“Nourishing 9 Billion People by 2050: Exploring the Role of Alternative Proteins in Low- and Middle-Income Countries” – A Current Developments in Nutrition Supplement Examination

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“Undernutrition remains a major public health issue in low- and middle-income countries, particularly as it relates to protein intake,” according to An Introduction to Traditional and Novel Alternative Proteins for Low- and Middle-Income Countries, which sets the stage for the recently published nine-part Current Developments in Nutrition Supplement, Nourishing 9 Billion People by 2050: The Role of Alternative Proteins in Low- and Middle-Income Countries.  ASN member Jacquelyn R. Bedsaul-Fryer et al., authors of the introduction, note that diets in low- and middle-income countries are typically composed mainly of cereals and legumes, resulting in a much lower total protein intake compared to high-income countries.  While scaling up animal protein production in low- and middle-income countries may improve protein intake, it will further exacerbate climate change.

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Alternatives to animal proteins, on the other hand, have the potential for positive impact on both people and the planet.  Currently, however, novel alternative protein products are considered premium items that carry prices that are unaffordable to many people in low- and middle-income countries today.  Moreover, local and culturally appropriate alternative protein sources have not been fully leveraged as sustainable and affordable solutions.

Sources of protein for human food consumption. Both animal (orange line) and nonanimal (green line) sources of protein are used to generate alternative proteins (red symbol). Derivatives (gray line) include hybrid protein alternatives such as plant- and animal-based products. Fermented foods are derivatives of both animal and nonanimal sources of protein and utilize microbes such as yeasts. The processing levels required to generate the diverse protein products are considered: unprocessed or minimally processed (blue fill) and processed or ultraprocessed (yellow fill).

Current Developments in Nutrition 2024 8DOI: (10.1016/j.cdnut.2023.102014)

This Current Developments in Nutrition Supplement consists of Perspectives and Reviews that examine how traditional and novel alternative proteins can be harnessed to provide sufficient protein intake for all populations in low- and middle-income countries. Following is a brief introduction to each article:

Suitability of Alternative Protein Foods for Agroecological Approaches to Address Nutrition in Low- and Middle-Income Countries

Agroecology, which emphasizes ecological principles, local knowledge, and traditions to increase food sustainability and equity, has been proposed as a holistic approach to transform food systems to meet global food requirements with favorable environmental and social impacts.  In this Perspective, Molly Gordon et al. apply agroecological principles to assess the suitability of different alternative protein sources in low and middle-income countries.  Based on their analysis, the authors believe that “legumes, simplified plant-based meat analogues, edible insects, and macroalgae would make excellent nutritional contributions alongside animal-sourced food within low- and middle-income countries.”  In contrast, they noted, “highly processed plant-based meats, fungal biomass, and cultivated meat do not align well with agroecological principles for large-scale human consumption.”

Alternative Proteins in Low- and Middle-Income Countries Face Questionable Future: Will Technology Negate Bennett’s Law?

Bennet’s law posits that rising incomes across low-and middle-income countries shift consumers away from starchy staples, creating a growing demand for high-quality animal protein.  There are, however, concerns that the resource-intensive nature of livestock production cannot meet the growing global demand for high-quality protein.  In response, some high-income countries have made major investments in the production of pulse crops, which can be converted into alternative proteins for export to low- and middle-income countries.  Author and ASN member Adam Drewnowski argues that regardless of current efforts to replace animal proteins with manufactured plant-based foods, it is likely that Bennett’s law will prevail.  Moreover, “it may take decades for low- and middle-income countries to reach the peak meat consumption that is currently the privilege of some countries that are farther along the economic scale.”

Generating Demand for Alternative Protein in Low- and Middle- Income Countries: Opportunities & Experiences from Nutritious and Sustainable Market Solutions

The projected growth of the alternative protein industry may be able to meet the growing demand for protein in low- and middle-income countries while also satisfying environmental sustainability and ethical standards.  However, Norah Sadowski et al. point out that “adoption of alternative protein products over traditional animal-sourced proteins is not always a clear choice, with factors such as consumer preferences and habitual behaviors influencing consumer decisions.”  Findings from three case studies—OBAASIMA Project in Ghana, Egg Initiative in Ethiopia, and World Food Programme Farming Coalition in Armenia—offer insights into effectively generating demand for alternative proteins.  In particular, the authors believe these case studies underscore “the importance of local sourcing, positive messaging, and integration within existing diets and behaviors.”

Policy Insights from High-Income Countries to Guide Safe, Nutritious, and Sustainable Alternative Proteins for Low- and Middle-Income Countries

This Perspective examines how policy insights from high-income countries shed light on how alternative proteins can support healthy sustainable diets and food systems in low- and middle-income countries.  In particular, ASN member Vivica Kraak et al. explore how these insights may help guide alternative protein development, formulation, processing, labelling, marketing and regulation that align with sustainable healthy diets.  Moreover, the authors discuss how policy insights from high-income countries “may facilitate the acceptability and affordability of next-generation alternative protein ingredients and products to meet the needs of culturally diverse low- and middle-income populations.”  Finally, the authors argue for a new food categorization taxonomy to guide alternative protein product recommendations.

What Is the Likely Impact of Alternative Proteins on Diet Quality, Health, and the Environment in Low- and Middle-Income Countries

Accurately assessing the environmental and nutritional impacts of alternative proteins in low- and middle-income countries is essential for informing policy.  In response, this Perspective examines current environmental and nutritional metrics, highlighting research gaps and proposing new metrics to gain a better understanding of how alternative proteins can be best leveraged.  Mansha Kapur et al. note that many environmental and nutritional metrics were developed for application in high-income countries.  As a result, “metrics addressing diverse contextual synergies in low- and middle-income countries, unifying nutritional, environmental and socioeconomic considerations, were found necessary to guide the integration of alternative proteins into low- and middle-income country diets.”

Local Sources of Protein in Low- and Middle-Income Countries: How to Improve the Protein Quality?

Nitya Vissamsetti et al. explore how small- and large-scale processing techniques that enhance protein bioavailability and digestibility of plant proteins can address malnutrition in low- and middle-income countries.  Small-scale food processing techniques such as soaking, cooking, and germination can be implemented at home.  On the other hand, large-scale processing techniques such as autoclaving and extrusion must be implemented on an industrial level.  The authors point out that both small- and large-scale processing raise concerns: small-scale processing can lead to loss of nutrients and contamination, while large-scale processing entails high energy requirements, costs, and safety considerations. The authors believe that “combining these small- and large-scale approaches could improve the quality of local sources of proteins, and thereby address adverse health outcomes, particularly in vulnerable population groups.”

Current and Future Market Opportunities for Alternative Proteins in Low- and Middle-Income Countries

Although alternative protein startups and investors focus on high-income countries, ASN member Resham Talwar et al. see a growing market opportunity for alternative proteins in low- and middle-income countries as a result of increasing incomes, urbanization, and market expansion.  In response, the authors evaluated current global alternative protein market trends and factors influencing consumer demand.  In particular, the risks, challenges, and strategies needed to develop and expand the market for alternative proteins in low- and middle-income countries were addressed.  According to the authors, “the expansion and adoption of alternative proteins in low- and middle-income countries could present a promising solution to nourish the world’s growing population while mitigating the global food and environmental crisis.”

What Technological and Economic Elements Must Be Addressed to Support the Affordability, Accessibility, and Desirability of Alternative Proteins in LMIC

Katrin Gradl et al. assess the technological, economic, and social tools needed to effectively develop and leverage diverse alternative dietary proteins, including plant-based proteins, mycoproteins and cultivated meat, in order to mitigate protein deficiency in low- and middle-income countries.  The authors note that “consumer awareness, acceptance and large-scale production of cultivated meat remains a challenge in low- and middle-income countries and high-income countries alike.”  They therefore believe that “due to low production costs, existing infrastructure, and consumer acceptance, plant-based proteins like soy may currently be the most attractive alternative protein to support protein intake.”  Overall, the authors believe that “investments in infrastructure and innovation are urgently needed to offer diverse sources of protein in low- and middle-income countries.”

Can the development of alternative proteins close major nutritional gaps at an affordable price while mitigating climate change?  According to the authors of this Supplement’s introduction, “this work represents a step toward acknowledging this possibility and analyzing the necessary considerations for low- and middle-income countries.”