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SPIRULINA PLATENSIS VE SPIRULINA PLATENSIS PROTEİN EKSTRAKTLARI İÇEREN BUĞDAY EKMEKLERİNİN IN VITRO SİNDİRİM SIRASINDA ANTİOKSİDAN AKTİVİTE VE PROTEİN SİNDİRİLEBİLİRLİĞİNDEKİ DEĞİŞİMİN ARAŞTIRILMASI

Yıl 2022, Cilt: 47 Sayı: 5, 776 - 789, 30.10.2022
https://doi.org/10.15237/gida.GD22053

Öz

Bu çalışmada, %0.125, %0.25 ve %0.50 oranlarında Spirulina platensis (SP) ve Spirulina platensis (SPE)’den elde edilen protein ekstraktı içeren buğday ekmekleri hazırlanmış ve ekmeklerin tekstürel, hacim, renk ve duyusal özellikleri araştırılmıştır. Ayrıca, ekmeklerin in vitro mide-bağırsak sindirim sırasında toplam fenolik madde içeriği (TFM), antioksidan aktivite (AOA) ve protein sindirilebilirliğindeki (PS) değişim belirlenmiştir. En yüksek sıkılık değerine sahip örnek kontrol örneğiydi (919.4 g, p≤0.05). SP ve SPE ilaveli ekmekler kontrol örneğinden daha yüksek hacim değerlerine sahipti (p≤0.05). SPE-0.25 örneği en düşük L* (52.2±1.0) ve b* (18.9±0.2) değerlerine sahipti (p≤0.05). Ekmeklerin AOA'leri (SP-0.125, SP-0.5 ve SPE-0.25) in vitro mide sindiriminden sonra artmıştır (p≤0.05). SPE-0.50 duyusal özellikler açısından en çok tercih edilen ekmek olmuştur. Ayrıca, SPE-0.125 ilaveli ekmek, en yüksek TFM içermiştir ve in vitro bağırsak sindirimi sonrası, tüm oranlarda SPE içeren ekmekler kontrol ve SP ilaveli ekmeklerden daha yüksek AOA’ye sahip olmuştur (p>0.05).

Kaynakça

  • Anonymous (1986). Official Method of Analysis. AACC International (methods 74-09), Eighth Edition, St. Paul, MN, USA.
  • Anonymous (2008). Official Method of Analysis. AACC International (methods 10-05), Tenth Edition, St. Paul, MN, USA.
  • Anonymous (1990). Official Method of Analysis. AOAC International. Fifteenth Edition, Washington, DC, USA.
  • Abd El Baky, H.H., El Baroty, G.S. ve Ibrahem, E.A. (2015). Functional characters evaluation of biscuits sublimated with pure phycocyanin isolated from Spirulina and Spirulina biomass. Nutricion Hospitalaria, 32 (1), 231-241.
  • Ak, B., Avsaroglu, E., Isik, O., Özyurt, G., Kafkas, E. ve Etyemez, M. (2016). Nutritional and physicochemical characteristics of bread enriched with microalgae Spirulina platensis,. International Journal of Engineering Research and Applications, 6 (9), 30-38.
  • Apak, R., Güçlü, K., Özyürek, M. ve Karademir, S.E. (2004). Novel total antioxidant capacity index for dietary polyphenols and vitamins C and E, using their cupric ion reducing capability in the presence of neocuproine: CUPRAC method. Journal of Agricultural and Food Chemistry, 52 (26), 7970-7981.
  • Apak, R., Güçlü, K., Demirata, B., Özyürek, M., Çelik, S. E., Bektaşoğlu, B., ... & Özyurt, D. (2007). Comparative evaluation of various total antioxidant capacity assays applied to phenolic compounds with the CUPRAC assay. Molecules, 12(7), 1496-1547.
  • Benelhadj, S., Gharsallaoui, A., Degraeve, P., Attia, H. ve Ghorbel, D. (2016). Effect of pH on the functional properties of Arthrospira (Spirulina) platensis protein isolate. Food Chemistry, 194, 1056-1063.
  • Bermejo, P., Pinero, E. ve Villar, A.M. (2008). Iron-chelating ability and antioxidant properties of phycocyanin isolated from a protean extract of Spirulina platensis. Food Chemistry, 110 (2), 436-445.
  • Chamorro-Cevallos, G., Garduño-Siciliano, L., Barrón, B.L., Madrigal-Bujaidar, E., Cruz-Vega, D.E. ve Pages, N. (2008). Chemoprotective effect of Spirulina (Arthrospira) against cyclophosphamide-induced mutagenicity in mice. Food and Chemical Toxicology, 46 (2), 567-574.
  • Chen, G.L., Chen, S.G., Zhao, Y.Y., Luo, C.X., Li, J. ve Gao, Y.Q. (2014). Total phenolic contents of 33 fruits and their antioxidant capacities before and after in vitro digestion. Industrial Crops and Products, 57, 150-157.
  • Chen, G.L., Chen, S.G., Xie, Y.Q., Chen, F., Zhao, Y.Y., Luo, C.X. ve Gao, Y.Q. (2015). Total phenolic, flavonoid and antioxidant activity of 23 edible flowers subjected to in vitro digestion. Journal of Functional Foods, 17, 243-259.
  • Çekiç, S. D., Başkan, K. S., Tütem, E., & Apak, R. (2009). Modified cupric reducing antioxidant capacity (CUPRAC) assay for measuring the antioxidant capacities of thiol-containing proteins in admixture with polyphenols. Talanta, 79(2), 344-351.
  • El-Tantawy, W.H. (2015). Antioxidant effects of Spirulina supplement against lead acetate-induced hepatic injury in rats. Journal of Traditional and Complementary Medicine, 6 (4), 327-331.
  • Estrada, J.P., Bescós, P.B. ve Del Fresno, A.V. (2001). Antioxidant activity of different fractions of Spirulina platensis protean extract. II Farmaco, 56 (5-7), 497-500.
  • Gad, A.S., Khadrawy, Y.A., El-Nekeety, A. A., Mohamed, S. R., Hassan, N. S. ve Abdel-Wahhab, M. A. (2011). Antioxidant activity and hepatoprotective effects of whey protein and Spirulina in rats. Nutrition, 27 (5), 582-589.
  • Ghaeni, M., & Roomiani, L. (2016). Review for application and medicine effects of Spirulina, microalgae. Journal of Advanced Agricultural Technologies, 3(2), 114-117.
  • İlhan, E., Büyükizgi, A.N. ve Ermiş, E. (2020). Mavi-yeşil alg Spirulina platensis’in buğday ekmeğinde kimyasal, duyusal ve antifungal etkisi. Gıda ve Yem Bilimi-Teknolojisi Dergisi, 24, 22-29.
  • Jenner, A.M., Rafter, J. ve Halliwell, B. (2005). Human fecal water content of phenolics: the extent of colonic exposure to aromatic compounds. Free Radical Biology and Medicine, 38 (6), 763–772.
  • Kumaran, A. (2006). Antioxidant and free radical scavenging activity of an aqueous extract of Coleus aromaticus. Food Chemistry, 97 (1), 109-114.
  • Lee, J.Y., Kang, S.H. ve Kim, M.R. (2011). Changes in the quality characteristics and antioxidant activities of Spirulina added bread during storage. Korean Journal of Food Preservation, 18 (1), 111-118.
  • Lowry, O.H., Rosebrough, N.J., Farr, A.L. ve Randall, R.J. (1951). Protein measurement with the Folin phenol reagent. Journal of Biological Chemistry, 193, 265-275.
  • Mamat, H., Matanjun, P., Ibrahim, S., Amin, S.F.M., Hamid, M.A. ve Rameli, A.S. (2014). The effect of seaweed composite flour on the textural properties of dough and bread. Journal of Applied Phycology, 26 (2), 1057-1062.
  • Minekus, M., Alminger, M., Alvito, P., Ballance, S., Bohn, Bourlieu, C., Carrière, F., Boutrou, …. ve Brodkorb A. (2014). A standardised static in vitro digestion method suitable for food–an international consensus. Food & Function, 5 (6), 1113-1124.
  • Pelizer, L.H., de Carvalho, J.C.M., ve de Oliveira Moraes, I. (2015). Protein production by Arthrospira (Spirulina) platensis in solid state cultivation using sugarcane bagasse as support. Biotechnology Reports, 5, 70-76.
  • Puangkam, K., Muanghorm, W. ve Konsue, N. (2017). Stability of bioactive compounds and antioxidant activity of Thai cruciferous vegetables during in vitro digestion. Current Research in Nutrition and Food Science Journal, 5 (2), 100-108.
  • Różyło, R., Hameed Hassoon, W., Gawlik-Dziki, U., Siastała, M. ve Dziki, D. (2017). Study on the physical and antioxidant properties of gluten-free bread with brown algae. CyTA-Journal of Food, 15 (2), 196-203.
  • Świeca, M., Gawlik-Dziki, U., Dziki, D., Baraniak, B., ve Czyż, J. (2013). The influence of protein–flavonoid interactions on protein digestibility in vitro and the antioxidant quality of breads enriched with onion skin. Food Chemistry, 141 (1), 451-458.
  • Stone, A.K., Karalash, A., Tyler, R.T., Warkentin, T.D., ve Nickerson, M.T. (2015). Functional attributes of pea protein isolates prepared using different extraction methods and cultivars. Food Research International, 76, 31-38.
  • Toor, R. K. ve Savage, G.P. (2006). Changes in major antioxidant components of tomatoes during post-harvest storage. Food Chemistry, 99(4), 724-727.
  • Vo, T., Ngo, D., ve Kim, S. (2016). Nutritional and pharmaceutical properties of microalgal Spirulina. In: Handbook of Marine Microalgae: Biotechnology Advances, Kim S. K. (ed.), Elsevier Inc, the UK. pp. 299-308.
  • Wang, L., Pan, B., Sheng, J., Xu, J. ve Hu, Q. (2007). Antioxidant activity of Spirulina platensis extracts by supercritical carbon dioxide extraction. Food Chemistry, 105 (1), 36-41.
  • Yılmaz, M. and Yucetepe, A. (2021). Spirulina platensis protein ekstraktları ile zenginleştirilmiş buğday unundan üretilen hamurun reolojik ve teknofonksiyonel özelliklerinin araştırılması. Avrupa Bilim ve Teknoloji Dergisi, 27, 768-775.
  • Yucetepe, A., Saroglu, O., Daskaya-Dikmen, C., Bildik, F., Ozcelik, B. (2018). Optimisation of ultrasound-assisted extraction of protein from Spirulina platensis using RSM. Czech Journal of Food Sciences, 36 (1), 98-108.

INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION

Yıl 2022, Cilt: 47 Sayı: 5, 776 - 789, 30.10.2022
https://doi.org/10.15237/gida.GD22053

Öz

In this study, wheat breads including Spirulina platensis (SP) and protein extracts from Spirulina platensis (SPE) at levels of 0.125%, 0.25% and 0.50% were prepared and textural, volume, color and sensory properties were determined. Moreover, changes in total phenolic content (TPC), antioxidant activity (AOA) and in vitro protein digestibility (PD) of breads were investigated during in vitro digestion. The sample with the highest firmness value was control (919.4 g, p≤0.05). Breads with SP and SPE had higher volume than control (p≤0.05). The L* (52.2±1.0) and b* (18.9±0.2) values were the lowest for bread with SPE-0.25 (p≤0.05). The AOA of breads (SP-0.125, SP-0.5 and SPE-0.25) increased after in vitro gastric digestion (p≤0.05). The SPE-0.50 was the most preferable in terms of sensory properties. The SPE-0.125 had the highest TPC and breads including SPE at all levels had higher AOA than control and breads with SP after in vitro intestinal digestion (p>0.05).

Kaynakça

  • Anonymous (1986). Official Method of Analysis. AACC International (methods 74-09), Eighth Edition, St. Paul, MN, USA.
  • Anonymous (2008). Official Method of Analysis. AACC International (methods 10-05), Tenth Edition, St. Paul, MN, USA.
  • Anonymous (1990). Official Method of Analysis. AOAC International. Fifteenth Edition, Washington, DC, USA.
  • Abd El Baky, H.H., El Baroty, G.S. ve Ibrahem, E.A. (2015). Functional characters evaluation of biscuits sublimated with pure phycocyanin isolated from Spirulina and Spirulina biomass. Nutricion Hospitalaria, 32 (1), 231-241.
  • Ak, B., Avsaroglu, E., Isik, O., Özyurt, G., Kafkas, E. ve Etyemez, M. (2016). Nutritional and physicochemical characteristics of bread enriched with microalgae Spirulina platensis,. International Journal of Engineering Research and Applications, 6 (9), 30-38.
  • Apak, R., Güçlü, K., Özyürek, M. ve Karademir, S.E. (2004). Novel total antioxidant capacity index for dietary polyphenols and vitamins C and E, using their cupric ion reducing capability in the presence of neocuproine: CUPRAC method. Journal of Agricultural and Food Chemistry, 52 (26), 7970-7981.
  • Apak, R., Güçlü, K., Demirata, B., Özyürek, M., Çelik, S. E., Bektaşoğlu, B., ... & Özyurt, D. (2007). Comparative evaluation of various total antioxidant capacity assays applied to phenolic compounds with the CUPRAC assay. Molecules, 12(7), 1496-1547.
  • Benelhadj, S., Gharsallaoui, A., Degraeve, P., Attia, H. ve Ghorbel, D. (2016). Effect of pH on the functional properties of Arthrospira (Spirulina) platensis protein isolate. Food Chemistry, 194, 1056-1063.
  • Bermejo, P., Pinero, E. ve Villar, A.M. (2008). Iron-chelating ability and antioxidant properties of phycocyanin isolated from a protean extract of Spirulina platensis. Food Chemistry, 110 (2), 436-445.
  • Chamorro-Cevallos, G., Garduño-Siciliano, L., Barrón, B.L., Madrigal-Bujaidar, E., Cruz-Vega, D.E. ve Pages, N. (2008). Chemoprotective effect of Spirulina (Arthrospira) against cyclophosphamide-induced mutagenicity in mice. Food and Chemical Toxicology, 46 (2), 567-574.
  • Chen, G.L., Chen, S.G., Zhao, Y.Y., Luo, C.X., Li, J. ve Gao, Y.Q. (2014). Total phenolic contents of 33 fruits and their antioxidant capacities before and after in vitro digestion. Industrial Crops and Products, 57, 150-157.
  • Chen, G.L., Chen, S.G., Xie, Y.Q., Chen, F., Zhao, Y.Y., Luo, C.X. ve Gao, Y.Q. (2015). Total phenolic, flavonoid and antioxidant activity of 23 edible flowers subjected to in vitro digestion. Journal of Functional Foods, 17, 243-259.
  • Çekiç, S. D., Başkan, K. S., Tütem, E., & Apak, R. (2009). Modified cupric reducing antioxidant capacity (CUPRAC) assay for measuring the antioxidant capacities of thiol-containing proteins in admixture with polyphenols. Talanta, 79(2), 344-351.
  • El-Tantawy, W.H. (2015). Antioxidant effects of Spirulina supplement against lead acetate-induced hepatic injury in rats. Journal of Traditional and Complementary Medicine, 6 (4), 327-331.
  • Estrada, J.P., Bescós, P.B. ve Del Fresno, A.V. (2001). Antioxidant activity of different fractions of Spirulina platensis protean extract. II Farmaco, 56 (5-7), 497-500.
  • Gad, A.S., Khadrawy, Y.A., El-Nekeety, A. A., Mohamed, S. R., Hassan, N. S. ve Abdel-Wahhab, M. A. (2011). Antioxidant activity and hepatoprotective effects of whey protein and Spirulina in rats. Nutrition, 27 (5), 582-589.
  • Ghaeni, M., & Roomiani, L. (2016). Review for application and medicine effects of Spirulina, microalgae. Journal of Advanced Agricultural Technologies, 3(2), 114-117.
  • İlhan, E., Büyükizgi, A.N. ve Ermiş, E. (2020). Mavi-yeşil alg Spirulina platensis’in buğday ekmeğinde kimyasal, duyusal ve antifungal etkisi. Gıda ve Yem Bilimi-Teknolojisi Dergisi, 24, 22-29.
  • Jenner, A.M., Rafter, J. ve Halliwell, B. (2005). Human fecal water content of phenolics: the extent of colonic exposure to aromatic compounds. Free Radical Biology and Medicine, 38 (6), 763–772.
  • Kumaran, A. (2006). Antioxidant and free radical scavenging activity of an aqueous extract of Coleus aromaticus. Food Chemistry, 97 (1), 109-114.
  • Lee, J.Y., Kang, S.H. ve Kim, M.R. (2011). Changes in the quality characteristics and antioxidant activities of Spirulina added bread during storage. Korean Journal of Food Preservation, 18 (1), 111-118.
  • Lowry, O.H., Rosebrough, N.J., Farr, A.L. ve Randall, R.J. (1951). Protein measurement with the Folin phenol reagent. Journal of Biological Chemistry, 193, 265-275.
  • Mamat, H., Matanjun, P., Ibrahim, S., Amin, S.F.M., Hamid, M.A. ve Rameli, A.S. (2014). The effect of seaweed composite flour on the textural properties of dough and bread. Journal of Applied Phycology, 26 (2), 1057-1062.
  • Minekus, M., Alminger, M., Alvito, P., Ballance, S., Bohn, Bourlieu, C., Carrière, F., Boutrou, …. ve Brodkorb A. (2014). A standardised static in vitro digestion method suitable for food–an international consensus. Food & Function, 5 (6), 1113-1124.
  • Pelizer, L.H., de Carvalho, J.C.M., ve de Oliveira Moraes, I. (2015). Protein production by Arthrospira (Spirulina) platensis in solid state cultivation using sugarcane bagasse as support. Biotechnology Reports, 5, 70-76.
  • Puangkam, K., Muanghorm, W. ve Konsue, N. (2017). Stability of bioactive compounds and antioxidant activity of Thai cruciferous vegetables during in vitro digestion. Current Research in Nutrition and Food Science Journal, 5 (2), 100-108.
  • Różyło, R., Hameed Hassoon, W., Gawlik-Dziki, U., Siastała, M. ve Dziki, D. (2017). Study on the physical and antioxidant properties of gluten-free bread with brown algae. CyTA-Journal of Food, 15 (2), 196-203.
  • Świeca, M., Gawlik-Dziki, U., Dziki, D., Baraniak, B., ve Czyż, J. (2013). The influence of protein–flavonoid interactions on protein digestibility in vitro and the antioxidant quality of breads enriched with onion skin. Food Chemistry, 141 (1), 451-458.
  • Stone, A.K., Karalash, A., Tyler, R.T., Warkentin, T.D., ve Nickerson, M.T. (2015). Functional attributes of pea protein isolates prepared using different extraction methods and cultivars. Food Research International, 76, 31-38.
  • Toor, R. K. ve Savage, G.P. (2006). Changes in major antioxidant components of tomatoes during post-harvest storage. Food Chemistry, 99(4), 724-727.
  • Vo, T., Ngo, D., ve Kim, S. (2016). Nutritional and pharmaceutical properties of microalgal Spirulina. In: Handbook of Marine Microalgae: Biotechnology Advances, Kim S. K. (ed.), Elsevier Inc, the UK. pp. 299-308.
  • Wang, L., Pan, B., Sheng, J., Xu, J. ve Hu, Q. (2007). Antioxidant activity of Spirulina platensis extracts by supercritical carbon dioxide extraction. Food Chemistry, 105 (1), 36-41.
  • Yılmaz, M. and Yucetepe, A. (2021). Spirulina platensis protein ekstraktları ile zenginleştirilmiş buğday unundan üretilen hamurun reolojik ve teknofonksiyonel özelliklerinin araştırılması. Avrupa Bilim ve Teknoloji Dergisi, 27, 768-775.
  • Yucetepe, A., Saroglu, O., Daskaya-Dikmen, C., Bildik, F., Ozcelik, B. (2018). Optimisation of ultrasound-assisted extraction of protein from Spirulina platensis using RSM. Czech Journal of Food Sciences, 36 (1), 98-108.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Gıda Mühendisliği
Bölüm Makaleler
Yazarlar

Meltem Yılmaz 0000-0003-2543-4166

Aysun Yücetepe 0000-0002-3800-4774

Yayımlanma Tarihi 30 Ekim 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 47 Sayı: 5

Kaynak Göster

APA Yılmaz, M., & Yücetepe, A. (2022). INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION. Gıda, 47(5), 776-789. https://doi.org/10.15237/gida.GD22053
AMA Yılmaz M, Yücetepe A. INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION. GIDA. Ekim 2022;47(5):776-789. doi:10.15237/gida.GD22053
Chicago Yılmaz, Meltem, ve Aysun Yücetepe. “INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION”. Gıda 47, sy. 5 (Ekim 2022): 776-89. https://doi.org/10.15237/gida.GD22053.
EndNote Yılmaz M, Yücetepe A (01 Ekim 2022) INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION. Gıda 47 5 776–789.
IEEE M. Yılmaz ve A. Yücetepe, “INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION”, GIDA, c. 47, sy. 5, ss. 776–789, 2022, doi: 10.15237/gida.GD22053.
ISNAD Yılmaz, Meltem - Yücetepe, Aysun. “INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION”. Gıda 47/5 (Ekim 2022), 776-789. https://doi.org/10.15237/gida.GD22053.
JAMA Yılmaz M, Yücetepe A. INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION. GIDA. 2022;47:776–789.
MLA Yılmaz, Meltem ve Aysun Yücetepe. “INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION”. Gıda, c. 47, sy. 5, 2022, ss. 776-89, doi:10.15237/gida.GD22053.
Vancouver Yılmaz M, Yücetepe A. INVESTIGATION OF CHANGES IN ANTIOXIDANT ACTIVITY AND PROTEIN DIGESTIBILITY OF WHEAT BREADS INCLUDING SPIRULINA PLATENSIS AND PROTEIN EXTRACTS FROM SPIRULINA PLATENSIS DURING IN VITRO DIGESTION. GIDA. 2022;47(5):776-89.

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