Plant-based Beverages Research Articles

Effects of a Cyperus esculentus L. plant-based beverage on FVB/n female mice

This work evaluated the effects of the consumption of a plant-based beverage (Cyperus esculentus L., Adansonia digitata L., and thermal water) on the physiological parameters of mice over a 28-day period. Thirty-two female FVB/n mice (n = 8) were randomly assigned to one of four groups divided into two experimental protocols: Group 1 drank water and Group 2 drank a plant-based beverage for 24 hours; in the second experimental protocol, Group 3 consumed water and Group 4 consumed plant-based beverage for a limited time (4 hours). Two experimental protocols were conducted to assess whether the exposure time to the beverage affects the animals' physiological parameters, to determine if there is a possible daily limit for consumption of the product and to analyze their adverse effects. The mice consuming a beverage ingested a larger amount of drink and a smaller amount of food. Histologically there are no pathological changes in collected organs. The consumption of a plant-based beverage has been shown to have a positive effect on oxidative markers and can have a diuretic action. According to results, no behavioral changes or clinical signs of disease were observed throughout both experimental protocols, and no mortality was recorded.

Selenium micro-encapsulation: Innovative strategies for supplementing plant-based beverages

Selenium micro-encapsulation: Innovative strategies for supplementing plant-based beverages

Development of plant-based yogurt from munguba (Pachira aquatica) seeds: Stability and predictive growth of lactic acid cultures

Lactic fermentation is employed to enhance the nutritional quality of plant-based milks, and exploring underutilized plant matrices like munguba (Pachira aquatica) can bring innovation to the plant-based beverage market. This study aimed to develop a yogurt from munguba seeds and investigate the fermentation kinetics of lactic acid bacteria (LAB), as well as the product's stability during storage. Munguba seed milk was prepared through cleaning, peeling, blanching, blending, filtering, and storing at 5 °C. Fermentation was conducted with Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Lactobacillus fermentum at 36 °C, and microbial growth was monitored to construct a LAB growth curve. Ultra High Temperature (UHT) whole cow's milk was used for comparison. Munguba seed milk fermented for 9 h showed LAB growth from 3.89 to 8.22 log CFU/mL, while UHT cow's milk fermented for 6 h showed LAB growth from 4.55 to 6.33 log CFU/mL. The Baranyi model showed good fits for both data sets (R2 of 0.9528 for munguba milk and 0.9340 for UHT milk). Specific growth rates, doubling times, and multiplication rates were higher for munguba milk (μ of 1.10 h^-1, td of 0.66 h, MR of 1.59 h^-1) compared to UHT milk (μ of 0.85 h^-1, td of 0.84 h, MR of 1.22 h^-1). LAB, mold, and yeast counts, pH, and lactic acid content remained stable over 31 days of refrigerated storage of munguba seed yogurt. These results indicate that munguba seed milk is a promising substrate for fermented beverages and beneficial microorganisms.

Association between food security status and dietary patterns in a cohort of first-time food-aid users.

To examine the associations between food security status and dietary patterns among first-time food-aid users. From September 2018 to January 2020, a sample of 1001 newly registered food-aid users from 106 community-based food donation organizations were recruited across urban, rural, and peri-urban areas in four administrative regions of the province of Quebec, Canada. The Household Food Security Survey Module (HFSSM) and the Short Diet Questionnaire (SDQ) were used to assess food security status and food intake, respectively. A posteriori dietary patterns were identified through principal component analysis. Regression analyses were performed on 987 participants with complete data to quantify the association between food security status and dietary patterns. Three main dietary patterns were identified: prudent (intake of fruits and fruit juice, plant-based beverages and legumes, green salad, carrots, other vegetables, whole grains, and fish), western (intake of poultry, red meat, potatoes and fried potatoes, rice, and pasta and refined grains), and snack foods (intake of salty snacks, cheese, butter and margarine, sweets, condiments, sweet beverages, and processed meat). Food insecurity was negatively associated with the prudent dietary pattern and positively associated with the snackfood dietary pattern. This study highlights the complexity of dietary patterns in a vulnerable population of first-time food-aid users, especially among those who are severely food insecure.

Plant-Based Beverages: Consumption Habits, Perception and Knowledge on a Sample of Portuguese Citizens.

Plant-based beverages (PBB) consumption has increased significantly worldwide due to an interest in vegetarian/vegan diets, taste preferences, health and ethical and environmental issues. Therefore, this study intends to investigate consumption habits, consumer preferences and consumers' level of knowledge about PBB. In this study, a voluntary, anonymous questionnaire survey was applied to a sample of participants from Portugal. The sample was recruited by convenience, and therefore, the distribution among the groups was not even. Data analysis involved different statistical techniques: basic statistics, chi-square tests, factor analysis, cluster analysis and tree classification analysis. The results indicated that the most consumed PBB were almond, soy and oat beverages. The majority of consumers chose these beverages for nutritional and health reasons, while a smaller number consumed them as part of a vegetarian or vegan diet. The main motivations for consuming PBB are mainly associated with sustainability and health benefits. The results regarding the respondents' knowledge about PBB revealed that a health-related profession was the most significant predictor. These results allowed us to conclude that the factors of nutrition, health, ethics and practice of a vegetarian/vegan diet influence the consumption of PBB. It was also concluded that being in a healthcare profession, along with age and professional status within this field, were significant factors influencing the level of knowledge about PBB.

Binding mechanism and structural characteristics of alloyed protein complex for enhanced solubility of hemp seed protein isolate

Despite the numerous health benefits and high digestibility of hemp seed protein isolate (HPI), its low solubility at neutral pH limits its utilization in the food industry. Therefore, we subjected insoluble HPI and soluble mung bean protein isolate (MBPI) to pH co-shifting under extremely alkaline conditions to form an alloyed protein complex (A-HM). At a mass ratio of HPI:MBPI of 50:50, A-HM exhibited the highest solubility (95.30 ± 0.99 %), and also had high resistance to heat treatment. Native PAGE demonstrated the formation of alloyed protein complexes, and particle size analysis revealed that A-HM exhibited small particle sizes and dispersion in water without aggregation of HPI. Owing to their small size, numerous hydrophobic residues and aromatic ring of HPI were exposed on the surface. Hydrophobic interactions predominantly governed the binding force involved in the formation of A-HM. Our findings may enhance HPI applications in the food industry, particularly in plant-based beverages.

Role of bacterial exopolysaccharides in edible films for food safety and sustainability. Current trends and future perspectives

Bacterial biopolymers are changing the concepts in the food industry as customer demands the addition of no artificial additives and want products “Clean labelled.” Exopolysaccharides (EPS) produced by some bacterial strains are the best replacements for these artificial additives. The monomeric composition, quality, quantity, structure, molecular weight, and charge on these bioparticles decide the qualities, that is, rheology, texture, shelf life, and physiochemical properties of the product. Exopolysaccharides are the best biothickeners and are being widely used in the food industry. They are widely used as coatings and edible films in food substances, especially fruits and vegetables. These consist of substances that are Generally Recognized as Safe. These coatings and edible films promise improved shelf life and better nutritional properties and act as a protective barrier for food items. Bacterial EPS are widely used in edible films, yogurt-like and plant-based beverages, the meat industry, and fermented low-fat meat, sourdoughs, and low-fat cheese. It interacts with other components and improves the texture, stabilization, viscosity, and mouthfeel of end products. The structural and functional properties of these substances still need to be explored. The main objective of this review is to focus on the importance of EPS produced by various strains, its structure and uses as edible coatings and films, functionality, and applications in various food products. Overall, the future of bacterial EPS in the food industry appears promising, with avenues for innovation and application across multiple facets of food production, including texture modification, nutritional enhancement, and sustainability.

Combining heat treatment and conjugation between guarana extract and pea protein isolate to produce O/W emulsions loaded with vitamin D3

Growing interest in plant-based materials for stabilizing food emulsions is driven by the clean-label trend. Conjugating plant proteins with phenolic compounds from plant extracts enhances their techno-functionality and allows their use as stabilizers of emulsion-based systems. This study aimed to (i) combine heat treatment (HT) and conjugation with guarana extract (GE) to improve the emulsifying ability of pea protein isolate (PPI); (ii) encapsulate vitamin D3 (VD) in PPI/GE-stabilized emulsions; (iii) evaluate the potential of these formulations in improving VD retention during storage and in vitro bioaccessibility. The particles showed a size distribution ranging from 0.5 to 10 µm, depending on the processing sequence. Furthermore, HT on PPI dispersions followed by conjugation with GE led to microgels that stabilized emulsions during 30 days of storage at 25 °C. Also, the conjugates significantly improved VD retention, ranging from 74 to 100 %, after 30 days of storage at 25 °C, even in the presence of UV light. VD-loaded emulsions produced by PPI-GE conjugates showed higher bioaccessibility values (>65 %) compared to emulsions produced by PPI alone (∼58 %) and VD-incorporated sunflower oil (37 %). Given the above, the technological modification of PPI through conjugation with GE phenolic compounds and HT efficiently produced O/W emulsions loaded with VD, improving its bioaccessibility and tailoring a system with potential application in plant-based beverage and dessert formulations.

Chemical, Textural and Antioxidant Properties of Oat-Fermented Beverages with Different Starter Lactic Acid Bacteria and Pectin.

Currently, starter cultures for fermenting plant-based beverages are not widely available commercially, but producers can use starter cultures for dairy products. Therefore, the aim of this study was to determine the physicochemical, rheological, antioxidant and sensory properties of oat beverages with/without pectin fermented by four different dairy starter cultures. The use of a mono-starter with Lactobacillus bulgaricus or Sreptococcus thermophilus allows for the efficient use of glucose, and more lactic acid is accumulated. The beverage with L. bulgaricus is characterised by high adhesion, syneresis and low cohesiveness, and it has high antioxidant activity and a low sensory profile. Using starter with L. bulgaricus, S. thermophilus and some Lactococcus for fermentation yields a product with high sensory capacity, forming a high-viscosity beverage matrix with low syneresis, high water retention, chewy texture and stickiness. It has been observed that the absence of lactococci and the presence of Lactobacillus casei, L. Rhamnosus and L. paracasei in the starter yields a product with high antioxidant activity, especially in the presence of pectin. The use of pectin significantly improves the viscosity and textural properties of oat yoghurt, enhancing the drink's flavour and giving it body. For many reasons, the use of different commercial starters in the dairy industry results in different viscosities of oat fermented beverages, forming a matrix with different textural, sensory and antioxidant properties.

Fermented plant-based beverage supplemented with uvaia (Eugenia pyriformis) pulp: an innovative and pioneering approach to diversify plant-based diet product market

Over the years, there has been an increase in demand for plant-based foods as alternatives. In line with this, this work explores the production and in vitro digestion of a fermented plant-based beverage (FPBB) produced with pea and rice proteins and 0% (FPBB-C), 5% (FPBB-5), and 10% (FPBB-10) uvaia pulp through lactic fermentation with Lacticaseibacillus rhamnosus GG. The in vitro gastrointestinal digestion process was conducted to assess the bioaccessibility of L. rhamnosus GG, total phenolic content (TPC), and antioxidant activity before and after simulating the gastrointestinal conditions. After 48 h of digestion, highly viable L. rhamnosus GG cells remained throughout the gastrointestinal system. FPBB-C (106.89%) and FPBB-5 (109.38%) exhibited higher survival rates than FPBB-10 (102.20%), indicating that these beverages have a higher prebiotic action potential. Compared with the non-digested samples, after 48 h of digestion, all samples exhibited a significant increase in TPC. The same behavior occurs for the antioxidant activity of FPBB-C, FPBB-5, and FPBB-10 by DPPH (4.06, 3.96, and 8.44 mg TEAC mL−1), ABTS (10.28, 11.06, 11.97 mg TEAC mL−1), and FRAP method (917.02, 863.87, and 1983.23 mg TEAC mL−1). Thirteen compounds were identified and quantified in uvaia pulp by HPLC-DAD-ESI-MS, particularly epigallocatechin gallate, quercetin-3-rhamnose, and quercetin-3-glucoside. Isorhamnetin was the main phenolic compound detected in the colon, assumably due to the conversion of quercetin-3-glucoside by the probiotic cells. In conclusion, as all counts were above 9 log CFU g−1, the FPBB formulations containing pea, rice protein, and uvaia pulp become a promising vehicle for carrying L. rhamnosus GG.

Effects of Replacing Cow's Milk with Plant-Based Beverages on Potential Nutrient Intake in Sustainable Healthy Dietary Patterns: A Case Study.

More consumers are replacing cow's milk (CM) with plant-based drinks (PBD), but data indicating the nutritional impact are limited. This theoretical study aims to assess the effect of substituting CM with PBD sold in Italy on nutrient intake within two dietary patterns: one aligned with the EAT-Lancet Commission reference diet adapted to Italian food habits (EAT-IT) and another one in line with the Italian Dietary Guidelines (IDG). Nutrition information from 368 PBD were collected and categorized according to their descriptive name and their fortification or not with calcium (Ca- and nCa-fortified). The substitution of CM with each PBD category in both dietary patterns was conducted, and an analysis of nutrient content and adequacy was performed. Substituting CM with all PBD resulted in reduced protein intake, except for nCa-fortified soy drinks, decreased saturated fat and vitamins B2 and B12, and increased fiber intake. Replacing CM with nCa-fortified PBD within both diets decreased Ca intake. Following the substitution of CM with Ca-fortified PBD, variations in vitamin D intake depended on the PBD category. The main risk of nutritional inadequacy was observed in Ca and vitamin D levels, which may even be amplified considering the different bioavailability based on the source of nutrients. This study highlighted the important role of CM in meeting calcium requirements and the potential unintended consequences of substituting CM with PBD without considering their nutritional differences.

Understanding the synergistic effect of pea protein and rice bran protein interaction in stabilizing palm kernel oil-in-water emulsion assisted by high-pressure homogenization.

Plant-based beverages have recently seen a significant increase in market demand. However, many of these products suffer from poor emulsion stability and low protein content. Gums have commonly been used to enhance emulsion stability but they do not improve the amino acid profile. This study investigated the use of multiples plant proteins to enhance both the stability and nutritional value of plant-based beverages. Pea and rice bran proteins both enhanced emulsion stability. Pea protein enhanced the viscosity of the continuous phase whereas rice bran protein lowered interfacial tension. When applied synergistically, competitive adhesion occurred. Rice bran protein gradually displaced pea protein from the oil droplet surface as its concentration increased, leading to emulsion destabilization due to the displaced pea protein. The use of high-pressure homogenization further enhanced the stability of the emulsion by unfolding protein partially. However, increasing homogenization pressure (>500 Bar) and homogenization cycle (>2 cycles) led to protein aggregation due to excessive exposure of its hydrophobic core. The emulsion formed was resistant to coalescence at 4 °C for 28 days and was stable under high pH and low ionic conditions. The synergistic combination of plant proteins and the effective utilization of co-processing (homogenization) can enhance the functionality of the individual proteins significantly, leading to the formation of a stable emulsion. The use of plant protein mixture as a stabilizer not only improved the emulsion stability but also ensured a plant-based beverage with a complete amino acid profile for the vegan community. © 2024 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Lipid Marker ESI-MS Method for Quantification of Adulteration in Almond-Based Vegetable Beverage

ABSTRACT Almond-based beverages are valued for their functionalities. However, cases of adulteration are found in the literature aiming to reduce costs. In this study, almond (LA) and peanut (LP)-based beverages were used as investigational controls in commercial products analyzed by gas chromatography and direct infusion electrospray ionization mass spectrometry (ESI-MS) combined with principal component analysis (PCA). Thus, characteristic fatty acids were identified in plant-based beverages. The ESI-MS method combined with PCA indicated individualities regarding the disposition of triacylglycerol (TAG) composition, as higher intensities of TAG were found as a lipid marker at m/z 919 [TAG+NH4]+ of ions formed by arachidic (20:0), 8/heptadecenoic (17:1n-9) and oleic (18:1n-9) fatty acids in LP. The technique demonstrated efficiency in the detection of fraud due to its sensitivity, identifying peanut content in three almond-based commercial beverages (4.4–11.58%). This study highlights the importance of robust analytical methods to the authenticity and quality of food products.

Functional, nutritional, and sensorial evaluation of sorghum-based beverages produced by single- and two-stage acid, α-amylase enzyme, and germination treatments.

Nowadays, the consumption of functional foods, such as plant-based beverages, is increasing due to their health-promoting properties. The low extraction yield of nutritional and functional components is considered a major challenge during the production of sorghum-based beverages (SBB), as well as their sensorial properties. This investigation studied the effects of various treatments (acidic using phosphoric acid, enzymatic using α-amylase, germination, germination-acidic, germination-enzymatic, and acidic-enzymatic) on the functional, nutritional, and sensorial properties of SBB. The two-stage acidic-enzymatic treatment demonstrated the highest extraction yield, dry matter, ash, carbohydrates, and reducing sugar contents, as well as the lowest starch content (p < .05). Furthermore, the highest protein content (0.98%) was achieved by the germination treatments of sorghum grains. While the highest fat content was achieved by the acidic treatment (1.38%), the germination-acidic treatment exhibited the highest energy value (26.02 kcal/100 mL). Moreover, the total phenolic content of the acidic-enzymatic treatment (44.56 mg GAE/L) was significantly higher than that of other treatments. However, all treatments demonstrated lower antioxidant properties compared to the control treatment (142.85 mg BHT eq./L). Furthermore, the sensory evaluation of the germination and germination-enzymatic treatments showed acceptable scores (≥7) for consumers. In conclusion, the results indicated that the two-stage treatments of sorghum, especially the acidic-enzymatic treatment, were more effective than single treatments for the extraction of functional and nutritional components during the production of SBB.

Molecular characterisation of interactions between 11S glycinin and hexanal – An off flavour compound

This work examines the binding characteristics between the 11S glycinin from soy flour with the aldehyde compound hexanal, at near neutral pH and ambient temperature. FTIR and CD spectroscopy determined that secondary structure changes were evident upon complexation with observed increases in α-helical and unordered structures along with reductions in β-sheets and β-turn structures upon complexation. UV–Vis and MALDI-TOF-MS analysis confirmed the physical nature of hexanal stabilisation, with in silico analysis and fluorescence spectroscopy revealed a low to medium binding strength with a KA range of 3.1 × 102 to 3.1 × 104 M−1 along with a 1:1 binding stoichiometry between the compound and 11S. Molecular docking simulations determined the binding location is situated between chain A and B of the trimer and is largely stabilised by pi-alkyl, hydrogen and van der Waals forces. Findings from this study will provide increased knowledge in the field of flavour compound and protein interactions thus advancing our knowledge of flavour binding and release in plant-based beverage formulations.

Aspergillus niger Ochratoxinase Is a Highly Specific, Metal-Dependent Amidohydrolase Suitable for OTA Biodetoxification in Food and Feed.

Microbial enzymes can be used as processing aids or additives in food and feed industries. Enzymatic detoxification of ochratoxin A (OTA) is a promising method to reduce OTA content. Here, we characterize the full-length enzyme ochratoxinase (AnOTA), an amidohydrolase from Aspergillus niger. AnOTA hydrolyzes OTA and ochratoxin B (OTB) mycotoxins efficiently and also other substrates containing phenylalanine, alanine, or leucine residues at their C-terminal position, revealing a narrow specificity profile. AnOTA lacks endopeptidase or aminoacylase activities. The structural basis of the molecular recognition by AnOTA of OTA, OTB, and a wide array of model substrates has been investigated by molecular docking simulation. AnOTA shows maximal hydrolytic activity at neutral pH and high temperature (65 °C) and retained high activity after prolonged incubation at 45 °C. The reduction of OTA levels in food products by AnOTA has been investigated using several commercial plant-based beverages. The results showed complete degradation of OTA with no detectable modification of beverage proteins. Therefore, the addition of AnOTA seems to be a useful procedure to eliminate OTA in plant-based beverages. Moreover, computational predictions of in vivo characteristics indicated that AnOTA is neither an allergenic nor antigenic protein. All characteristics found for AnOTA supported the suitability of its use for OTA detoxification in food and feed.

Evaluation of the mineral and antinutritional composition of bottled and sterilized Tigernut (Cyperus esculentus) milk

Nowadays, beverages are not just considered as thirst quenchers; specific functionality is the major ingredient expected in beverages, which has becomes a lifestyle. In recent years, these initiations have led to newly developed products in the beverages sector. Companies are learning the consumption styles of various individuals and making novel beverages through blends of milk and energy drinks. Tigernut milk is among the most valued plant-based beverages, obtained from the aqueous extract of tigernuts tubers. This study investigated the mineral and antinutritional components of bottled and sterilized tigernut milk. Two varieties of tigernut tuber (Yellow and brown) were processed using three methods (Boiling, soaking and malting), and the milk was bottled and further sterilized. The results obtained showed that Iron recorded the least value at (1.73mg and 2.24mg) for yellow and brown tigernut tubers; alsotigernut tubers were low in some antinutrients except flavonoids. The result for the tigernut milk elucidated that processing and sterilization had little effect on the mineral content of tigernut milk. The study also showed that the pre-processing treatment applied (Soaking, boiling and malting) to the tigernut either increased or caused a decline in the mineral content of the tigernut milk, whereas, processing and sterilization affected the antinutrient content of tigernut milk. All processing methods showed a significant difference (p&lt;0.05.) as there was a decrease in the phytate and oxalate content. The study highlighted the possibility of processing tigernut tubers into milk extract that can be bottled and sterilized for a period of time.

Role of Quinoa (Chenopodium quinoa Willd) and Chickpea (Cicer arietinum L.) Ratio in Physicochemical Stability and Microbiological Quality of Fermented Plant-Based Beverages during Storage.

Three different fermented plant-based beverages were prepared and stored for a long period (50 days) to assess the effect of the quinoa-to-chickpea ratio on physicochemical stability and microbiological quality. Physicochemical stability was evaluated based on pH, acidity, Brix degrees, water-holding capacity (WHC), viscosity, and viscoelasticity. At the end of the long-term storage period, the pH, acidity, and WHC remained stable. During the entire storage period, the beverages maintained good bacterial, fungal, and lactic acid bacteria (LAB) counts. Quinoa and chickpea flour ratios of 50% showed a higher viscosity (18 Pa.s) and WHC (65%) during short-term storage (0-30 d), indicating that the presence of chickpea flour had a positive effect on these parameters, possibly because chickpea starch contains higher amounts of amylose and long-branch chain amylopectin, which impacts the retrogradation pattern under acidic and refrigerated conditions. However, at the end of storage (50 days), the same blend had a higher acidity, lower viscosity (0.78 Pa.s), and lower LAB counts (~1 × 108 CFU/mL), indicating that the increase in chickpea flour had an adverse long-term effect on these parameters. These results suggest that although different ratios of plant sources can improve the physical aspects, they need to be incorporated in a balanced manner to avoid negative effects on both short- and long-term storage, owing to the incorporation of different types of starches and proteins affecting the stability of the system.

A comparison of the quality of UHT milk and its plant-based analogs

The aim of this study was to compare selected physical (density) and physicochemical (color, pH, titratable acidity) properties and the fatty acid profile of dairy UHT milk and its plant-based analogs, i.e., almond, soy, rice, oat, and coconut beverages. Ten products of each type were analyzed in each group. UHT milk was characterized by higher values of color lightness (L*) and titratable acidity than all plant-based milk alternatives, higher yellowness (b*) than rice drink, higher density than almond drink, and higher pH than rice and coconut drinks. In comparison with UHT milk, all plant-based beverages were characterized by higher redness (a*), soy drink was characterized by higher values of b* and chroma (C*), and almond and soy drinks had higher pH values. In the group of non-dairy beverages, the values of b* and C* were highest in soy drink, and the value of a* was highest in almond drink. Almond drink had the highest pH value, and soy and coconut drinks had the highest titratable acidity. Rice drink had higher density than oat, soy and almond drinks. The indicators characterizing the nutritional value of fat were considerably lower in coconut drink and dairy milk than in the remaining products. The values of UFA/SFA, MUFA/SFA, and DFA/OFA ratios and the indicator of nutritional value were highest in rice drink. The PUFA/SFA ratio and the total content of EFAs were highest in soy drink, and the n-6/n-3 PUFA ratio was highest in almond drink.

World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update – XVI - Nutritional management of cow's milk allergy

Cow's milk allergy (CMA) is one of the most common presentations of food allergy in early childhood. Management of CMA involves individualized avoidance of cow's milk and other mammalian milk and foods containing these. Optimal elimination of cow's milk avoidance includes: label reading; information about safe and nutritious substitute foods; appropriate choice of infant formula or a plant-based food; establishing tolerance to baked milk and monitoring nutritional intake and growth. Substitute formulas are divided into soy formula (not hydrolyzed), milk-based extensively hydrolyzed formulas, rice based extensive, and partially hydrolyzed formulas and amino acid-based formulas. The use of other mammalian milks is not recommended for the management of cow's milk allergy due to a high level of cross-reactivity and nutritional concerns. For toddlers who are eating well, children, and adults, a suitable plant-based beverage may be a suitable alternative to a specialized formula, following careful nutritional considerations. Families need to be instructed on finding suitable nutritious foods and how to prepare suitable meals at home. Individuals with CMA also need to know how to identify and treat acute severe reactions.