A comparative analysis of nutritional quality, amino acid profile, and nutritional supplementations in plant-based products and their animal-based counterparts in the UK

Plant-based (PB) food products have surged in popularity over the past decade. Available PB products in the UK market were extracted from NielsenIQ Brandbank and compared with animal-based (AB) counterparts in their nutrient contents and calculated Nutri-Scores. The amino acid contents of four beef products and their PB alternatives were analysed by LC-MS/MS. PB products consistently exhibited significantly higher fibre content across all food groups. Protein was significantly higher in AB products from all food groups except beef and ready meals. PB products were more likely to have higher Nutri-Scores compared to AB counterparts, albeit with greater score variability within each food group. Nutrient fortifications were primarily focused on dairy and ready meals; the most supplemented nutrient was vitamin B12 (found in 15% of all products). A higher proportion of EAAs in relation to total protein content was observed in all beef products.

Are novel plant-based meat alternatives the healthier choice?

The global market for plant-based meat alternatives (PBMAs) is expanding quickly. In this narrative review, analysis of the most recent scientific literature was achieved to understand the nutritional profile, health implications, and the challenges faced by PBMAs. On the positive side, most PBMAs are good sources of dietary fiber, contain phytochemicals, have comparable levels of iron, and are lower in calories, saturated fat, and cholesterol than meat. However, PBMAs frequently contain anti-nutrients, have less protein, iron, and vitamin B12, are lower in protein quality, and also have higher amounts of sodium. Substituting PBMAs for meats may cause iron, vitamin B12, and less likely protein deficiency for these vulnerable population such as women, older adults, and individuals with disorders. PBMAs fall into the category of ultra-processed foods, indicating a need to develop minimally processed, clean-label products. Replacing red meat with healthy plant-based foods is associated with lower risks of cardiovascular diseases, type 2 diabetes, and total mortality. There is a lack of robust, long-term evidence on the role of PBMAs consumption in health. As the nutrient contents of PBMAs can vary, consumers must read nutrition facts labels and ingredient lists to select a product that best fits their nutritional and health objectives.

Mapping the evidence of novel plant-based foods: a systematic review of nutritional, health, and environmental impacts in high-income countries

CONTEXT

Shifting from current dietary patterns to diets rich in plant-based (PB) foods and lower in animal-based foods (ABFs) is generally regarded as a suitable strategy to improve nutritional health and reduce environmental impacts. Despite the recent growth in supply of and demand for novel plant-based foods (NPBFs), a comprehensive overview is lacking.

OBJECTIVES

This review provides a synthesis of available evidence, highlights challenges, and informs public health and environmental strategies for purposeful political decision-making by systematically searching, analyzing, and summarizing the available literature.

DATA SOURCES

Five peer-reviewed databases and grey literature sources were rigorously searched for publications.

DATA EXTRACTION

Study characteristics meeting the inclusion criteria regarding NPBF nutrient composition and health and environmental outcomes in high-income countries were extracted.

DATA ANALYSIS

Fifty-seven peer-reviewed and 36 grey literature sources were identified; these were published in 2016-2022. NPBFs typically have substantially lower environmental impacts than ABFs, but the nutritional contents are complex and vary considerably across brands, product type, and main primary ingredient. In the limited evidence on the health impacts, shifts from ABFs to PB meats were associated with positive health outcomes. However, results were mixed for PB drinks, with links to micronutrient deficiencies.

CONCLUSION

If carefully selected, certain NPBFs have the potential to be healthier and nutrient-rich alternatives to ABFs and typically have smaller environmental footprints. More disaggregated categorization of various types of NPBFs would be a helpful step in guiding consumers and key stakeholders to make informed decisions. To enable informed policymaking on the inclusion of NPBFs in dietary transitions as part of a wider net-zero and health strategy, future priorities should include nutritional food standards, labelling, and subdivisions or categorizations of NPBFs, as well as short- and long-term health studies evaluating dietary shifts from ABFs to NPBFs and standardized environmental impact assessments, ideally from independent funders.

Leveraging microalgae as a sustainable ingredient for meat analogues

As the world's population and income levels continue to rise, there is a substantial increase in the demand for meat, which poses significant environmental challenges due to large-scale livestock production. This review explores the potential of microalgae as a sustainable protein source for meat analogues. The nutritional composition, functional properties, and environmental advantages of microalgae are analyzed. Additionally, current obstacles to large-scale microalgal food production are addressed, such as strain development, contamination risks, water usage, and downstream processing. The challenges associated with creating meat-like textures and flavors using techniques like extrusion and emulsion formation with microalgae are also examined. Lastly, considerations related to consumer acceptance, marketing, and regulation are summarized. By focusing on improvements in cultivation, structure, sensory attributes, and affordability, microalgae demonstrate promise as a transformative and eco-friendly protein source to enhance the next generation of meat alternatives.

Breaking Conventional Eating Habits: Perception and Acceptance of 3D-Printed Food among Taiwanese University Students

Considering the prevalent strain on environmental resources imparted by existing food systems, prioritizing environmental sustainability is an imperative course of action. Subsequently, the shift towards sustainable production and consumption patterns engenders an escalating demand for environmentally conscious food systems. Thus, 3D-printed food technology surfaces are a promising solution noted for their efficacy in curtailing food waste, bolstering environmental sustainability, and imparting innovative strategies to the food supply chain. Herein, we amalgamate the theory of planned behavior (TPB) framework with several variables, namely 'sensory appeal', 'food neophobia', 'perceived health risk', and 'environmental friendliness' to probe the behavioral intentions of Taiwanese university students' perceptions about 3D-printed food. Employing the snowball sampling method, 370 questionnaires were disseminated, out of which 319, constituting an effective retrieval rate of 86.2%, were deemed valid. Statistical analysis produced intriguing findings. Consumers' inclination to purchase 3D-printed food is substantially determined by their attitudes, subjective norms, sensory appeal, food neophobia, perceived health risks, and environmental friendliness. Contrary to our initial hypothesis, perceived behavioral control did not exhibit a significant impact on consumers' propensity to purchase 3D-printed food. Therefore, businesses should focus on magnifying the sensory appeal of 3D-printed food, coupled with precise nutritional labeling, to bolster consumer interest, enhance acceptance, and augment behavioral intentions. This study sheds light on the potential for the development of 3D-printed food in Taiwan, providing an indispensable reference for future endeavors in Taiwan's 3D-printed food industry.

In vitro digestibility and solubility of phosphorus of three plant-based meat analogues

Interest in plant-based meat analogues has increased and can be expected to be applied to pet foods, which necessitates the understanding of the nutrient supply in those foods. Our primary aim was to advance our understanding of the digestive properties of sterilized plant-based meat analogues. The impact of the preparatory processing steps on the solubility of meat analogues was studied. Meat analogues were made by mixing water, salt, and wheat gluten with soy protein isolate, pea protein isolate, or faba bean concentrate. Mixed materials were processed into model meat analogues using shear cell technology. Products were canned in water or gravy and sterilized. An animal-based canned pet food was made as a reference. Products sampled at the processing steps (mixing, shearing, sterilization) were digested in vitro. Samples of digestate were taken at the gastric phase (0 and 120 min) and small intestinal phase (120, 200, 280, and 360 min) for analysis of protein hydrolysis. The extent digestion of nitrogen and dry matter was determined at the end of incubation. Total phosphorus, soluble phosphorus after acid treatment, and after acid and enzymatic treatment were determined. The degree of hydrolysis after gastric digestion was low but increased immediately in the small intestinal phase; products based on pea had the highest values (56%). Nitrogen digestibility was above 90% for all materials at each processing step, indicating that bioactive compounds were absent or inactivated in the protein isolates and concentrate. Phytate seemed to play a minor role in meat analogues, but phosphorus solubility was influenced by processing. Shearing decreased soluble phosphorus, but this effect was partly reversed by sterilization. Nutrient digestibility as well as phosphorus solubility in plant-based products was higher than or comparable with the reference pet food. These findings show that the digestive properties of the tested plant-based meat analogues do not limit the supply of amino acids and phosphorus.

The impact of consumers' preferences for domestic food on dietary sustainability

A sustainable dietary transition requires knowledge of the drivers and barriers of dietary choices. We investigate the role of preferences for domestic food, as well as environmental and health concerns, as drivers for the consumption of red and white meat, fish, ready-made plant-based food products and self-identification as some type of meat reducer (flexitarian, vegetarian, or vegan). A survey of 1102 consumers was conducted in Norway with questions about food attitudes, beliefs and preferences regarding health, the environment and domestic food as well as dietary habits and demographics. The results from interval and logistic regression analyses show that stronger preferences for domestic food are associated with higher consumption of red meat and a lower likelihood of eating plant-based food and identifying as a meat reducer. Health concerns are associated with higher consumption of white meat and fish, and environmental concern is associated with lower consumption of white meat and a higher likelihood of eating plant-based food. The results also confirm previous research results that disbelief regarding the negative health and environmental impacts of meat correlate with higher meat consumption and a lower likelihood of eating plant-based food. In addition, we find that people who believe that Norway is a country primarily suited for livestock production have higher consumption of meat and a lower likelihood of eating plant-based food. We conclude that to make certain consumers transition away from meat, it is important to provide domestically produced, plant-based alternatives and to implement policy measures that will generate positive storylines of improved farmer livelihoods.

Masculinity, Meat, and Veg*nism: A Scoping Review

Men historically consume more meat than women, show fewer intentions to reduce meat consumption, and are underrepresented among vegans and vegetarians. Eating meat strongly aligns with normative masculinities, decisively affirming that "real men" eat meat and subordinating men who choose to be veg*n (vegan or vegetarian). The emergence of meat alternatives and increasing environmental concerns may contest these long-standing masculine norms and hierarchies. The current scoping review addresses the research question what are the connections between masculinities and men's attitudes and behaviors toward meat consumption and veg*nism? Using keywords derived from two key concepts, "men" and "meat," 39 articles were selected and analyzed to inductively derive three thematic findings; (a) Meat as Masculine, (b) Veg*n Men as Othered, and (c) Veg*nism as Contemporary Masculinity. Meat as Masculine included how men's gendered identities, defenses, and physicalities were entwined with meat consumption. Veg*n Men as Othered explored the social and cultural challenges faced by men who adopt meatless diets, including perceptions of emasculation. Veg*nism as Contemporary Masculinity was claimed by men who eschewed meat in their diets and advocated for veg*nism as legitimate masculine capital through linkages to physical strength, rationality, self-determination, courage, and discipline. In light of the growing concern about the ecological impact of meat production and the adverse health outcomes associated with its excessive consumption, this review summarizes empirical connections between masculinities and the consumption of meat to consider directions for future men's health promotion research, policy, and practice.

Sustainability benefits of transitioning from current diets to plant-based alternatives or whole-food diets in Sweden

Plant-based alternatives (PBAs) are increasingly becoming part of diets. Here, we investigate the environmental, nutritional, and economic implications of replacing animal-source foods (ASFs) with PBAs or whole foods (WFs) in the Swedish diet. Utilising two functional units (mass and energy), we model vegan, vegetarian, and flexitarian scenarios, each based on PBAs or WFs. Our results demonstrate that PBA-rich diets substantially reduce greenhouse gas emissions (30-52%), land use (20-45%), and freshwater use (14-27%), with the vegan diet showing the highest reduction potential. We observe comparable environmental benefits when ASFs are replaced with WFs, underscoring the need to reduce ASF consumption. PBA scenarios meet most Nordic Nutrition Recommendations, except for vitamin B12, vitamin D and selenium, while enhancing iron, magnesium, folate, and fibre supply and decreasing saturated fat. Daily food expenditure slightly increases in the PBA scenarios (3-5%) and decreases in the WF scenarios (4-17%), with PBA diets being 10-20% more expensive than WF diets. Here we show, that replacing ASFs with PBAs can reduce the environmental impact of current Swedish diets while meeting most nutritional recommendations, but slightly increases food expenditure. We recommend prioritising ASF reduction and diversifying WFs and healthier PBAs to accommodate diverse consumer preferences during dietary transitions.

Plant-based meat substitute analysis using microextraction with deep eutectic solvent followed by LC-MS/MS to determine acrylamide, 5-hydroxymethylfurfural and furaneol

For the analysis of plant-based meat substitutes and the determination of Maillard reaction products such as acrylamide, 5-hydroxymethylfurfural and furaneol, a novel and effective procedure based on hydrophobic natural deep eutectic solvent and liquid chromatography coupled with tandem mass spectrometry was developed for the first time. The 49 compositions of the deep eutectic solvents were designed and screened to select the most suitable option. The terpenoids eugenol and thymol in a molar ratio of 2:1 were selected as precursors for solvent formation, allowing effective extraction of the target analytes. The developed procedure comprised two main steps: extraction - in which the analytes are isolated from the solid sample due to the salting-out effect and pre-concentrated in the deep eutectic solvent, and back-extraction - in which the analytes are re-extracted into the formic acid solution for subsequent mass spectrometric detection. As the density of the aqueous phases changed during the extraction and back-extraction steps, the phenomenon of inversion of the coalesced organic phase was observed, which simplified the withdrawing of the phases. The linear range was 1-50 ng/mL for acrylamide, 10-1000 ng/mL for 5-hydroxymethylfurfural and 200-1000 ng/mL for furaneol with coefficients of determination above 0.9952. The developed method was fully validated and found recoveries were in the range 83-120%, with CVs not exceeding 4.9%. The method was applied to real sample analysis of pea-based meat substitutes.

Towards Sustainable Protein Sources: The Thermal and Rheological Properties of Alternative Proteins

Reducing meat consumption reduces carbon emissions and other environmental harms. Unfortunately, commercial plant-based meat substitutes have not seen widespread adoption. In order to enable more flexible processing methods, this paper analyzes the characteristics of commercially available spirulina, soy, pea, and brown rice protein isolates to provide data for nonmeat protein processing that can lead to cost reductions. The thermal and rheological properties, as well as viscosity, density, and particle size distribution, were analyzed for further study into alternative protein-based food processing. The differential scanning calorimetry analysis produced dry amorphous-shaped curves and paste curves with a more distinct endothermic peak. The extracted linear temperature ranges for processing within food production were 70-90 °C for spirulina, 87-116 °C for soy protein, 67-77 °C for pea protein, and 87-97 °C for brown rice protein. The viscosity analysis determined that each protein material was shear-thinning and that viscosity increased with decreased water concentration, with rice being an exception to the latter trend. The obtained viscosity range for spirulina was 15,100-78,000 cP, 3200-80,000 cP for soy protein, 1400-32,700 cP for pea protein, and 600-3500 cP for brown rice protein. The results indicate that extrusion is a viable method for the further processing of protein isolates, as this technique has a large temperature operating range and variable screw speed. The data provided here can be used to make single or multi-component protein substitutes.

Modelling the mass consumption potential of Plant Based Meat: Evidence from an emerging economy

The rising demand for plant-based meat (PBM) has the potential to minimize environmental degradation and save the lives of numerous animals. Furthermore, the intention to consume eco-friendly products triggers people to consume PBM. However, it is essential to understand the factors that influence consumer intentions and actual PBM consumption to enhance its adoption. By incorporating the Theory of Consumption Value, this study examines the impact of health consciousness, health motivation, personal innovativeness, perceived critical mass, perceived cost, and perceived product value on the intention to consume PBM. The impact of intention to consume PBM on actual consumption is also analyzed. Furthermore, the mediating role of the intention to consume PBM in the relationship between these factors and actual consumption behavior is investigated. Using a cross-sectional research design, 978 responses were obtained from Indonesia. The data were analyzed using partial least squares structural equation modelling (PLS-SEM). The results showed that health motivation, perceived critical mass perceived cost, and perceived product value were significant predictors of the intention to consume PBM. However, health motivation and personal innovation had insignificant effects on the intention to consume PBM. Moreover, the intention to consume PBM translated into actual consumption behavior. Furthermore, the intention to consume PBM significantly mediated the relationship between actual consumption behavior and factors other than health motivation, personal innovation, and perceived product value. The findings offer valuable insights for industry, policymakers, and producers interested in PBMA markets in developing focused marketing strategies, improving consumer perceptions, and addressing barriers, such as perceived costs to promote PBM consumption, particularly in emerging markets. Integrating the theory of consumption value and PLS-SEM provides a comprehensive understanding of the underlying dynamics and sheds light on the unique factors driving PBM consumption behavior.

Nutritional and health benefits and risks of plant-based substitute foods

Plant-based substitutes (PBS) are seen as a convenient way to transition to a more plant-based diet, but their potential health benefits and nutritional concerns remain debated. Based on a review of the literature, it is concluded here that the primary risk of insufficient nutrient intake with PBS concerns iron and calcium, which are critical to the nutritional value of PBS. Other risks were identified but these would depend on the characteristics of the overall diet, as is the case for iodine in a diet containing no seafood or dairy, and vitamin B12 in a vegetarian/vegan diet. Conversely, the use of PBS is also expected to confer some benefits for long-term health because it would result in higher fibre intakes (in the case of meat PBS) and lower SFA intakes (but higher PUFA/MUFA intakes), but attention should be paid to a potential increase in sodium intake with PBS of meat products. In fact, a recurring finding in this review was that PBS is a very heterogeneous food category involving considerable variations in ingredient and nutrient composition, and whose design could be improved in order to foster nutritional and health benefits. The latter also depend on the animal food that is being replaced and are only deemed likely when PBS replace red meat. The fortification of PBS with key nutrients such as iron and calcium may constitute an actionable public health solution to further shift the balance in favour of PBS in the context of the current dietary transition in western countries.

Comparative Evaluation of Polysaccharide Binders on the Quality Characteristics of Plant-Based Patties

Polysaccharides have been used in the production of plant-based meat analogs to replicate the texture of real meat. However, there has been no study that comprehensively compares the effects of different polysaccharides, and a limited number of polysaccharides have been evaluated. Thus, we aimed to identify the most suitable polysaccharide and concentration for plant-based patties. Plant-based patties were manufactured by blending different concentrations (0%, 1%, and 2%) of six polysaccharides with other ingredients, and the quality characteristics and sensory properties were evaluated. The L* values of plant-based patties reduced during the cooking process resembled the color change of beef patty (BP). In particular, a 2% κ-carrageenan-added patty (Car-2) exhibited the lowest L* value among the plant-based patties, measured at 44.05 (p < 0.05). Texture parameters exhibited high values by adding 2% κ-carrageenan and locust bean gum, which was close to BP. In the sensory evaluation, Car-2 showed higher scores for sensory preferences than other plant-based patties. Based on our data, incorporating 2% κ-carrageenan could offer a feasible way of crafting plant-based meat analogs due to its potential to enhance texture and flavor. Further studies are required to evaluate the suitability of polysaccharides in various types of plant-based meat analogs.

Feeding climate and biodiversity goals with novel plant-based meat and milk alternatives

Plant-based animal product alternatives are increasingly promoted to achieve more sustainable diets. Here, we use a global economic land use model to assess the food system-wide impacts of a global dietary shift towards these alternatives. We find a substantial reduction in the global environmental impacts by 2050 if globally 50% of the main animal products (pork, chicken, beef and milk) are substituted-net reduction of forest and natural land is almost fully halted and agriculture and land use GHG emissions decline by 31% in 2050 compared to 2020. If spared agricultural land within forest ecosystems is restored to forest, climate benefits could double, reaching 92% of the previously estimated land sector mitigation potential. Furthermore, the restored area could contribute to 13-25% of the estimated global land restoration needs under target 2 from the Kunming Montreal Global Biodiversity Framework by 2030, and future declines in ecosystem integrity by 2050 would be more than halved. The distribution of these impacts varies across regions-the main impacts on agricultural input use are in China and on environmental outcomes in Sub-Saharan Africa and South America. While beef replacement provides the largest impacts, substituting multiple products is synergistic.

Plant-based foods as meat and fat substitutes

Animal proteins have in the past been used in food production due to their functional properties that range from gelation and emulsification to foaming ability and stability. However, animal husbandry has been shown to be a major contributor to global warming and climate change. Consequently, there has been a drive toward the use of alternative proteins, for example, proteins from plant sources which are perceived to be cheaper, healthier, and sustainable. The use of trans and saturated fatty acids in the food industry has been associated with various health issues that include an increased risk of metabolic disorders. This has resulted in an increased search for fat substitutes that are healthier and sustainable. To contribute toward a reduction in the consumption of meats from animal sources and the consumption of trans and saturated fatty acids, the formulation of plant-based meat and fat analogs/substitutes has been carried out. However, there has been a lower acceptance of these meat or fat substitutes which was attributed to their sensorial and textural properties that fail to mimic or resemble real fat or meat. Therefore, this review aims to discuss the advances that have been made when it comes to plant-based meat and fat substitutes. Additionally, consumer perception and acceptance of these products will be reviewed as well as future markets will be discussed and the opportunities and challenges that exist in the formulation of these products will be explored.

Significance of Fermentation in Plant-Based Meat Analogs: A Critical Review of Nutrition, and Safety-Related Aspects

Plant-based meat analogs have been shown to cause less harm for both human health and the environment compared to real meat, especially processed meat. However, the intense pressure to enhance the sensory qualities of plant-based meat alternatives has caused their nutritional and safety aspects to be overlooked. This paper reviews our current understanding of the nutrition and safety behind plant-based meat alternatives, proposing fermentation as a potential way of overcoming limitations in these aspects. Plant protein blends, fortification, and preservatives have been the main methods for enhancing the nutritional content and stability of plant-based meat alternatives, but concerns that include safety, nutrient deficiencies, low digestibility, high allergenicity, and high costs have been raised in their use. Fermentation with microorganisms such as Bacillus subtilis, Lactiplantibacillus plantarum, Neurospora intermedia, and Rhizopus oryzae improves digestibility and reduces allergenicity and antinutritive factors more effectively. At the same time, microbial metabolites can boost the final product's safety, nutrition, and sensory quality, although some concerns regarding their toxicity remain. Designing a single starter culture or microbial consortium for plant-based meat alternatives can be a novel solution for advancing the health benefits of the final product while still fulfilling the demands of an expanding and sustainable economy.

Comprehensive Review on the Role of Plant Protein As a Possible Meat Analogue: Framing the Future of Meat

Animal proteins from meat and goods derived from meat have recently been one of the primary concerns in the quest for sustainable food production. According to this perspective, there are exciting opportunities to reformulate more sustainably produced meat products that may also have health benefits by partially replacing meat with nonmeat substances high in protein. Considering these pre-existing conditions, this review critically summarizes recent findings on extenders from a variety of sources, including pulses, plant-based ingredients, plant byproducts, and unconventional sources. It views these findings as a valuable opportunity to improve the technological profile and functional quality of meat, with a focus on their ability to affect the sustainability of meat products. As a result, meat substitutes like plant-based meat analogues (PBMAs), meat made from fungi, and cultured meat are being offered to encourage sustainability.

How Different Dimensions Shape the Definition of Meat Alternative Products: A Scoping Review of Evidence between 2000 and 2021

Consumer awareness of meat-associated health and environmental risks is increasing and motivates a shift toward consuming meat alternatives. This is also reflected in efforts invested in studying meat alternatives from the perspective of nutritional, environmental, and consumer sciences. Despite shared research interest, these studies cannot be readily compared and interpreted because there is no clear consensus on what meat alternatives are. Scholarly debates on acceptance, nutritional value, and environmental advantages of meat alternatives would benefit from a clear definition of meat alternatives. With the goal of defining meat alternatives, relevant scientific literature in the past 10 years was systematically searched and screened guided by the scoping review Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension. The initial search resulted in >100,000 hits, which was reduced to 2465 papers. Next, titles and abstracts were scrutinized using Rayyan.ai, resulting in 193 articles considered for the present review. Article screening and data extraction was performed using ATLAS.ti software. Three major themes were identified to define meat alternative products including: 1) producing and sourcing of ingredients; 2) product characteristics (that is, sensory characteristics, nutritional value, and health profile, social and environmental sustainability profile); and 3) consumer characteristics concerning the marketing and consumption context. Meat alternatives are multifaceted, that is, certain products can be considered as meat alternatives in some context, but not in another context. For any product, it is impossible to unequivocally state that it is a meat alternative. There is a lack of consensus from the diverse literature on what constitutes meat alternatives. However, products may be qualified as meat alternatives according to three key criteria as proposed in a taxonomy: 1) production and sourcing, 2) product characteristics, and/or 3) consumption. We recommend researchers (and other stakeholders) to do so as it allows for better informed future discussions of meat alternatives.

Exploring Ethical, Ecological, and Health Factors Influencing the Acceptance of Cultured Meat among Generation Y and Generation Z

Growing research and technological development is making the commercial production of cultured meat as a sustainable alternative to livestock-derived meat an increasing reality. However, to competitively position cultured meat on the food market, appropriate marketing and communication tailored to specific demographics is required. We aimed to define the motives that influence the willingness to include cultured meat in consumption based on age, specifically in Generation Z and Generation Y. To achieve this, data from a questionnaire survey that asked about ethical, ecological and health and safety factors around cultured meat was collected from 740 respondents (301 Generation Z and 439 Generation Y) and analyzed using the Mann-Whitney test and structural equation modeling. Generation Z were significantly more likely than Generation Y (p < 0.05) to consider cultured meat healthier than conventional meat because of the possibility of adjusting the composition and nutrient content. Generation Z were also significantly less concerned than Generation Y (p < 0.05) about the consequences that consuming cultured meat might have on human health. In Generation Z, ethical, ecological and health and safety factors significantly influenced their willingness to consume cultured meat (all p < 0.01). In conclusion, we confirmed the influence of ecological and ethical awareness, as well as health and safety, on willingness to include cultured meat in consumption; these areas could be targeted when marketing cultured meat.

Novel plant-based meat alternatives: Implications and opportunities for consumer nutrition and health

Against the backdrop of the global protein transition needed to remain within planetary boundaries, there is an influx of plant-based meat alternatives that seek to approximate the texture, flavor and/or nutrient profiles of conventional animal meat. These novel plant-based meat alternatives, enabled by advances in food technology, can be fundamentally different from the whole-plant foods from which they are derived. One of the reasons is the necessity to use food additives on various occasions, since consumers' acceptance of plant-based meat products primarily depends on the organoleptic properties. Consequently, a high degree of heterogeneity in formulation and nutritional profiles exists both within and between product categories of plant-based meat alternatives with unknown effects on several aspects of human health. This is further complicated by the differences in digestibility and bioavailability between proteins from animal and plant sources, which have a profound impact on colonic fermentation, nutritional adequacy and potential health effects. On the other hand, emerging strategies provide opportunities to develop affordable, delicious and nutritious plant-based meat alternatives that align with consumer interests.

Addressing Clean Label Trends in Commercial Meat Processing: Strategies, Challenges and Insights from Consumer Perspectives

BACKGROUND

The concept of a clean label is difficult to define, even in common language, as the interpretation of what a "clean" food is differs from one person to another and from one organisation to another. The lack of a unique definition and regulations of what the term "clean" means, along with the growing consumer demand for more "natural" and healthier foods, is posing new challenges for manufacturers and ingredient producers. The meat industry, in particular, has been affected by this new movement owing to negative attitudes and feelings consumers associate with consuming processed meat products. Scope and approach: The review scope is to describe attributes and associations around the "clean" label term by analysing the most recent ingredients, additives and processing methods currently available for meat manufacturers. Their application in meat, plant-based alternatives and hybrid meat/plant products, current limitations and challenges presented in consumer perception, safety and potential impacts on product quality are also presented.

KEY FINDINGS AND CONCLUSIONS

The availability of a growing number of "clean" label ingredients provides a new suite of approaches that are available for application by meat processors to help overcome some of the negative connotations associated with processed meat products and also support plant-based meat alternatives and hybrids.

Nutritional Quality and Biological Application of Mushroom Protein as a Novel Protein Alternative

PURPOSE OF REVIEW

Global concerns about population growth, economic, and nutritional transitions and health have led to the search for a low-cost protein alternative to animal origins. This review provides an overview of the viability of exploring mushroom protein as a future protein alternative considering the nutritional value, quality, digestibility, and biological benefits.

RECENT FINDINGS

Plant proteins are commonly used as alternatives to animal proteins, but the majority of them are low in quality due to a lack of one or more essential amino acids. Edible mushroom proteins usually have a complete essential amino acid profile, meet dietary requirements, and provide economic advantages over animal and plant sources. Mushroom proteins may provide health advantages by eliciting antioxidant, antitumor, angiotensin-converting enzyme (ACE), inhibitory and antimicrobial properties over animal proteins. Protein concentrates, hydrolysates, and peptides from mushrooms are being used to improve human health. Also, edible mushrooms can be used to fortify traditional food to increase protein value and functional qualities. These characteristics highlight mushroom proteins as inexpensive, high-quality proteins that can be used as a meat alternative, as pharmaceuticals, and as treatments to alleviate malnutrition. Edible mushroom proteins are high in quality, low in cost, widely available, and meet environmental and social requirements, making them suitable as sustainable alternative proteins.

Plant-Based Meat Alternatives Can Help Facilitate and Maintain a Lower Animal to Plant Protein Intake Ratio

The health and environmental advantages of plant-predominant diets will likely lead to increasing numbers of consumers reducing their reliance on animal products. Consequently, health organizations and professionals will need to provide guidance on how best to make this change. In many developed countries, nearly twice as much protein is derived from animal versus plant sources. Potential benefits could result from consuming a higher share of plant protein. Advice to consume equal amounts from each source is more likely to be embraced than advice to eschew all or most animal products. However, much of the plant protein currently consumed comes from refined grains, which is unlikely to provide the benefits associated with plant-predominant diets. In contrast, legumes provide ample amounts of protein as well other components such as fiber, resistant starch, and polyphenolics, which are collectively thougt to exert health benefits. But despite their many accolades and endorsement by the nutrition community, legumes make a negligible contribution to global protein intake, especially in developed countries. Furthermore, evidence suggests the consumption of cooked legumes will not substantially increase over the next several decades. We argue here that plant-based meat alternatives (PBMAs) made from legumes are a viable alternative, or a complement, to consuming legumes in the traditional manner. These products may be accepted by meat eaters because they can emulate the orosensory properties and functionality of the foods they are intended to replace. PBMAs can be both transition foods and maintenance foods in that they can facilitate the transition to a plant-predominant diet and make it easier to maintain. PBMAs also have a distinct advantage of being able to be fortified with shortfall nutrients in plant-predominant diets. Whether existing PBMAs provide similar health benefits as whole legumes, or can be formulated to do so, remains to be established. Adv Nutr 2023;xx:xx-xx.

Nutritional Assessment of Plant-Based Meat Alternatives: A Comparison of Nutritional Information of Plant-Based Meat Alternatives in Spanish Supermarkets

Since the classification of processed meat as carcinogenic by the International Agency for Research on Cancer (IARC) in 2015, an increase in consumption of plant-based meat alternatives (PBMAs) has been observed worldwide. This occurs in a context characterized by concern for health, animal welfare, and sustainability; however, evidence of their nutritional quality is still limited. Therefore, our objective was to evaluate the nutritional profile and processing degree of PBMAs available in Spain. In 2020, products from seven Spanish supermarkets were analyzed for their nutritional content and ingredients. Of the 148 products, the majority were low in sugars but moderate in carbohydrates, total and saturated fat, and high in salt. The main vegetable protein sources were soy (91/148) and wheat gluten (42/148). Comparatively, 43/148 contained animal protein, the most common being egg. Overall, PBMAs had a long list of ingredients and additives, and they were classified as ultra-processed foods (UPFs) according to the NOVA system. This study shows that the PBMAs available in Spanish supermarkets have a variable nutritional composition within and between categories. Further research is needed to determine if replacing meat with these UPFs could be a good alternative towards healthier and more sustainable dietary patterns.

Will cultured meat be served on Chinese tables? A study of consumer attitudes and intentions about cultured meat in China

This research investigates the attitudes and intentions of Chinese consumers about cultured "meat" (CM). We also investigate framing effects through the names used for these products ("cultured meat," "artificial meat," and "cell-based meat") and the effect of information provision. Of the 1532 consumers in our sample, most had not heard of "cultured meat" or "cell-based meat" before, although 70% had heard of "artificial meat". Around 44% of the participants indicated that they would be willing to try CM, and 32% would be likely to purchase it. Participants disliked the terms "cultured meat" and "cell-based meat" less than they disliked the term "artificial meat," although the latter was the most familiar to them. The provision of neutral information on the production process increased consumer support for CM, but the effect was limited. Prior knowledge and naming terms were strong predictors of attitudes and willingness to buy. A key implication is that stakeholders should cautiously apply framing strategies when introducing CM to the public.

Meat substitutes: Resource demands and environmental footprints

The modern food system is characterized with high environmental impact, which is in many cases associated with increased rates of animal production and overconsumption. The adoption of alternatives to meat proteins (insects, plants, mycoprotein, microalgae, cultured meat, etc.) might potentially influence the environmental impact and human health in a positive or negative way but could also trigger indirect impacts with higher consumption rates. Current review provides a condensed analysis on potential environmental impacts, resource consumption rates and unintended trade-offs associated with integration of alternative proteins in complex global food system in the form of meat substitutes. We focus on emissions of greenhouse gases, land use, non-renewable energy use and water footprint highlighted for both ingredients used for meat substitutes and ready products. The benefits and limitations of meat substitution are highlighted in relation to a weight and protein content. The analysis of the recent research literature allowed us to define issues, that require the attention of future studies.

The neglected potential of red and processed meat replacement with alternative protein sources: Simulation modelling and systematic review

BACKGROUND

What we eat is fundamental to human and planetary health, with the current global dietary transition towards increased red meat intakes and ultra-processed foods likely detrimental.

METHODS

We modelled five red and processed meat replacement scenarios to consider health, equity, greenhouse gas emissions (GHGe), and cost outcomes using an established multistate life table model using data from New Zealand as a case study of a developed, westernised country. Current red and processed meat intakes were replaced with: minimally or ultra-processed plant based meat alternatives, cellular meat, or diets in line with EAT-Lancet or Heart Foundation recommendations on red meat intake. We then conducted a systematic review of literature from database inception to 14 November 2022 to identify implemented population-level meat replacement strategies which could inform evidence-based recommendations to achieve any benefits observed in modelling. PROSPERO CRD42020200023.

FINDINGS

When compared with current red and processed meat intakes, all red and processed meat replacement scenarios were nutritionally adequate and improved overall Quality Adjusted Life Years (159-297 per 1000 people over life course for the five scenarios modelled). Age standardised per capita health gain for Māori was 1.6-2.3 times that of non-Māori. Health system cost savings were $2530-$5096 per adult, and GHGe reduced 19-35%. Finally, grocery cost varied (↓7%-↑2%) per modelled scenario when compared with baseline costs. The greatest benefits for all outcomes were achieved by meat replacement with minimally-processed plant-based foods, such as legumes. The systematic review identified only two implemented population-level strategies to reduce meat intakes within the academic literature.

INTERPRETATION

All meat replacement scenarios considered indicated appreciable health gains and GHGe reductions. Replacement with minimally-processed plant-based foods appeared consistently superior than other scenarios. Evidence of real-world population strategies to achieve these benefits however is currently lacking.

FUNDING

Healthier Lives National Science Challenge (Grant UOOX1902).

The nutritional profile of plant-based meat analogues available for sale in Australia

AIM

To assess the nutritional quality of plant-based meat analogues in Australia, compared to equivalent meat products, and to assess levels of micronutrient fortification in meat analogues.

METHODS

This cross-sectional study used nutrition composition data for products collected in 2021 from major supermarkets in Australia. Nutritional quality was assessed using the Health Star Rating, energy (kJ), protein (g), saturated fat (g), sodium (mg), total sugars (g), and fibre content (g) per 100 g, and level of food processing using the NOVA classification. Proportion of products fortified with iron, vitamin B₁₂ and zinc were reported. Differences in health star rating and nutrients between food categories were assessed using independent t-tests.

RESULTS

Seven hundred ninety products (n = 132 plant-based and n = 658 meat) across eight food categories were analysed. Meat analogues had a higher health star rating (mean 1.2 stars, [95% CI: 1.0-1.4 stars], p < 0.001), lower mean saturated fat (-2.4 g/100 g, [-2.9 to -1.8 g/100 g], p < 0.001) and sodium content (-132 mg/100 g, [-186 to -79 mg/100 g], p < 0.001), but higher total sugar content (0.7 g/100 g, [0.4-1.1 g/100 g], p < 0.001). Meat analogues and meat products had a similar proportion of ultra-processed products (84% and 89%, respectively). 12.1% of meat analogues were fortified with iron, vitamin B₁₂ and zinc.

CONCLUSION

Meat analogues generally had a higher health star rating compared with meat equivalents, however, the nutrient content varied. Most meat analogues were also ultra-processed and few are fortified with key micronutrients found in meat. More research is needed to understand the health impact of these foods.

Predicting the Textural Properties of Plant-Based Meat Analogs with Machine Learning

Plant-based meat analogs are food products that mimic the appearance, texture, and taste of real meat. The development process requires laborious experimental iterations and expert knowledge to meet consumer expectations. To address these problems, we propose a machine learning (ML)-based framework to predict the textural properties of meat analogs. We introduce the proximate compositions of the raw materials, namely protein, fat, carbohydrate, fibre, ash, and moisture, in percentages and the "targeted moisture contents" of the meat analogs as input features of the ML models, such as Ridge, XGBoost, and MLP, adopting a build-in feature selection mechanism for predicting "Hardness" and "Chewiness". We achieved a mean absolute percentage error (MAPE) of 22.9%, root mean square error (RMSE) of 10.101 for Hardness, MAPE of 14.5%, and RMSE of 6.035 for Chewiness. In addition, carbohydrates, fat and targeted moisture content are found to be the most important factors in determining textural properties. We also investigate multicollinearity among the features, linearity of the designed model, and inconsistent food compositions for validation of the experimental design. Our results have shown that ML is an effective aid in formulating plant-based meat analogs, laying out the groundwork to expediently optimize product development cycles to reduce costs.

Veganuary and the vegan sausage (t)rolls: conflict and commercial engagement in online climate-diet discourse

Social media platforms have become critical venues for a wide spectrum of influence campaigns, from activism to advertising. Sometimes these two ends overlap and it remains unknown how the latter might impact the former. Situated within contemporary scholarship on vegan activism, this work examines corporate involvement with the Veganuary 2019 campaign on Twitter, as well as the antagonistic backlash it received. We find that the activists and commercial entities engage mostly separate audiences, suggesting that commercial campaigns do little to drive interactions with Veganuary activism. We also discover strong threads of antagonism reflecting the "culture wars" surrounding discussions of veganism and climate-diet science. These findings inform our understanding of the challenges facing climate-diet discourses on social media and motivate further research into the role of commercial agents in online activism.

CRISPR/Cas technology: Opportunities for phytopathogenic viruses detection

Detection and monitoring of viruses are essential for healthy plants and prosperity. Recent development in CRISPR/Cas system in diagnosis has open an avenue well suited for pathogen detection. Variety of CRISPR associated proteins are being discovered, suggesting array of application and detection strategies in diagnosis. Phytopathogenic viruses are diverse with respect to their nucleic acid compositions, which presents a challenge in developing a single device applicable for almost all viruses. The review describes about the efficient use of CRISPR/Cas Technology in diagnosis, such as SHERLOCK, DETECTR and SATORI. These methods are different in their characteristic to identify specific nucleic acids and processing the detectable signals. These technologies are in their infancy and lot of scope is there to develop commercial kits. Plant tissue culture-based industries, climate control green houses, indoor cultivation facilities etc. has been considered as few examples. This review will be beneficial for researchers seeking to develop detection mechanism based on CRISPR/Cas technology. The outcome in the form of cost-effective detection of viruses will be boon for agro-based industries, which are facing challenges through virus contamination.

Prospects for Plant-Based Meat: Current Standing, Consumer Perceptions, and Shifting Trends

Dietary habits have a substantial influence on both planet and individual health. High intake of animal products has significant negative effects on the environment and on human health; hence, a reduction in meat consumption is necessary. The transition towards plant-based meat (PBM) is one of the potential solutions for environmental and health issues. To achieve this goal, it is important to understand the dietary habits and demands of consumers. This review was designed with a focus on PBM alternatives, dietary shifts during the COVID-19 pandemic, the drivers of consumers' perceptions in various countries, and the measures that can promote the shift towards PBM. The PBM market is predicted to grow with rising awareness, familiarity, and knowledge in the coming years. Companies must focus on the categories of anticipated benefits to aid consumers in making the switch to a diet higher in PBM alternatives if they want to win over the target market.

The Moral Pitfalls of Cultivated meat: Complementing Utilitarian Perspective with eco-republican Justice Approach

The context of accelerated climate change, environmental pollution, ecosystems depletion, loss of biodiversity and growing undernutrition has led human societies to a crossroads where food systems require transformation. New agricultural practices are being advocated in order to achieve food security and face environmental challenges. Cultivated meat has recently been considered one of the most desired alternatives by animal rights advocates because it promises to ensure nutrition for all people while dramatically reducing ecological impacts and animal suffering. It is therefore presented as one of the fairest means of food production for the coming decades, according to utilitarian arguments. However, food security, environmental concerns and animal welfarism guided by a short-term utilitarianism could have techno-optimism bias and could result in some forms of oppression such as anthropocentrism. I argue that there are still deep-rooted moral issues in food systems that are not addressed primarily by lab-grown meat, mainly derived from a loss of sovereignty. Food practices developed in high-tech labs with artificial interventionism constrain the ability of living entities (that are used as food) to flourish on their own terms. This paper aims to explore how sovereignty entitlements for humans and nonhumans are often overlooked by advocates of cultivated meat and the moral challenges it may pose. Accordingly, a more than utilitarian approach framed by ecological and republican justice is proposed here to shed light on some pitfalls of food chains based on cellular agriculture.

SWAP-MEAT Athlete (study with appetizing plant-food, meat eating alternatives trial) - investigating the impact of three different diets on recreational athletic performance: a randomized crossover trial

BACKGROUND

Plant-based diets are known to be beneficial for cardiovascular health and promote environmental sustainability. However, many athletes avoid plant-based diets due to concerns of protein inadequacy.

OBJECTIVES

To investigate the impact of two predominately plant-based diets-whole food plant-based (WFPB) and plant-based meat alternatives (PBMA)-vs. an omnivorous diet, favoring red meat and poultry (Animal), on endurance and muscular strength.

METHODS

12 recreational runners and 12 resistance trainers were assigned to three diets-WFPB, PBMA, and Animal-for 4 weeks each, in random order. Primary outcomes for runners (12-minute timed run) and resistance trainers (composite machine strength) were collected at baseline and after diets, along with secondary performance outcomes and dietary data.

RESULTS

22 recreational athletes completed the study (age: 26.2 ± 4.4 years; sex: 10 female, 12 male; BMI: 23.1 ± 2.4 kg/m2). Mean differences in 12-minute timed run - WFPB vs. Animal (- 23.4 m; 95% CI: - 107 to 60.0 m) and PBMA vs. Animal (- 2.9 m; 95% CI: - 119 to 113 m) - were not significant. Mean percent differences in composite machine strength - WFPB vs. Animal (- 2.7%; 95% CI: - 5.8 to 0.4% and PBMA vs. Animal (- 0.7%; 95% CI: - 3.5 to 2.2%) - were not significant. Average protein intake for all diets met International Society for Sports Nutrition recommendations.

CONCLUSIONS

Our findings suggest recreational athletes can maintain athletic performance on both an omnivorous diet and two diets that are predominately plant-based.

TRIAL REGISTRATION

NCT05472701. Retrospectively registered.

Food extrusion: An advanced process for innovation and novel product development

Extrusion is a versatile process capable of producing a variety of new and novel foods and ingredients, thus increasing manufacturing opportunities. Further, it could provide nutritious, safe, sustainable, and affordable foods, especially directed at individualized consumer needs. In addition to past research efforts, more investigations should be conducted in order to refine, redesign, or develop new extrusion processing technologies. The present review highlights the current advances made in new and novel food product development by considering the extrusion process, the influencing parameters, and product characteristics and properties; the most promising extrusion processes that can be used in novel food product and ingredient development, such as extrusion cooking, hot-melt extrusion, reactive extrusion, and extrusion-based 3D printing; the possibilities of using various raw materials in relation to process and product development; and the needs for product development modeling along with extrusion process design and modeling. In correlation with extruded product development, topics that merit further investigation may include structure formation, plant and animal biopolymers functionalization, biopolymer reactions, process simulation, modeling and control, engineering and mechanical aspects of extruders, analysis of pre-processing treatments, as well as prototyping, risk analysis, safety, sensory and consumer acceptance.

A systematic scoping review of the sustainability of vertical farming, plant-based alternatives, food delivery services and blockchain in food systems

Food system technologies (FSTs) are being developed to accelerate the transformation towards sustainable food systems. Here we conducted a systematic scoping review that accounts for multiple dimensions of sustainability to describe the extent, range and nature of peer-reviewed literature that assesses the sustainability performance of four FSTs: plant-based alternatives, vertical farming, food deliveries and blockchain technology. Included literature had a dominant focus on environmental sustainability and less on public health and socio-economic sustainability. Gaps in the literature include empirical assessments on the sustainability of blockchain technology, plant-based seafood alternatives, public health consequences of food deliveries and socio-economic consequences of vertical farming. The development of a holistic sustainability assessment framework that demonstrates the impact of deploying FSTs is needed to guide investments in and the development of sustainable food innovation.

Framing the futures of animal-free dairy: Using focus groups to explore early-adopter perceptions of the precision fermentation process

This paper reports on the findings from a series of virtual focus groups that explored consumer perceptions of animal-free dairy (AFD), an emerging type of animal product alternative produced using the tools of synthetic biology and precision fermentation. Focus group participants came from an international sample of potential "early adopters." To stimulate conversation, participants were presented with a series of visual "moodboards" that framed key arguments both in favor of and in opposition to AFD. Three primary thematic clusters emerged from the discussion. The first focused on issues of "process, safety, and regulation," centered on the general reaction of participants to the concept of AFD, their primary concerns, key questions, and the assurances they would need in order to support its advancement. The second focused on issues of "consumer preferences and priorities," highlighted by the often complicated, and sometimes outright contradictory, stated consumer interests of the participants. The third focused on issues of "food technology and the future," wherein participants expressed broader views on the role of food technology in society, generally speaking, and the potential futures of AFD, specifically. The general consensus among participants was a cautious openness to the idea of AFD. Outright opposition to the concept was rare, but so too was unabashed enthusiasm. Instead, respondents had a number of questions about the nature of the technological process, its overall safety and regulatory standards, its potential contributions to individual health and climate change mitigation, as well as its organoleptic qualities and price to consumers. Among the positive frames, claims about animal welfare were deemed the most pertinent and convincing. Among the negative frames, concerns about messing with nature and creating potential health risks to individuals were seen as the strongest arguments against AFD. The findings suggest that the key to AFD's future as a viable market option will depend in large part on the extent to which it can clearly demonstrate that it is preferable to conventional dairy or its plant-based competitors, particularly in the arena of taste, but also across considerations of health and safety, nutrition, environmental effects, and animal well-being.

Cultured Meat on the Social Network Twitter: Clean, Future and Sustainable Meats

The rapid development of technologies for cultured meat production has led to new challenges for producers regarding appropriate communication with future customers in order to deliver products to a viable market. Communication analysis of social media enables the identification of the key characteristics of the monitored topic, as well as the main areas of communication by individual users based on active digital footprints. This study aimed to identify the key characteristics of cultured meat based on communication analysis of the social network Twitter. Communication analysis was performed based on 36,356 Tweets posted by 4128 individual users. This analysis identified the following main communicated characteristics: clean meat, future meat, and sustainable meat. Latent Dittrich allocation identified five communication topics: (1) clean and sustainable products, (2) comparisons with plant-based protein and the impact on agribusiness, (3) positive environmental aspects, (4) cultured meat as an alternative protein, and (5) the regulation of cultured meat.

Using Regulatory Stances to See All the Commercial Determinants of Health

Policy Points The commercial determinants of health (CDoH) concept, which currently focuses on markets that harm health, should be expanded to refer to the interface between commerce and health, which can sometimes have positive public health consequences. The regulatory stances framework helps us classify public health preferences for regulating specific markets related to CDoH, based on the intended effects of regulations on market size. The regulatory stances a jurisdiction can adopt can be classified as ranging from prohibitionist through contractionist, permissive, and expansionist, to universalist. The regulatory stances framework increases the usefulness of the CDoH concept by expanding the conversation beyond negative determinants of health and providing a fuller view of the tools at the disposal of society to alter markets and improve health.

CONTEXT

The effects of commerce on the public health are omnipresent. The commercial determinants of health (CDoH) represent a burgeoning area of scholarly debate and activist policymaking to redress markets that adversely affect public health. The CDoH debate is a logical extension of the tobacco control movement, but, to its detriment, the CDoH conversation remains primarily focused policies and proposals that are analogous to historical tobacco control strategies.

METHODS

This paper argues that for the CDoH to develop further and broaden its appeal, it should expand to cover markets with conditional and positive impacts on health. To explain and order this conversation, a comparative framework for regulatory policy is introduced: the regulatory stances. The regulatory stances classify a regulatory policy based on the intended effect of policy on the size of a market in the future relative to the present.

FINDINGS

Some markets that interface between commerce and health do not inherently harm health. Regulatory policy toward these markets should be different in intent than regulatory policy for markets with negative health effects.

CONCLUSIONS

By using the regulatory stances framework to encompass markets that have positive or conditional effects on health as well as those that have adverse health effects, the CDoH conversation can shift away from the exclusive focus on strategies to shrink markets with adverse health impacts to consider a wider array of policy options.