Research

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12 pages, 261 KiB

Open AccessArticle

The GReat-Child Trial^TM: A Quasi-Experimental Dietary Intervention among Overweight and Obese Children

by Hui Chin Koo, Bee Koon Poh and Ruzita Abd. Talib

Nutrients 2020, 12(10), 2972; https://doi.org/10.3390/nu12102972 - 29 Sep 2020

Cited by 3 | Viewed by 3768

Diet composition is a key determinant of childhood obesity. While whole grains and micronutrients are known to decrease the risk of obesity, there are no interventions originating from Southeast Asia that emphasize whole grain as a strategy to improve overall quality of diet [...] Read more.

Diet composition is a key determinant of childhood obesity. While whole grains and micronutrients are known to decrease the risk of obesity, there are no interventions originating from Southeast Asia that emphasize whole grain as a strategy to improve overall quality of diet in combating childhood obesity. The GReat-Child Trial aimed to improve whole grain intake and quality of diet among overweight and obese children. It is a quasi-experimental intervention based on Social Cognitive Theory. It has a 12-week intervention and 6-month follow-up, consisting of three components that address environmental, personal, and behavioral factors. The intervention consists of: (1) six 30 min lessons on nutrition, using the Malaysian Food Pyramid to emphasize healthy eating, (2) daily deliveries of wholegrain foods to schools so that children can experience and accept wholegrain foods, and (3) diet counseling to parents to increase availability of wholegrain foods at home. Two primary schools with similar demographics in Kuala Lumpur were assigned as control (CG) and intervention (IG) groups. Inclusion criteria were: (1) children aged 9 to 11 years who were overweight/obese; (2) who did not consume whole grain foods; and (3) who had no serious co-morbidity problems. The entire trial was completed by 63 children (31 IG; 32 CG). Study outcomes were measured at baseline and at two time points post intervention (at the 3rd [T1] and 9th [T2] months). IG demonstrated significantly higher intakes of whole grain (mean difference = 9.94, 95%CI: 7.13, 12.75, p < 0.001), fiber (mean difference = 3.07, 95% CI: 1.40, 4.73, p = 0.001), calcium (mean difference = 130.27, 95%CI: 74.15, 186.39, p < 0.001), thiamin (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001), riboflavin (mean difference = 0.84, 95%CI: 0.37, 1.32, p = 0.001), niacin (mean difference = 0.35, 95%CI: 1.91, 5.16, p < 0.001), and vitamin C (mean difference = 58.71, 95%CI: 26.15, 91.28, p = 0.001) compared to CG in T1, after adjusting for covariates. However, T1 results were not sustained in T2 when intervention had been discontinued. The findings indicate that intervention emphasizing whole grains improved overall short-term but not long-term dietary intake among schoolchildren. We hope the present trial will lead to adoption of policies to increase whole grain consumption among Malaysian schoolchildren. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

7 pages, 203 KiB

Open AccessCommunication

Cardiovascular Healthcare Cost Savings Associated with Increased Whole Grains Consumption among Adults in the United States

by Mary M. Murphy and Jordana K. Schmier

Nutrients 2020, 12(8), 2323; https://doi.org/10.3390/nu12082323 - 03 Aug 2020

Cited by 13 | Viewed by 3690

Abstract

Little is known about the potential health economic impact of increasing the proportion of total grains consumed as whole grains to align with Dietary Guidelines for Americans (DGA) recommendations. Health economic analysis estimating difference in costs developed using (1) relative risk (RR) estimates [...] Read more.

Little is known about the potential health economic impact of increasing the proportion of total grains consumed as whole grains to align with Dietary Guidelines for Americans (DGA) recommendations. Health economic analysis estimating difference in costs developed using (1) relative risk (RR) estimates between whole grains consumption and outcomes of cardiovascular disease (CVD) and a selected component (coronary heart disease, CHD); (2) estimates of total and whole grains consumption among US adults; and (3) annual direct and indirect medical costs associated with CVD. Using reported RR estimates and assuming a linear relationship, risk reductions per serving of whole grains were calculated and cost savings were estimated from proportional reductions by health outcome. With a 4% reduction in CVD incidence per serving and a daily increase of 2.24 oz-eq of whole grains, one-year direct medical cost savings were estimated at US$21.9 billion (B) (range, US$5.5B to US$38.4B). With this same increase in whole grains and a 5% reduction in CHD incidence per serving, one-year direct medical cost savings were estimated at US$14.0B (US$8.4B to US$22.4B). A modest increase in whole grains of 0.25 oz-eq per day was associated with one-year CVD-related savings of $2.4B (US$0.6B to US$4.3B) and CHD-related savings of US$1.6B (US$0.9B to US$2.5B). Increasing whole grains consumption among US adults to align more closely with DGA recommendations has the potential for substantial healthcare cost savings. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

20 pages, 1331 KiB

Open AccessArticle

Whole Grains and Consumer Understanding: Investigating Consumers’ Identification, Knowledge and Attitudes to Whole Grains

by Shara Foster, Eleanor Beck, Jaimee Hughes and Sara Grafenauer

Nutrients 2020, 12(8), 2170; https://doi.org/10.3390/nu12082170 - 22 Jul 2020

Cited by 33 | Viewed by 5592

Abstract

Whole grains may assist in reducing risk of non-communicable disease, but consumption is limited in many countries. In Australia, the reasons for poor consumption are not well understood. The aim of this study was to investigate consumers’ knowledge, attitudes and identification of whole [...] Read more.

Whole grains may assist in reducing risk of non-communicable disease, but consumption is limited in many countries. In Australia, the reasons for poor consumption are not well understood. The aim of this study was to investigate consumers’ knowledge, attitudes and identification of whole grains, incorporating an exploration of factors influencing consumption, promotion and provision. An online semi-structured questionnaire was used to gather responses from 735 participants (61% complete responses). Although 92% of respondents consumed grains, only 8% reported an intake consistent with age and gender recommendations. Refined pasta and rice were the most frequently purchased grain foods followed by wholemeal/whole grain bread. Of whole grain foods, bread and breakfast cereals were consumed more frequently. However, overall, participants did not prioritise consumption of whole grains. Despite this, 93% of participants had seen food packaging information drawing attention to whole grain content, with a high proportion describing whole grain as less processed (72%) or high in dietary fibre (67%). Two-thirds were aware of health benefits but stated that if they had further information, they would be more likely to swap to whole grain. Further education, increasing exposure, accessibility and extensive promotion of whole grain health benefits are required to facilitate whole grain consumption. Furthermore, removing the negative stigma associated with carbohydrate foods, including grains, will be necessary to improve consumption. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

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14 pages, 296 KiB

Open AccessArticle

Flour for Home Baking: A Cross-Sectional Analysis of Supermarket Products Emphasising the Whole Grain Opportunity

by Jaimee Hughes, Verena Vaiciurgis and Sara Grafenauer

Nutrients 2020, 12(7), 2058; https://doi.org/10.3390/nu12072058 - 10 Jul 2020

Cited by 8 | Viewed by 6986

Abstract

Flour, typically derived from wheat, rye, corn and rice is a pantry staple, providing structure to bread and baked goods. This study aimed to provide a cross-sectional analysis of flour for home baking, highlighting the nutrition composition of whole grain flour and identifying [...] Read more.

Flour, typically derived from wheat, rye, corn and rice is a pantry staple, providing structure to bread and baked goods. This study aimed to provide a cross-sectional analysis of flour for home baking, highlighting the nutrition composition of whole grain flour and identifying novel categories. An audit was undertaken in February 2020, in four major supermarkets in metropolitan Sydney (Aldi, Coles, IGA and Woolworths). Ingredient lists, Nutrition Information Panel, claims, and country of origin were collected. The median and range were calculated for energy, protein, fat, saturated fat, carbohydrate, sugars, dietary fibre and sodium. Overall, 130 products were collected, including 26 plain flour, 12 self-raising, 17 plain wholemeal, 4 wholemeal self-raising, 20 bread-making mixes (4 were whole grain), 20 other refined grain (including corn and rice flour), 17 gluten-free, 3 legume, 4 fruit/vegetable, 4 coconut and 3 other non-grain (e.g., hemp seed, cricket flour) products. Plain wheat flour dominated the category, while whole grain (wholemeal) made up 19% of products, yet they contained significantly more dietary fibre (p < 0.001) and protein (p < 0.001). Self-raising flours were significantly higher in sodium (p < 0.001) and gluten-free products were lower in protein and dietary fibre, making legume, buckwheat and quinoa flour a better choice. Sustainability principles in fruit and vegetable production and novel insect products have driven new product development. There is a clear opportunity for further on-pack promotion of whole grain and dietary fibre within the category via food product labelling. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

14 pages, 279 KiB

Open AccessArticle

Growing the Business of Whole Grain in the Australian Market: A 6-Year Impact Assessment

by Felicity Curtain, Alexandra Locke and Sara Grafenauer

Nutrients 2020, 12(2), 313; https://doi.org/10.3390/nu12020313 - 24 Jan 2020

Cited by 7 | Viewed by 6239

Abstract

The Australia New Zealand Food Standards Code does not regulate on-pack claims describing the amount of whole grain in foods. In July 2013, The Grains & Legumes Nutrition Council^™ (GLNC) established a voluntary Code of Practice for Whole Grain Ingredient Content Claims [...] Read more.

The Australia New Zealand Food Standards Code does not regulate on-pack claims describing the amount of whole grain in foods. In July 2013, The Grains & Legumes Nutrition Council^™ (GLNC) established a voluntary Code of Practice for Whole Grain Ingredient Content Claims (the Code) providing guidance for whole grain claims, with cut-off values and suggested wording ≥8 g, ≥16 g, and ≥24 g per manufacturer serve (contains; high and very high in whole grain), based on a 48 g whole grain daily target intake. The aim of this impact assessment was to report the uptake of the Code by manufacturers, changes in numbers of whole grain products, and claims on-pack since 2013, including compliance. The impact assessment was undertaken in August 2019, comparing current registered manufacturers (“users”) and their products to the total number of products in the market deemed eligible for registration through GLNC product audits since 2013. Reporting included breakfast cereals, bread products, crispbreads, crackers, rice/corn cakes, rice, pasta, noodles, couscous, other grains (e.g., quinoa, buckwheat, freekeh), and grain-based muesli bars. As of 30 June 2019, there were 33 registered users and 531 registered products in Australia and New Zealand representing 43% of the eligible manufacturers and 65% of the eligible whole grain foods. Three-quarters (78% and 74%) of the eligible breakfast cereals and bread products were registered with the Code in 2019, followed by 62% of grain-based muesli bars. Only 39% of crispbread, crackers, rice/corn cakes, and rice, pasta, noodles, couscous, and other grains were registered. From 2013 there has been a 71% increase in the number of whole grain foods making claims, demonstrating strong uptake by industry, with clearer, more consistent, and compliant on-pack communication regarding whole grain content. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

Review

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20 pages, 1278 KiB

Open AccessReview

Dietary Fibre from Whole Grains and Their Benefits on Metabolic Health

by Nirmala Prasadi V. P. and Iris J. Joye

Nutrients 2020, 12(10), 3045; https://doi.org/10.3390/nu12103045 - 05 Oct 2020

Cited by 171 | Viewed by 28343

Abstract

The consumption of whole grain products is often related to beneficial effects on consumer health. Dietary fibre is an important component present in whole grains and is believed to be (at least partially) responsible for these health benefits. The dietary fibre composition of [...] Read more.

The consumption of whole grain products is often related to beneficial effects on consumer health. Dietary fibre is an important component present in whole grains and is believed to be (at least partially) responsible for these health benefits. The dietary fibre composition of whole grains is very distinct over different grains. Whole grains of cereals and pseudo-cereals are rich in both soluble and insoluble functional dietary fibre that can be largely classified as e.g., cellulose, arabinoxylan, β-glucan, xyloglucan and fructan. However, even though the health benefits associated with the consumption of dietary fibre are well known to scientists, producers and consumers, the consumption of dietary fibre and whole grains around the world is substantially lower than the recommended levels. This review will discuss the types of dietary fibre commonly found in cereals and pseudo-cereals, their nutritional significance and health benefits observed in animal and human studies. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

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13 pages, 625 KiB

Open AccessReview

Next Generation Health Claims Based on Resilience: The Example of Whole-Grain Wheat

by Femke Hoevenaars, Jan-Willem van der Kamp, Willem van den Brink and Suzan Wopereis

Nutrients 2020, 12(10), 2945; https://doi.org/10.3390/nu12102945 - 25 Sep 2020

Cited by 11 | Viewed by 2914

Abstract

Health claims on foods are a way of informing consumers about the health benefits of a food product. Traditionally, these claims are based on scientific evaluation of markers originating from a pharmacological view on health. About a decade ago, the definition of health [...] Read more.

Health claims on foods are a way of informing consumers about the health benefits of a food product. Traditionally, these claims are based on scientific evaluation of markers originating from a pharmacological view on health. About a decade ago, the definition of health has been rephrased to ‘the ability to adapt’ that opened up the possibility for a next generation of health claims based on a new way of quantifying health by evaluating resilience. Here, we would like to introduce an opportunity for future scientific substantiation of health claims on food products by using whole-grain wheat as an example. Characterization of the individual whole wheat grain food product or whole wheat flour would probably be considered as sufficiently characterized by the European Food Safety Authority, while the food category whole grain is not specific enough. Meta-analysis provides the scientific evidence that long-term whole-grain wheat consumption is beneficial for health, although results from single ‘gold standard’ efficacy studies are not always straight forward based on classic measurement methods. Future studies may want to underpin the scientific argumentation that long-term whole grain wheat consumption improves resilience, by evaluating the disruption and rate of a selected panel of blood markers in response to a standardized oral protein glucose lipid tolerance test and aggregated into biomarkers with substantiated physiological benefits, to make a next-generation health claim for whole-grain wheat achievable in the near future. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

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20 pages, 2141 KiB

Open AccessReview

Anthocyanins in Whole Grain Cereals and Their Potential Effect on Health

by Alyssa Francavilla and Iris J. Joye

Nutrients 2020, 12(10), 2922; https://doi.org/10.3390/nu12102922 - 24 Sep 2020

Cited by 77 | Viewed by 7383

Abstract

Coloured (black, purple, blue, red, etc.) cereal grains, rich in anthocyanins, have recently gained a lot of attention in the food industry. Anthocyanins are water-soluble flavonoids, and are responsible for red, violet, and blue colours in fruits, vegetables, and grains. Anthocyanins have demonstrated [...] Read more.

Coloured (black, purple, blue, red, etc.) cereal grains, rich in anthocyanins, have recently gained a lot of attention in the food industry. Anthocyanins are water-soluble flavonoids, and are responsible for red, violet, and blue colours in fruits, vegetables, and grains. Anthocyanins have demonstrated antioxidant potential in both in vitro and in vivo studies, and the consumption of foods high in anthocyanins has been linked to lower risks of chronic diseases. As such, whole grain functional foods made with coloured grains are promising new products. This paper will review the characteristics of cereal anthocyanins, and assess their prevalence in various commercially relevant crops including wheat, barley, maize, and rice. A brief overview of the antioxidant potential, and current research on the health effects of cereal-based anthocyanins will be provided. Finally, processing of coloured cereals in whole grain products will be briefly discussed. A full understanding of the fate of anthocyanins in whole grain products, and more research targeted towards health outcomes of anthocyanin supplementation to/inclusion in cereal food products are the next logical steps in this research field. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

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22 pages, 1840 KiB

Open AccessReview

Main Factors Influencing Whole Grain Consumption in Children and Adults—A Narrative Review

by Alexandra Meynier, Aurélie Chanson-Rollé and Elisabeth Riou

Nutrients 2020, 12(8), 2217; https://doi.org/10.3390/nu12082217 - 25 Jul 2020

Cited by 27 | Viewed by 5106

Abstract

Despite their recognized health benefits, intakes of whole grains (WG) are below recommended levels in almost all countries worldwide. This observation highlights the need to increase WG consumption by understanding factors influencing this consumption and how they could be favorably impacted. This review [...] Read more.

Despite their recognized health benefits, intakes of whole grains (WG) are below recommended levels in almost all countries worldwide. This observation highlights the need to increase WG consumption by understanding factors influencing this consumption and how they could be favorably impacted. This review focused on facilitators of and barriers to WG consumption and how to improve the effectiveness of programs aiming at increasing WG consumption. The main methods to facilitate WG intakes in both adults and children seem to be to (i) increase the availability and the variety of foods containing WG, (ii) improve their sensory appeal, (iii) reduce their purchase cost, (iv) use a familiarization period to introduce them to consumers (with a gradual increase in consumed amounts and repeated exposure), and (v) improve communication and labeling to enhance consumers’ ability to identify products with WG. These strategies may be used to improve the effectiveness of programs aiming at promoting WG consumption, with a further emphasis on the need to apply them over a long period of time, and potentially to include tasting sessions of new foods containing WG. Finally, these strategies should involve broad partnerships between multiple stakeholders at the regulatory, institutional and industrial levels. Full article

(This article belongs to the Special Issue Whole Grains for Nutrition and Health Benefits)

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