriched by phytosterols (campesterol and sitosterol) and phytostanols (campestanol and sistostanol) on serum lipids. A modest drop (<5%) in total and LDL cholesterol was observed. The result can be explained by the low dose of plant stanols (1.2 g/day) and reduced length of intervention (3 weeks).
A number of controlled trials have shown a positive association between diets rich in soluble dietary fibers (β-glucan, pectins, and gums) and reduced serum cholesterol (Aller et al., 2004; Ballesteros et al., 2001; Chen et al., 2005; Karmally et al., 2005). The mechanisms proposed to explain the hypocholesterolemic effects of soluble fiber are: reduction of bile salt reabsorption from the small intestine leading to a cholesterol catabolization by the hepatocyte; decline of insulin stimulation triggering to a reduced cholesterol synthesis by the liver; inhibition of cholesterol biosynthesis by propionate produced during fermentation of soluble fiber (Gunness and Gidley, 2010). In any case, few studies had an intervention duration of longer than 12 weeks, which decrease in total cholesterol and LDL cholesterol with increased fiber intake did not lead to a drop CVD events (Hartley et al., 2016).
To conclude this section on the effects of dietary cholesterol, a metaanalysis performed by Berger et al. (2015) reported that reviewed studies were heterogeneous and the methodological rigor was required to draw any conclusions regarding the effects of dietary cholesterol on CVD risk. This was expected, because there are many factors associated with CVD, such as age, sex, ethnic group, body weight, physical activity, blood pressure, glycaemia, cholesterolemia, and other diseases. Various clinical guidelines take into account such factors to predict and manage the CVD risk (Anderson et al., 2013; Eckel et al., 2014; Koba and Yanagita, 2014; O’Callaghan et al., 2014; Piepoli et al., 2016). Although in the healthy people restricting cholesterol intake is meaningless, patients at risk of CVD should limit their consumption of dietary cholesterol (Spence et al., 2010).
2.1.3. Lipid modification
2.1.3.1. Saturated and unsaturated fats
A research that contributed to the heart-diet hypothesis
was the Seven Countries Study
(USA, Netherlands, Finland, Yugoslavia, Italy, and Japan), developed from 1958 to 1964. The cohorts (US railroad, East Finland, West Finland, Zutphen, Crevalcore, Montegiorgio, Rome railroad, Crete, Corfu, Dalmatia, Slavonia, Velika Krsna, Zerenjanin, Belgrade, Tanushimaru, and Ushibuka) were not representative of the correspondent countries. The objective was examination in lifestyle, diet, and CVD mortality. A significant association between saturated fat intake and CVD mortality was found. It did not necessarily establish dietary saturated fat or high-blood cholesterol as causal. But the epidemiological study that truly provided the evidence for the CVD risk was the Framingham Heart Study.
This research was carried out in the town of Framingham, Massachusetts, beginning in 1948, and it continues to this day. The research identified the risk factors for CVD, such as high-blood pressure, serum cholesterol, sedentary lifestyle, and smoking. It is shown that dietary cholesterol is not related to either blood cholesterol or heart disease deaths (Steinberg, 2005).
Intake of saturated fats is not associated with CVD risk, and all-cause of mortality. SFA that differ in carbon chain length may also differ in their effects on blood lipids and thereby on CVD risk. Many studies have shown no association with CVD risk for short- to medium-chain SFAs. The doubt remains with stearic acid. However, a small but potentially important reduction in CVD risk when saturated fat is replaced by polyunsaturated fat (De Souza et al., 2015; Hooper et al., 2015; Praagman et al., 2016).
It is accepted that certain dietary FAs affect plasma lipid profile. For this reason, it is suggested to modify the lipid profile of the meat products. In this way the content of SFA is reduced in favor of an increase in monounsaturated fatty acids (MUFA), n−3, an n−6 PUFA. Total and LDL cholesterol are reduced when replacing a SFA diet (14.7% E) with MUFA diet (13.7% E) (Gill et al., 2003). Regarding PUFA, their effects are summarized in Table 1.4.
Table 1.4
Source: Modified from: Ooi, E.M., Watts, G.F., Ng, T.W., Barrett, P.H.R., 2015. Effect of dietary fatty acids on human lipoprotein metabolism: a comprehensive update. Nutrients 7, 4416–4425.
Both n−6 and n−3 PUFA are considered essentials to maintain the health. Generally, it is accepted that an unbalanced diet based in the high amount of n−6 PUFA and low amount of n−3 PUFA generates larger quantities of prostaglandins, thromboxanes, and leukotrienes. A long-term consequence is an increased CVD risk. As metabolism of n−6 and n−3 PUFA is interrelated, n−6/n−3 ratio has been proposed as a rule to assess the diet quality. Several authors have suggested that the Western diet is characterized by a ratio 15/1–16.7/1. Hence, such a ratio is a cause of CVD. The same authors postulated that an n−6/n−3 ratio of 3/1 to 4/1 could prevent the pathogenesis of many diseases. Findings on the effects of both n−3 and n−6 PUFA from intervention and epidemiological studies