Association between whole grain food intake in Canada and nutrient intake, food group intake and diet quality: Findings from the 2015 Canadian Community Health Survey

Exploring the reporting, intake and recommendations of primary food sources of whole grains globally: a scoping review

Whole-grain intake is associated with reduced risk of non-communicable diseases. Greater understanding of major food sources of whole grains globally, and how intake has been quantified, is essential to informing accurate strategies aiming to increase consumption and reduce non-communicable disease risk. Therefore, the aim of this review was to identify the primary food sources of whole-grain intake globally and explore how they are quantified and reported within literature, and their recommendation within respective national dietary guidelines. A structured scoping review of published articles and grey literature used a predefined search strategy across electronic databases. Data were extracted and summarised based on identified outcomes (e.g. primary sources of whole-grain intake and quantification methods). Dietary intake values were noted where available. Thirteen records across twenty-four countries identified bread and bread rolls, and ready-to-eat cereals as primary sources of whole-grain intake in Australia, New Zealand, Europe, the UK and Northern America. Elsewhere, sources vary and for large parts of the world (e.g. Africa and Asia), intake data are limited or non-existent. Quantification of whole grain also varied across countries, with some applying different whole-grain food definitions, resulting in a whole-grain intake based on only consumption of select ‘whole-grain’ foods. National dietary guidelines were consistent in promoting whole-grain intake and providing examples of country-specific whole-grain foods. Consistency in whole-grain calculation methods is needed to support accurate and comparative research informing current intake evidence and promotional efforts. National dietary guidelines are consistent in promoting whole-grain intake; however, there is variability in recommendations.

Increasing particle size of oat flours decreases postprandial glycemia and increases appetite in healthy adults

Consumption of oats is associated with lowered risks of type 2 diabetes and obesity. However, many oat-based products (e.g., breakfast cereals) use finely milled flours but are associated with health claims based on oats of larger particle sizes. The objective of this study was to test the hypothesis that increasing oat flour particle size will result in lower postprandial glycemia and appetite. Using a randomized-controlled, crossover design, 20 participants (10 males, 10 females; age: 25.3 ± 1.0 years; body mass index: 23.2 ± 0.6 kg/m2) consumed a serving of porridge made using 40 g of coarse (675.7 ± 19.6 µm), whole (443.3 ± 36.2 µm), fine (96.0 ± 2.1 µm), or a commercial (375.9 ± 14.8 µm) oat flour unmatched in available carbohydrate, protein, and dietary fiber content. After a 12-hour overnight fast, blood glucose, insulin, and appetite were measured at 15 to 30-minute intervals over 120 minutes posttreatment consumption. Coarse and whole flours led to lower blood glucose between 30 and 60 minutes (P < .02). Blood glucose area under the curve (AUC) was lower after coarse than fine and commercial oat flours (P < 0.03), and after whole than fine oat flour (P < .002). Both coarse and whole oat flours resulted in lower insulin AUC than finer flours (P < .05). Appetite AUC was lower after the commercial than coarse flour (P < .007). Controlling milling to produce coarser oat flour to add to common foods may have health benefits. This study was registered at ClinicalTrials.gov (NCT05291351).

Randomised controlled trial of lifestyle interventions for abdominal obesity in primary health care

AIM

Assess effects on waist circumference from diet with or without cereal grains and with or without long-term physical exercise.

BACKGROUND

Elevated waist circumference is an indicator of increased abdominal fat storage and is accordingly associated with increased cardiovascular mortality. This is likely due to the association between lifestyle-induced changes in waist circumference and cardiovascular risk factors. Reductions in waist circumference may be facilitated by diet without cereal grains combined with long-term physical exercise.

METHODS

Two-year randomised controlled trial with factorial trial design in individuals at increased risk of cardiovascular disease with increased waist circumference. Participants were allocated diet based on current Swedish dietary guidelines with or without cereal grains (baseline diet information supported by monthly group sessions) and with or without physical exercise (pedometers and two initial months of weekly structured exercise followed by written prescription of physical activity) or control group. The primary outcome was the change in waist circumference.

FINDINGS

The greatest mean intervention group difference in the change in waist circumference among the 73 participants (47 women and 26 men aged 23-79 years) was at one year between participants allocated a diet without cereal grains and no exercise and participants allocated a diet with cereal grains and no exercise [M = -5.3 cm and -0.9 cm, respectively; mean difference = 4.4 cm, 4.0%, 95% CI (0.0%, 8.0%), P = 0.051, Cohen's d = 0.75]. All group comparisons in the change in waist circumference were non-significant despite the greatest group difference being more than double that estimated in the pre-study power calculation. The non-significance was likely caused by too few participants and a greater than expected variability in the change in waist circumference. The greatest mean intervention group difference strengthens the possibility that dietary exclusion of cereal grains could be related to greater reduction in waist circumference.

Whole grain intake, diet quality and risk factors of chronic diseases: results from a population-based study in Finnish adults

OBJECTIVES

Better diet quality of whole grain consumers could contribute to the associations between whole grain intake and chronic disease risk factors. We examined whole grain intake in relation to diet quality and chronic disease risk factors (anthropometrics, blood pressure, cholesterol, triglycerides, C-reactive protein and glucose) and the role of diet quality in whole grains' associations with each risk factor.

METHODS

Our data included 5094 Finnish adults who completed a validated food frequency questionnaire and participated in a health examination within the National FinHealth 2017 Study. We assessed diet quality by the modified Baltic Sea Diet Score. P trends were calculated across whole grain intake quintiles by linear regression analysis. Interactions were assessed by including an interaction term in the analyses.

RESULTS

Higher whole grain intake was associated with slightly better diet quality compared with lower intakes in both sexes (P < 0.001). Whole grain intake was inversely associated with body mass index (P < 0.001), waist circumference (P < 0.001) and total cholesterol (P = 0.02) in men. Adjusting for medication use attenuated the inverse associations with diastolic blood pressure (P = 0.06) and HDL cholesterol (P = 0.14) in men. We observed no associations in women. Diet quality did not modify the associations between whole grain intake and chronic disease risk factors.

CONCLUSIONS

Our results suggest that whole grain intake was associated with small improvements in the chronic disease risk factors in men, regardless of diet quality. The sex differences may arise from varying health associations of whole grains from different cereal sources.

Ready-to-eat cereal consumption is associated with improved nutrient intakes and diet quality in Canadian adults and children across income levels

Background

Results from observational studies suggest ready-to-eat cereal (RTEC) consumption is associated with higher diet quality. In the United States, studies have shown that RTEC is an important contributor to nutrient intakes across income levels. However, it is unknown if this association varies by income level in the Canadian population. Given its affordability, RTEC may represent an important source of nutrients for lower-income individuals.

Objective

This study evaluated the association of RTEC consumption with nutrient intakes and diet quality across household income levels in Canadian adults and children.

Methods

Income and dietary data from 24 h dietary recalls were obtained from the 2015 Canadian Community Health Survey (CCHS)-Nutrition in 6,181 children (2-18 years) and 13,908 adults (19+ years). Diet quality was assessed with a modified Nutrient Rich Food Index (NRF) 9.3. Income levels were stratified into low, middle, and high based on family size, and data were analyzed by RTEC consumption and income level using multivariate linear regression adjusted for energy, age, and sex.

Results

Diet quality was greater in adult and child RTEC consumers across all household income levels. Children and adults consuming RTEC also had higher nutrient intakes, including shortfall nutrients such as calcium, dietary fiber, iron, magnesium, and vitamin D. RTEC provided <10% of energy intake, <4% of saturated fat intake, and <9% of total sugar intake across all ages and income levels, while also providing one-third of daily iron intake and at least 10% of daily intake of dietary fiber, thiamin, folate, and vitamin B6.

Conclusion

RTEC consumption was associated with improved nutrient intakes and diet quality in adults and children across household income levels. Nutrient dense and affordable food choices, such as RTEC, may be a helpful strategy to improve the diet quality of Canadians, particularly those with a lower household income.

Whole grain metabolite 3,5-dihydroxybenzoic acid is a beneficial nutritional molecule with the feature of a double-edged sword in human health: a critical review and dietary considerations

Nonprocessed foodstuffs of plant origin, especially whole-grain cereals, are considered to be health-promoting components of the human diet. While most of their well-studied effects derive from their high fiber content and low glycemic index, the presence of underrated phenolic phytonutrients has recently been brought to the attention of nutritionists. In this review, we report and discuss findings on the sources and bioactivities of 3,5-dihydroxybenzoic acid (3,5-DHBA), which is both a direct dietary component (found, e.g., in apples) and, more importantly, a crucial metabolite of whole-grain cereal-derived alkylresorcinols (ARs). 3,5-DHBA is a recently described exogenous agonist of the HCAR1/GPR81 receptor. We concentrate on the HCAR1-mediated effects of 3,5-DHBA in the nervous system, on the maintenance of cell stemness, regulation of carcinogenesis, and response to anticancer therapy. Unexpectedly, malignant tumors take advantage of HCAR1 expression to sense 3,5-DHBA to support their growth. Thus, there is an urgent need to fully identify the role of whole-grain-derived 3,5-DHBA during anticancer therapy and its contribution in the regulation of vital organs of the body via its specific HCAR1 receptor. We discuss here in detail the possible consequences of the modulatory capabilities of 3,5-DHBA in physiological and pathological conditions in humans.

Associations between Avocado Consumption and Diet Quality, Dietary Intake, Measures of Obesity and Body Composition in Adolescents: The Teen Food and Development Study

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12-18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (β [SE] = 0.11 [0.03]) and moderation (β [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.