Taste and digestibility in the spotlight for clinical nutrition

03 Jun 2020 --- The right delivery of critical nutrients in an appealing format is crucial in clinical nutrition. While protein has been underscored for its importance in maintaining muscle in hospital patients, formulation with the macronutrient has its challenges. In addition, digestibility is a key concern in clinical nutrition both for infants and older consumers. Highlighting ways to tackle these challenges, NutritionInsight speaks to key suppliers about their ongoing research and development in delivering the right nutrition to patients and optimizing digestibility in dairy products.

“There is a clear priority in improving the taste, texture, formats and general variety of clinical nutrition products. Different illnesses and medications cause a decline in appetite, which can lead to patients not finishing their prescribed supplements,” says Rebecca Cuthbertson, Global Head of Marketing, Medical Nutrition NZMP.

For patients who have lost their gusto for eating, suppliers point to great taste as a vital aspect of promoting proper nutrition. “High-quality raw materials, taste and other sensory elements should always be a starting point for creating new products, even for special diets,” notes Tuula Tuure, Senior Scientist at Valio. “Also, combining different consumer benefits, such as indulgence, convenience, health and well-being, can be appealing to people with dietary needs,” she adds.

Protein: “Key to recovery”
Protein is a key component in clinical nutrition, as recovery from treatment or surgical procedures requires the body to rebuild and repair, necessitating adequate amounts of daily protein, according to Mindy Leveille, Global Strategic Marketing Manager of Proteins at Kerry Taste & Nutrition.

“Protein is critical for clinical nutrition diets, therefore it is important to ensure the consumer receives adequate protein each day. Solutions in taste, flavors, sweeteners, nutritional fortification, off-note masking ingredients and plant and dairy proteins can assist product developers in the clinical nutrition area. This is by developing tasty, highly nutritious products that reach clinical goals for patient care and recovery,” says Leveille.

Loss of appetite can lead to a deficiency in necessary nutrients in consumers with special dietary needs.The need for protein in a hospital setting was recently underscored by Nutricia, part of Danone. Estimates from the company note that ICU patients can lose as much as a kilogram of muscle mass per day, and so an elongated stay can result in severe depletion of muscle mass, strength and resilience. Therefore, there is a need for nutrition products enriched with calories and proteins, to help patients regain lost weight and strength after recovering from a serious illness, notes Nutricia.

However, many of these products that have high protein content have historically been challenging to formulate with in terms of taste and texture. This has limited its reach into powder and ready-to-drink beverages, observes Leveille.

Processing proteins can be a source of off-notes, she adds. “Some manufacturing processes require high temperatures to denature the protein and reduce its solubility, a strategy aimed at allowing easier separation from the other components of the raw material. Not only does this heat treatment impact functionality, but it can also significantly affect taste. Taste-masking techniques can help address such challenges, such as through the addition of bitterness inhibitors, either singly or in combination with other flavor or sweetener components,” Leveille further explains.

“Advancements in protein-processing and flavor-masking technologies, however, now enable diversification into many new protein applications, driven by a new ability to modulate taste, texture and flavor while delivering higher functionality across many different food and beverage applications. As a result, there is emerging room in the category for innovation – things like puree pouches, bakery, juices and soups,” she adds.

Supplementation with modular protein is another way to up the protein in a targeted format. Cuthbertson notes that brands are investing in extending their ranges to include gels, jellies, syrups, and fresh flavored waters and juices with modular protein.

“With heat-stable, acid-stable proteins and stable final formulations, beverages can be easily incorporated into a patient’s comfort food to provide an enjoyable, enriched snack or meal. Ensuring low viscosity beverage products with a clean taste and texture, which are easily incorporated into other foods is a key way to improving patient adherence and enjoyment while supporting their recovery with great nutrition,” adds Cuthbertson.

“Clinical nutrition must be ‘compromise-free’ in the eyes of the consumer,” adds Cuthbertson. This includes having good taste and texture, easy-to-open packaging, scientific claims and comfortable digestion.

Gentle digestion in focus
While flavor and texture can encourage patients to continue a routine of important nutrition, digestibility and compatibility with the patient will determine if the product is suitable or not.

Suppliers of dairy ingredients are continuing to do research in the field of more digestible products. At Kerry Ingredients, the company’s casein protein fraction Ultranor Beta Kappa+ was shown to be more digestible than both the commercial α-casein and sodium caseinate samples on the market. The findings were based on in vitro studies undertaken at the NIZO food research center.

Lactose-free infant formula may provide more digestive comfort.Moreover, Anu Turpeinen, Nutrition Research Manager at Valio, notes that gut comfort is an increasing area in infant milk formula. “In Asia, in particular, there are also more lactose-free products in the infant formula sector.

“Infant digestive discomfort is a concern for many parents across the globe, and ‘comfort’ formulas offer easy-to-digest proteins that support an infant’s growth and development; globally, 25 percent of infant formulas launched in 2019 had comfort/digestive aid communications on the package. The journey of ‘comfort’ formula products began with lactose reduction and has now evolved to include advanced innovative solutions that offer better digestibility and high-quality nutrition,” notes Leveille.

For infants who have sensitivities to cow milk protein, Leveille explains that allergen-free plant proteins such as those from pea and rice are growing rapidly in the infant nutrition category. “Product developers are now using organic hypoallergenic rice or soy protein as a plant-based solution to cow milk. Hypo-allergenicity (or non-allergenic) is invaluable for this highly sensitive market.

Innovation in lactose-free products goes beyond infants to also target better digestibility in adults and seniors. Valio reports that there is significant potential in lactose-free products, which may be more valuable than is currently understood in the area of inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS). There is new evidence that partially hydrolyzed proteins can decrease gastrointestinal symptoms,” states Turpeinen.

In line with its findings, Valio has introduced Valio Eila NUTRI F+ lactose-free formulated milk protein powder for aging nutrition. The product is positioned to fulfill the key needs of older adults in terms of essential nutrients and maintaining cognitive and physical functioning.

The Finnish dairy manufacturer further reports that clinical studies demonstrate that milk fat globule membrane (MFGM) affects gut well-being, as well as having an impact on cognitive development and immune function. Its list of beneficial attributes expands MFGM’s traditional place in infant formula out to healthy aging and functional food applications.

“The health benefits of phospholipids located on the MFGM have raised great interest among food industry professionals. Dairy fat contains phospholipids that, according to research, are associated with positive effects on brain function in those with mild memory impairment,” adds Turpeinen.

Clinical nutrition is a space to watch as healthcare systems are in the spotlight during the current global health crisis. Flavors, formats and variety provide ample room for creativity from ingredient suppliers, while focus on the right nutrient intake and increased digestibility will have an important functional role.

By Missy Green