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Stiletto A, Vecchio R, Cembalo L, Trestini S. The impact of nutri-score on consumers' preferences for geographical indications. Evidence from a non-hypothetical experiment. Appetite 2024; 199:107400. [PMID: 38735306 DOI: 10.1016/j.appet.2024.107400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Abstract
The EU Farm to Fork strategy (F2F) promotes the compulsory adoption of a nutritional front of pack label to improve the diets of the citizens, supporting healthier food choices. In the public debate, Nutri-Score (NS) is the most favored candidate. Although being widely supported, oppositions on the political and producer levels are raised against the NS, due to the economic impact it could have on specific food sector, and specifically on Geographical Indications (GIs). Recent literature has stressed the need to explore it in more detail. The current study contributes to fill this gap by analyzing consumers' monetary preferences for GI products labelled with different NS levels. An incentivized non-hypothetical experiment was conducted on 188 Italian consumers. Different products representing different levels of NS were used. Specifically, a conventional pasta and the Pasta di Gragnano PGI (NS = A), a conventional flatbread (piadina) and the Piadina Romagnola PGI (NSC), and a conventional hard cheese and the Parmigiano Reggiano PDO (NS = D) were considered in the survey. Results reveal that the NS elicits favorable responses and unfavorable reactions in consumers' preferences, aligning with expectations for A and D scores, respectively. The perceived healthiness of the product significantly affects consumers' WTP, increasing it. Results stress the need to have effective communication strategies within the EU to reach the F2F goals. NS diminishes the premium in prices associated with GIs independently from its level, when considering those consumers who value more the GIs. However, the most well-known GIs does not suffer from this negative effect of the NS, as the positive value associated to the GI offset the negative effect of the NS.
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Affiliation(s)
- Alice Stiletto
- Department of Land, Environment, Agriculture, and Forestry, University of Padova, Viale dell'Università 16, Legnaro, Padova, Italy.
| | - Riccardo Vecchio
- Department of Agricultural Sciences, University of Naples Federico II, Via Università 100, Portici, Naples, Italy.
| | - Luigi Cembalo
- Department of Agricultural Sciences, University of Naples Federico II, Via Università 100, Portici, Naples, Italy.
| | - Samuele Trestini
- Department of Land, Environment, Agriculture, and Forestry, University of Padova, Viale dell'Università 16, Legnaro, Padova, Italy.
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Dicken SJ, Batterham RL, Brown A. Nutrients or processing? An analysis of food and drink items from the UK National Diet and Nutrition Survey based on nutrient content, the NOVA classification and front of package traffic light labelling. Br J Nutr 2024; 131:1619-1632. [PMID: 38220223 PMCID: PMC11043912 DOI: 10.1017/s0007114524000096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 01/16/2024]
Abstract
UK front of package labelling (FOPL) informs consumers on the nutrient content of food. However, FOPL does not consider food processing, and with the UK government being urged to act on ultra-processed food (UPF), whether UPF should be added to FOPL is unclear. This study compared food and drink in the UK National Diet and Nutrition Survey (NDNS) Intake24 database based on FOPL, nutrient content and NOVA classification, to understand whether UPF are covered by dietary recommendations for foods high in fat, salt and sugar. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients, processed food and UPF according to the NOVA classification and FOPL traffic lights. UPF contained greater energy, fat, saturated fat (SF), total sugar (TS) and salt than MPF. UPF had a greater odds of containing red FOPL and an unhealthier overall FOPL score (OR:4·59 (95 % CI: 3·79, 5·57); OR:7·0 (95 % CI: 6·1, 8·2), respectively) and lower odds of containing green FOPL (OR:0·05 (95 % CI: 0·03, 0·10)), compared with MPFs. For items with no red FOPL, UPF still contained greater energy, fat, SF, TS and salt than MPF. However, several UPF have healthier FOPL scores. UPF had an unhealthier nutritional profile and FOPL score than MPF. For items with no red FOPL, UPF still had an unhealthier profile than MPF, with a higher energy density. Importantly, not all UPF were unhealthy according to FOPL. These results indicate partial overlap between FOPL, nutrient content and NOVA classification of UK food and drink products, with implications for UK food and drink labelling.
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Affiliation(s)
- Samuel J. Dicken
- Centre for Obesity Research, Department of Medicine, University College London (UCL), LondonWC1E 6JF, UK
| | - Rachel L. Batterham
- Centre for Obesity Research, Department of Medicine, University College London (UCL), LondonWC1E 6JF, UK
| | - Adrian Brown
- Centre for Obesity Research, Department of Medicine, University College London (UCL), LondonWC1E 6JF, UK
- National Institute for Health Research, Biomedical Research Centre, University College London Hospital (UCLH), LondonW1T 7DN, UK
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital (UCLH), LondonNW1 2BU, UK
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Sarda B, Kesse-Guyot E, Deschamps V, Ducrot P, Galan P, Hercberg S, Deschasaux-Tanguy M, Srour B, Fezeu LK, Touvier M, Julia C. Complementarity between the updated version of the front-of-pack nutrition label Nutri-Score and the food-processing NOVA classification. Public Health Nutr 2024; 27:e63. [PMID: 38297466 PMCID: PMC10897572 DOI: 10.1017/s1368980024000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/04/2024] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To compare the initial and the updated versions of the front-of-pack label Nutri-Score (related to the nutritional content) with the NOVA classification (related to the degree of food processing) at the food level. DESIGN Using the OpenFoodFacts database - 129,950 food products - we assessed the complementarity between the Nutri-Score (initial and updated) with the NOVA classification through a correspondence analysis. Contingency tables between the two classification systems were used. SETTINGS The food offer in France. PARTICIPANTS Not applicable. RESULTS With both versions (i.e. initial and updated) of the Nutri-Score, the majority of ultra-processed products received medium to poor Nutri-Score ratings (between 77·9 % and 87·5 % of ultra-processed products depending on the version of the algorithm). Overall, the update of the Nutri-Score algorithm led to a reduction in the number of products rated A and B and an increase in the number of products rated D or E for all NOVA categories, with unprocessed foods being the least impacted (-3·8 percentage points (-5·2 %) rated A or B and +1·3 percentage points (+12·9 %) rated D or E) and ultra-processed foods the most impacted (-9·8 percentage points (-43·4 %) rated A or B and +7·8 percentage points (+14·1 %) rated D or E). Among ultra-processed foods rated favourably with the initial Nutri-Score, artificially sweetened beverages, sweetened plant-based drinks and bread products were the most penalised categories by the revision of Nutri-Score while low-sugar flavoured waters, fruit and legume preparations were the least affected. CONCLUSION These results indicate that the update of the Nutri-Score reinforces its coherence with the NOVA classification, even though both systems measure two distinct health dimensions at the food level.
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Affiliation(s)
- Barthélemy Sarda
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Valérie Deschamps
- Nutritional Epidemiology Surveillance Team (ESEN), Santé publique France, The French Public Health Agency, Bobigny, France
| | - Pauline Ducrot
- Santé publique France, French National Public Health Agency, Saint- Maurice, France
| | - Pilar Galan
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Serge Hercberg
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
- Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
| | - Melanie Deschasaux-Tanguy
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Bernard Srour
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Leopold K Fezeu
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Mathilde Touvier
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
| | - Chantal Julia
- Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and StatisticS (CRESS), 74 rue Marcel Cachin, F-93017Bobigny, France
- Public health Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Bobigny, France
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Neumann NJ, Eichner G, Fasshauer M. Flavour, emulsifiers and colour are the most frequent markers to detect food ultra-processing in a UK food market analysis. Public Health Nutr 2023; 26:3303-3310. [PMID: 37855120 PMCID: PMC10755427 DOI: 10.1017/s1368980023002185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/17/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To elucidate which markers of ultra-processing (MUP) and their combinations are best suited to detect ultra-processed food (UPF). DESIGN The study was based on the 206 food and 32 beverage items of the Oxford WebQ which encompass all major foods consumed in the UK. For each Oxford WebQ question, ingredient lists of up to ten matching different commercial products (n 2146) were researched online using data from the two market leaders of groceries in the UK sorted by relevance (Tesco) and by top sellers (Sainsbury's), respectively. According to the NOVA classification, sixty-five MUP were defined, and if the ingredient list of a food product was positive for at least one MUP, it was regarded as UPF. The percentage of UPF items containing specific MUP was calculated. In addition, all combinations of two to six different MUP were assessed concerning the percentage of identified UPF items. SETTING Cross-sectional analysis. PARTICIPANTS None. RESULTS A total of 990 products contained at least one MUP and were, therefore, regarded as UPF. The most frequent MUP were flavour (578 items, 58·4 % of all UPF), emulsifiers (353 items, 35·7 % of all UPF) and colour (262 items, 26·5 % of all UPF). Combined, these three MUP detected 79·2 % of all UPF products. Detection rate increased to 88·4 % of all UPF if ingredient lists were analysed concerning three additional MUP, that is, fibre, dextrose and firming agent. CONCLUSIONS Almost 90 % of all UPF items can be detected by six MUP.
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Affiliation(s)
- Nathalie Judith Neumann
- Institute of Nutritional Science, Justus-Liebig University of Giessen, Goethestr. 55, Giessen, Hessen35390, Germany
| | - Gerrit Eichner
- Mathematical Institute, Justus-Liebig University of Giessen, Giessen, Germany
| | - Mathias Fasshauer
- Institute of Nutritional Science, Justus-Liebig University of Giessen, Goethestr. 55, Giessen, Hessen35390, Germany
- Center for Sustainable Food Systems, Justus-Liebig University of Giessen, Giessen, Germany
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Moraes JMM, Moraes CHDC, Alvarenga MDS, Sproesser G. Effect of nutrient, processing and hedonic claims on food-related perceptions: An experimental online study in Brazil and Germany. Appetite 2023; 190:107033. [PMID: 37678587 DOI: 10.1016/j.appet.2023.107033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
Prior studies on perceived healthiness of foods have often compared nutrient and hedonic claims, neglecting comparisons to a control condition. The effect of food claims focusing on the food processing level has received considerably less research attention, although food processing has been included in dietary guidelines in Brazil. Thus, the present study aimed to explore the effect of a control and processing claim, additionally to the effects of a nutrient. and hedonic claim, on perceptions related to a food item typically considered "less healthy" (chocolate cake). We further compared these effects between Brazil and Germany, a country where food processing is currently not included in dietary guidelines. A total of 634 lay adults were recruited in a cross-sectional online study and randomised to see the photo of a piece of cake with one of the four different claim conditions and to report their health-related perceptions of the cake. The main analyses included two-way ANCOVAs (4 claims x 2 countries) for each dependent variable controlled for gender, age and level of hunger; followed by post hoc tests. Overall, results revealed that in both countries, the claims highlighting nutrients or processing aspects rendered the perceptions of the cake healthier compared to the control claim. These effects were more pronounced among Brazilian than among German participants. Food-related perceptions mostly did not differ between the hedonic and control claim and did not differ at all between the nutrient and processing claims. In conclusion, it is noteworthy that, even for an inherently considered "less healthy food item" (chocolate cake) nutrient and processing claims increase healthiness perceptions. While our findings may imply that in both countries lay people are highly susceptible to nutrient claims, food processing aspects seem to be similarly relevant.
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Affiliation(s)
- Jessica Maria Muniz Moraes
- Postgraduate Program in Nutrition in Public Health, School of Public Health, University of São Paulo, Brazil.
| | | | - Marle Dos Santos Alvarenga
- Postgraduate Program in Nutrition in Public Health, School of Public Health, University of São Paulo, Brazil
| | - Gudrun Sproesser
- Institute of Psychology, Johannes Kepler University Linz, Linz, Austria; Department of Psychology, University of Konstanz, Konstanz, Germany
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Stiletto A, Cei L, Trestini S. A Little Bird Told Me… Nutri-Score Panoramas from a Flight over Europe, Connecting Science and Society. Nutrients 2023; 15:3367. [PMID: 37571304 PMCID: PMC10421117 DOI: 10.3390/nu15153367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Within the Farm to Fork Strategy, the European Commission ask for a unified Front Of Pack nutritional label for food to be used at the European level. The scientific debate identified the Nutri-Score (NS) as the most promising candidate, but within the political discussion, some Member States brought to attention several issues related to its introduction. This misalignment led to a postponement of the final decision. With the aim to shed some light on the current stances and contribute to the forthcoming debate, the objective of the present work is to understand to what extent scientific research addresses the issues raised by the general public. We applied a structural topic model to tweets from four European countries (France, Germany, Italy, Spain) and to abstracts of scientific papers, all dealing with the NS topic. Different aspects of the NS debate are discussed in different countries, but scientific research, while addressing some of them (e.g., the comparison between NS and other labels), disregards others (e.g., relations between NS and traditional products). It is advisable, therefore, to widen the scope of NS research to properly address the concerns of European society and to provide policymakers with robust evidence to support their decisions.
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Affiliation(s)
| | | | - Samuele Trestini
- Department of Land, Environment, Agriculture and Forestry, University of Padova, 35020 Legnaro, Italy; (A.S.); (L.C.)
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Angelino D, Dinu M, Gandossi B, Pellegrini N, Martini D. Processing and Nutritional Quality of Breakfast Cereals Sold in Italy: Results from the Food Labelling of Italian Products (FLIP) Study. Nutrients 2023; 15:nu15082013. [PMID: 37111232 PMCID: PMC10145012 DOI: 10.3390/nu15082013] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to compare the level of processing (as assessed by the NOVA classification) and the nutritional quality (as assessed by nutrition values, Nutri-Score and NutrInform battery) of breakfast cereals currently on the Italian market. A total of 349 items were found, mostly belonging to the NOVA 4 group (66.5%) and to Nutri-Score C and A (40% and 30%, respectively). The NOVA 4 products showed the highest energy, total fat, saturates, and sugar content per 100 g and had the highest number of items with Nutri-Score C (49%) and D (22%). Conversely, NOVA 1 products had the highest content of fibre and protein, the lowest amounts of sugars and salt, and 82% of them were Nutri-Score A, while few Nutri-Score B and C were found. Differences were attenuated when products were compared for their NutrInform battery, with NOVA 4 items showing only slightly fuller batteries for saturated fats, sugar, and salt than NOVA 1 and NOVA 3 products. Overall, these results suggest that the NOVA classification partially overlaps with systems based on the nutritional quality of foods. The lower nutritional quality of NOVA 4 foods may at least partially explain the association found between the consumption of ultra-processed foods and the risk of chronic diseases.
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Affiliation(s)
- Donato Angelino
- Department of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, 64100 Teramo, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Barbara Gandossi
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
| | - Nicoletta Pellegrini
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, 33100 Udine, Italy
| | - Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
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Rodríguez-Martín NM, Córdoba P, Sarriá B, Verardo V, Pedroche J, Alcalá-Santiago Á, García-Villanova B, Molina-Montes E. Characterizing Meat- and Milk/Dairy-like Vegetarian Foods and Their Counterparts Based on Nutrient Profiling and Food Labels. Foods 2023; 12:1151. [PMID: 36981078 PMCID: PMC10048389 DOI: 10.3390/foods12061151] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
Vegetarian foods are plant-based (PB) foods, often perceived as healthier foods than animal-based (AB) foods. The objective of this study was to analyze the nutritional quality of a set of PB foods (meat, milk and dairy products) marketed in Spain, and to compare their nutrient profiles with respect to some AB counterparts. Nutritional information per 100 g or mL, ingredients, and nutritional declarations, as well as the Nutri-Score, NOVA, and Eco-Score of each food were collected from Open Food Facts. Differences in the nutrient compositions between PB foods and their counterparts, and between the different groups of PB foods, were assessed at a 5% significance level. A total of 544 PB foods and 373 AB foods were identified. Overall, PB foods had a higher median content of fiber and carbohydrates, but a lower amount of proteins (except PB "meat" analogues: 14 g) and saturated fats (except PB "cheese alternatives": 12.5 g), than the AB counterparts (p < 0.05). PB "milk alternatives", particularly oat "milk", showed a higher median content of total carbohydrates (8 g) and sugars (5.5 g) compared to cow milks (4.7 g carbohydrates/sugars, on average; p < 0.001). PB "meat alternatives" also had a significantly higher value of carbohydrates (9 g) than AB meats (2 g, on average; p < 0.001). PB foods were mostly classified as Nutri-Score A and B (86%). However, more than half of them were of NOVA groups 3 and 4. Thus, there is a great diversity of PB meat and milk/dairy product alternatives on the Spanish market. Despite being products of good nutritional quality compared to AB foods, they also carry drawbacks that could have an impact on nutritional health.
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Affiliation(s)
- Noelia María Rodríguez-Martín
- Group of Plant Protein, Department of Food and Health, Instituto de la Grasa-CSIC, Campus Universitario Pablo de Olavide, Edificio 46, Carretera de Utrera Km. 1, 41013 Seville, Spain
| | - Patricia Córdoba
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
| | - Beatriz Sarriá
- Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Spanish National Research Council (CSIC), José Antonio Nováis 10, 28040 Madrid, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy, University Complutense of Madrid, 28040 Madrid, Spain
| | - Vito Verardo
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, 18071 Granada, Spain
| | - Justo Pedroche
- Group of Plant Protein, Department of Food and Health, Instituto de la Grasa-CSIC, Campus Universitario Pablo de Olavide, Edificio 46, Carretera de Utrera Km. 1, 41013 Seville, Spain
| | - Ángela Alcalá-Santiago
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Belén García-Villanova
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
| | - Esther Molina-Montes
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Avenida del Conocimiento s/n, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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