Journal Club 2

Question 1

What was the study looked at?

Answer 1

A dietary intervention with mycoprotein-containing food products on the serum cholesterol concentrations

(Pavis et al, 2024)

Question 2

What is mycoprotein?

Answer 2

A high protein, high fibre food source produced by the continuous fermentation of the fungus Fusarium Venenatum

• its a complete protein source (contains all 9 essential amino acids)

Question 3

What is biomass fermentations?

Answer 3

Uses the rapid growth of some protein-rich microorganisms to make large amounts of protein

Question 4

Why was this research / study conducted?

Answer 4

1. CVD prevalence - leading global cause of mortality with modifiable risk factors
2. Need for dietary substitutions - easy to implement dietary changes are required to improve CMRF
3. Mycoprotein potential - is a high protein, high fibre food source (shown to lower cholesterol)
4. Translation to real world - study assesses feasibility of 4-week, home-based mycoprotein intervention

Question 5

What was the hypothesis?

Answer 5

The provision of 4 weeks of daily mycoprotein-containing meat-replacement products consumed at home by individuals with a high BMI + hypercholesterolaemia would reduce circulating cholesterol, glucose, c-peptide conc comapred to provision of daily meat + fish

Question 6

What was the study setting?

Answer 6

A home-based dietary intervention

• each week, participants received a home delivery of foods from supermarket + required to provide finger-tip blood samples and send back to lab

Question 7

What was the eligibility criteria + any exclusion criteria?

Age, BMI etc

Answer 7

Age - 18-70 yrs
BMI - greater than 27.5 kg.m2
Omnivores

Exclusion…
1. Medication - using cholesterol-lowering medication
2. Intention to lose or gain weight during intervention
3. Dietary restrictions - allergies / intolerances to penicillin / mycoprotein

Question 8

What was the study design?

Answer 8

A 4 week paralle-group RCT comparing meat/fish control products to mycoprotein-containing food products

Question 9

What were the primary + secondary outcomes?

Answer 9

Primary - total cholesterol concentrations

Secondary - concentrations of LDL-c, HDL-c + triglycerides as well as conc of glucos and C-peptide

Question 10

When were the outcomes measured (in what state)

Answer 10

Post absorptive state (fasted) and postprandial state (3h following habitual breakfast)

Question 11

Describe the dietary intervention in more detail

Answer 11

Mycoprotein group - Quorn foods products with daily targets of…

• 180g mycoprotein foods for 60-80kg (150g <60kg and 210 >80kg)

Meat + fish group - matched protein intake with meat / fish products

• 27g (<60kg), 32g (60-80kg) and 37g (>80kg)

Question 12

What instructions did the participants receive?

Answer 12

1. Must consume all provided foods + maintain body mass to minimise weight change effects
2. Continue usual diet and PA outside of intervention

Question 13

What level of processing were the foods in the mycoprotein diet and control diet according to the NOVA classification scheme?

Answer 13

Mycoprotein - ultra-processed foods (group 4) as contained firming agents + flavourings

Control group - range from ultra-processed (ready meals) to minimally processed (cod fillet)

Question 14

What are the UK recommendations of total cholesterol and LDL cholesterol levels in the blood?

Answer 14

TC - below 5 mmol/L

LDL-cholesterol - below 3 mmol/l

Question 15

RESULTS

Were the groups comparable at baseline / pre-intervention?

Answer 15

Yes - the groups were similar at baseline

• BMI - 33 in CON vs 32 in MYC
• TC - participants had, on avg, mild hypercholesterolaemia (only just above UK recommendations)

Question 16

RESULTS

Were there differences between the 2 groups in terms of energy + macronutrient consumption?

Answer 16

MYC group had significantly higher fibre intake due to the mycoprotein products, CON group remained unchanged

Question 17

RESULTS

Were there differences in blood cholesterol profile?

Answer 17

The reduction in total + LDL cholesterol was greater in MYC than CON group

• MYC group - mean decrease of 0.3mmol/l in TC + LDL
• CON group - almost no change

Question 18

RESULTS

Were there differences in fasting blood glucose concentrations?

Answer 18

CON group - fasting glucose levels increased pre-to-post intervention

MYC group - levels remained relatively stable

• as a result, fasting glucose concentrations were lower in MYC group compared to CON after intervention (3.7 vs 4.3mmol/L)

Question 19

RESULTS

Were there differences in postprandial blood glucose concentrations?

Answer 19

Blood glucose levels were higher after meals (postprandial) compared to fasting, but the meal-related response was not affected by the group

Question 20

What did the author conclude from these results?

Answer 20

• the study showed a successful translation of tightly controlled nutritional intervention to a dietary intervention people can adopt remotely
• intervening with mycoprotein-containing food is feasible + effective in reducing circulating cholesterol, blood glucose and c-peptide conc in adults with risk of CVD

Question 21

What were the main limitations?

Answer 21

1. Short duration - 4 week intervention limits long term effects + sustainability
2. Self-reported data - may introduce potential reporting bias
3. Blood sampling method - sampling variability + transit delays could affect results
4. Pop. selection - a BMI >27.5 assumed high cholesterol but lack of screening limits generalisability to patients with established hypercholesterolemia

Question 21

What were some key strengths to the research?

Answer 21

1. Real world application - free-living setting which improves ecological validity + shows feasibility
2. Remove + innovative approach -postal blood-spot sampling + virtual follow-ups
3. Dietary adherence - weekly virtual follow-ups + food tailored to needs supported adherence
4. Mycoprotein is more sustainable than meat + fish