Personalization, plant-based protein and COVID-19: Clinical nutrition experts discuss challenges driving innovation

09 Jun 2021 --- As the COVID-19 pandemic continues to severely impact many regions of the world, suppliers highlight that clinical nutrition is more important than ever before.

Delivering the proper nutrients to hospital patients, vulnerable people with comorbidities and consumers following strict diets continues to challenge industry. This, combined with increasingly elderly populations, brings discussions of delivery formats, ingredients and diversification in clinical nutrition to the fore. 

NutritionInsight speaks with experts from Kerry, FrieslandCampina Ingredients and Lactalis Ingredients about how this segment has developed over the past year and what innovations will shape the future.

“If anything, COVID-19 has taught us that being reactionary isn’t enough. Young or old, with existing health conditions or not, we must be proactive in protecting our health through nutrition and exercise. Changing eating habits and routines can have a lasting effect now and post-pandemic,” says Renata Soliva, global marketing manager, medical nutrition, FrieslandCampina Ingredients.

The emergence of “long COVID” has compounded patient compliance problems with clinical nutrition.Personalization in focus
Soliva explains that while nutrition has long been recognized as essential in aiding people with illnesses, lessons regarding the specificity and importance of individualization have arisen during the pandemic. 

“There is no one-size-fits-all approach for nutritional needs; they vary from person to person and change depending on our lifestyles, age, health conditions and many other factors.” 

When done well, good nutrition can address specific health issues like heart-healthy nutrients for people worried about coronary disease, or low-sugar alternatives for people at risk of Type 2 diabetes (T2D).

Innova Market Insights pegged “Tailored to Fit” as a top trend for 2021, noting that technological innovations are set to revolutionize individuality in the nutrition market.

Soliva moreover emphasizes that driving a personalized approach to clinical nutrition is essential for policymakers and governments. 

“Keeping people healthy at home reduces the financial burden on governments and healthcare systems and insurers – and improves the quality of life.”

Intensive care and long COVID
One of the most critical areas of the clinical nutrition market throughout the pandemic has been delivering the right nutrients to hospital patients, particularly those in intensive care units (ICU), explains Melissa Sheridan, strategic marketing director, applied health and nutrition, Kerry. 

“With COVID-19, many patients were admitted to the ICU, which impacted the capacity of patients to feed themselves. Clinical nutrition products such as tube feeding solutions are essential to support patients nutritionally during these difficult times, and oral nutrition solutions play an important role with patients during and after recovery.”Creating protein supplements for vegan patients presents particular problems for taste and texture.

However, delivering oral solutions raises its own set of complications, with many patients requiring long-term dietary plans to overcome the lasting impacts of COVID-19 symptoms. 

“While many people who contract COVID-19 get better within weeks, some experience symptoms for months after the infection has passed. These symptoms, sometimes referred to as ‘long COVID,’ feature a wide range of new, returning or ongoing health problems such as fatigue, loss of strength and muscle mass,” says Soliva. 

The problem with patient compliance 
Sheridan explains that this has raised difficulties in getting consumers to take the right supplements and follow correct diets during illness and recovery since the duration of clinical diets must be extended. 

“One of the biggest challenges in clinical nutrition, especially in oral nutrition, is patient’s compliance. Clinical nutrition solutions – especially beverages – can be challenging with taste, texture and volume as their protein content is very high,” she emphasizes. 

“Patients might start the treatment but won’t follow through until the end as these solutions can be very thick, with high volumes up to 300 mL several times per day. Moreover, taste is also one of the features patients are calling out as challenging with these solutions.”

Protein and diversification 
Elodie Macariou, senior product manager at Lactalis Ingredients, explains that one of the most important issues in facing these challenges is increasing the protein content of oral supplements once patients are out of the ICU. 

“Industry players are looking to fight undernutrition through appropriate nutritional management. This includes increasing the protein content of oral nutritional supplements. At the same time, they must also meet consumers’ expectations for appetizing products. It is indeed essential to improve compliance.” 

Achieving a PDCAAS score of 1 with plant proteins is a challenge Kerry says it has accomplished.“However, increasing the protein content beyond 10 percent while offering palatable products with the right texture and taste is a real technical challenge. This is why we have developed Pronativ – Native Micellar Casein. 

Thanks to its micellar casein content of 90 percent compared to 80 percent in a classic milk protein, this protein has a low viscosity. Therefore, it is possible to obtain more nutritionally dense drinks without compromising the organoleptic quality.

Sheridan emphasizes that diversification is another important technique in raising patient compliance, particularly by expanding the pool of texture and taste formats. 

“Huge advancements in protein processing technologies have opened the door for innovation in protein-fortified food and beverages. Possibilities for new formats include waters, gels, soups, bakery, coffee and ice cream,” she says. 

Plant-based problems 
A compounding obstacle with patient compliance is the rising prevalence of vegan or plant-based diets, which can make supplementation – particularly with protein – difficult to make palatable. 

With consumers increasingly moving toward plant-based diets, the clinical nutrition segment will also be impacted. Today, most clinical nutrition products are dairy-based, and clinical nutrition manufacturers will have to develop plant-based solutions to meet this consumer need, asserts Sheridan. 

Plant protein is more challenging than dairy protein in terms of taste and texture, she explains, especially with high-protein content such as clinical nutrition solutions. 

“The nutritional profile of some plant proteins can also be challenging as plant proteins don’t have a complete nutritional profile with a Protein Digestibility Corrected Amino-Acid Score (PDCAAS) of 1.” 

“Plant protein ingredients optimized for taste, texture and nutrition will be essential to develop clinical nutrition solutions that meet their dairy-based equivalents. Kerry’s solution ProDiem Complete is a plant protein solution that was developed to solve the challenges of taste, texture and nutrition with plant protein.”

With Kerry’s proprietary processing technology, flavor-masking technology and combination of different protein sources such as pea and rice or pea and sunflower, the company offers plant protein solutions that are optimized for taste, texture and nutrition with a PDCAAS up to 1 – just like milk protein.

US-based Kate Farm’s uses organic hydrolyzed pea protein for its plant-based clinical nutrition shakes and tube feeding formulas, addressing the demand for vegan and allergen-free clinical nutrition. 

By Louis Gore-Langton