Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults

The Effects of the Mixed Fermentation of Honeysuckle Cereal Mixed Flour on the Dough Characteristics and Bread Quality

This study investigated the effects of the mixed solid fermentation of honeysuckle cereal mixed flour with lactic acid bacteria and yeast on dough characteristics and bread quality. Honeysuckle powder and whole wheat flour were mixed to make reconstituted cereal flour, and yeast and Lactobacillus plantarum were implanted and mixed to make dough for fermentation. The dynamic rheological properties of the dough were determined, and the properties of the reconstituted cereal flour bread were determined, including the texture characteristics and color; then, the sensory evaluation and antioxidant capacity of the bread were determined. The storage modulus (G′) and loss modulus (G″) of the dough increased gradually with the increase in the honeysuckle powder content, and the loss tangent value, tanδ (G″/G′), was less than 1.0. The loss tangent value of the dough had no significant change (p > 0.05) with the increase in honeysuckle powder content; the L* value of the bread decreased from 88.50 to 76.00, the a* value increased from −1.87 to 0.79, and the b* value decreased from 21.04 to 13.68 with the increase in the amount of honeysuckle powder. When the honeysuckle powder addition was 4%, the reconstituted cereal bread was bright yellow and gave off a hint of bean and wheat flavor and had the best taste and quality. The hardness, chewiness, and the recovery of the bread decreased when the content of the honeysuckle powder was in the range of 0~4%, but the elasticity and the antioxidant and antiaging activity of the bread increased significantly (p > 0.05). It was determined that the best content of honeysuckle powder was 4%. The mixed microbial fermentation of honeysuckle cereal mixed flour can improve the quality and enhance the nutritional value of bread.

Legume Intake Is Associated with Potential Savings in Coronary Heart Disease-Related Health Care Costs in Australia

Legume intake has been associated with lower risk for a number of chronic disorders of high financial burden, and is advocated by dietary guidelines as an important part of healthy dietary patterns. Still, the intake of legumes generally falls short of the recommended levels in most countries around the world despite their role as an alternative protein source. The aim of this study was to assess the potential savings in costs of health care services that would follow the reduction in incidences of coronary heart disease (CHD) when adult consumers achieve a targeted level of 50 g/day of legumes intake in Australia. A cost-of-illness analysis was developed using estimates of current and targeted legumes intake in adults (age 25+ y), the estimated percent reduction in relative risk (95% CI) of CHD following legumes intake, and recent data on health care costs related to CHD in Australia. A sensitivity analysis of ‘very pessimistic’ through to ‘universal’ scenarios suggested savings in CHD-related health care costs equal to AUD 4.3 (95% CI 1.2–7.4) to AUD 85.5 (95% CI 23.3–147.7) million annually. Findings of the study suggest an economic value of incorporating attainable levels of legumes within the dietary behaviors of Australians. Greater prominence of legumes in dietary guidelines could assist with achieving broader sustainability measures in relation to diet, helping to bring together the environment and health as an important pillar in relation to sustainability.

Consumer Understanding of the Australian Dietary Guidelines: Recommendations for Legumes and Whole Grains

Dietary guidelines provide evidence-based guidance for healthy individuals to improve dietary patterns, although they are most often based on individual foods or food groups. Legumes are a class of food included in current Australian Dietary Guidelines (ADG), mentioned in two of the five food groups, as a vegetable and as an alternative to meat. Whole grain consumption is encouraged in ADG via the statement focused on cereal grains due to their health-promoting properties. Despite their prominence in guidelines, average legume and whole grain consumption in Australia remains lower than recommendations outlined in the ADG. This exploratory study aimed to understand consumer perspectives of wording utilised in dietary guidelines specifically focused on legumes and whole grains. Based on the analysis, there was a significant preference for the statement “each day, consume at least one serve of legumes either as a serve of vegetables or as an alternative to meat” (p < 0.05), which provides a specific frequency and quantification for legume consumption. For whole grain, the significantly preferred statement was “choose whole grain products over refined grains/white flour products whenever you can” indicating a less prescriptive option. Effective messaging in guidelines could consider greater specificity regarding frequency, quantity and quality of foods recommended. This exploratory study suggests an improvement in the adoption and consumption of legumes and whole grains in the Australian diet may be better facilitated through consumer-tested messaging.

Whole Grain Consumption and Inflammatory Markers: A Systematic Literature Review of Randomized Control Trials

Whole grain foods are rich in nutrients, dietary fibre, a range of antioxidants, and phytochemicals, and may have potential to act in an anti-inflammatory manner, which could help impact chronic disease risk. This systematic literature review aimed to examine the specific effects of whole grains on selected inflammatory markers from human clinical trials in adults. As per the Preferred Reporting Items for Systematic Reviews (PRISMA) protocol, the online databases MEDLINE, Embase, Cochrane, CINAHL, and Scopus were searched from inception through to 31 August 2021. Randomized control trials (RCTs) ≥ 4 weeks in duration, reporting ≥1 of the following: C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor (TNF), were included. A total of 31 RCTs were included, of which 16 studies recruited overweight/obese individuals, 12 had pre-existing conditions, two were in a healthy population, and one study included participants with prostate cancer. Of these 31 RCTs, three included studies with two intervention arms. A total of 32 individual studies measured CRP (10/32 were significant), 18 individual studies measured IL-6 (2/18 were significant), and 13 individual studies measured TNF (5/13 were significant). Most often, the overweight/obese population and those with pre-existing conditions showed significant reductions in inflammatory markers, mainly CRP (34% of studies). Overall, consumption of whole grain foods had a significant effect in reducing at least one inflammatory marker as demonstrated in 12/31 RCTs.

Consensus, Global Definitions of Whole Grain as a Food Ingredient and of Whole-Grain Foods Presented on Behalf of the Whole Grain Initiative

Proposed global definitions of whole grain as an ingredient and whole grain food are presented by the authors on behalf of the Whole Grain Initiative. Whole grains are an important pillar of healthy and sustainable diets. Internationally accepted credible definitions of whole grains as food ingredients and whole-grain foods are necessary to ensure that all global stakeholders have shared standards, and that consumers find them clear, credible, and useful. Based on widely accepted, existing definitions and new developments, the Definitions Working Group of the global Whole Grain Initiative, with experts from academia, government agencies and industry, developed definitions for global application. The key statements of the definition documents are as follows: "Whole grains shall consist of the intact, ground, cracked, flaked or otherwise processed kernel after the removal of inedible parts such as the hull and husk; all anatomical components, including the endosperm, germ, and bran must be present in the same relative proportions as in the intact kernel" and "A whole-grain food shall contain at least 50% whole-grain ingredients based on dry weight. Foods containing 25-50% whole-grain ingredients based on dry weight, may make a front-of-pack claim on the presence of whole grain but cannot be designated 'whole grain' in the product name". The definition documents have been ratified by the leading international scientific associations in this area. We urge that these consensus Whole Grain Initiative definitions be adopted as the basis for definitions used by national regulatory authorities and for health promotion organisations worldwide to use in nutrition education and food labelling.

Type 2 Diabetes-Related Health Economic Impact Associated with Increased Whole Grains Consumption among Adults in Finland

The prevalence of type 2 diabetes (T2D) is increasing rapidly worldwide. A healthy diet supporting the control of energy intake and body weight has major importance in the prevention of T2D. For example, a high intake of whole grain foods (WGF) has been shown to be inversely associated with risk for T2D. The objective of the study was to estimate the expected health economic impacts of increased WGF consumption to decrease the incidence of T2D in the Finnish adult population. A health economic model utilizing data from multiple national databases and published scientific literature was constructed to estimate these population-level health economic consequences. Among the adult Finnish population, increased WGF consumption could reduce T2D-related costs between 286€ and 989€ million during the next 10-year time horizon depending on the applied scenario (i.e., a 10%-unit increase in a proportion of daily WGF users, an increased number (i.e., two or more) of WGF servings a day, or alternatively a combination of these scenarios). Over the next 20–30 years, a population-wide increase in WGF consumption could lead to much higher benefits. Furthermore, depending on the applied scenario, between 1323 and 154,094 quality-adjusted life years (QALYs) could be gained at the population level due to decreased T2D-related morbidity and mortality during the next 10 to 30 years. The results indicate that even when the current level of daily WGF consumption is already at a relatively high-level in a global context, increased WGF consumption could lead to important health gains and savings in the Finnish adult population.

Whole Grain Intakes Are Associated with Healthcare Cost Savings Following Reductions in Risk of Colorectal Cancer and Total Cancer Mortality in Australia: A Cost-of-Illness Model

Whole grain consumption has been associated with the reduced risk of several chronic diseases with significant healthcare monetary burden, including cancer. Colorectal cancer (CRC) is one of the most common cancers globally, with the highest rates reported in Australia. Three servings of whole grains provide a 15% reduction in total cancer and 17% reduction in CRC risk; however, 70% of Australians fall short of this level of intake. The aim of this study was to assess the potential savings in healthcare costs associated with reductions in the relative risk of CRC and total cancer mortality following the whole grain Daily Target Intake (DTI) of 48 g in Australia. A three-step cost-of-illness analysis was conducted using input parameters from: (1) estimates of current and targeted whole grain intakes among proportions (5%, 15%, 50%, and 100%) of the Australian adult (≥20 years) population; (2) estimates of reductions in relative risk (with 95% confidence intervals) of CRC and total cancer mortality associated with specific whole grain intake from meta-analysis studies; and (3) estimates of annual healthcare costs of CRC and all cancers from disease expenditure national databases. A very pessimistic (5% of population) through to universal (100% of population) adoption of the recommended DTI in Australia were shown to potentially yield savings in annual healthcare costs equal to AUD 1.9 (95% CI 1.2-2.4) to AUD 37.2 (95% CI 24.1-48.1) million for CRC and AUD 20.3 (95% CI 12.2-27.0) to AUD 405.1 (95% CI 243.1-540.1) million for total cancers. As treatment costs for CRC and other cancers are increasing, and dietary measures exchanging whole grains for refined grains are not cost preclusive nor does the approach increase energy intake, there is an opportunity to facilitate cost-savings along with reductions in disease for Australia. These results suggest specific benefits of encouraging Australians to swap refined grains for whole grains, with greater overall adherence to suggestions in dietary guidelines.

Spatial-Temporal Footprints Assessment and Driving Mechanism of China Household Diet Based on CHNS

Food consumption is closely associated with resource consumption and environmental sustainability. An unreasonable dietary pattern would cause great pressure or damage to resources and the environment. It is particularly important to reduce the negative impact of household food consumption on resources and the environment while simultaneously ensuring people’s nutrient intake and health. This study applied the China Health and Nutrition Survey (CHNS) database to quantitatively study the spatial-temporal analysis of multiple footprints of household food consumption at multiple scales and explored the driving mechanism of the multiple footprints. The results showed that, except land footprint (LF), the other four types of footprints all decreased at varying degrees; the water footprint (WF), carbon footprint (CF), nitrogen footprint (NF) and energy footprint (EF) decreased by 18.24%, 17.82%, 12.03% and 20.36%, respectively, from 2000 to 2011; multiple footprints of food consumption of household in Guizhou was the highest among the 12 provinces involved in the study; this shows that resource consumption (water, energy and land resource) and environmental influences (CO₂ emissions and nitrogen emissions) brought by food consumption of per household in Guizhou are much greater than in other provinces, which has a negative influence on sustainable development; by analyzing the driving factors of multiple footprints, it is shown that nutrient intake, household attributes, educational level and health conditions were significantly correlated to multiple footprints. Among them, nutrient intake has greater impact on the multiple footprints of Chinese household food consumption. By comparing multiple footprints of different dietary patterns, it was found that the current Chinese dietary pattern would cause excessive resource consumption, which would bring more pressure on resources and the environment. Adjusting household living habits would possibly reverse the unsustainable situation, such as reducing the consumption of animal-derived foods and adjusting the dietary pattern of households with a higher educational level and income status. Chinese Dietary Guidelines 2016 has better sustainability; the promotion of this dietary pattern across the country would help China to relieve the pressure on resources and environment from the consumer side, promoting the realization of sustainable development.

Oat and Barley in the Food Supply and Use of Beta Glucan Health Claims

Beta glucan is a type of soluble dietary fibre found in oats and barley with known cholesterol-lowering benefits. Many countries globally have an approved beta glucan health claim related to lowering blood cholesterol, an important biomarker for cardiovascular disease. However, the use of these claims has not been examined. The aim of this study was to explore the range and variety of oat and barley products in the Australian and global market within a defined range of grain food and beverage categories and examine the frequency of beta glucan health claims. Australian data were collected via a recognised nutrition audit process from the four major Australian supermarkets in metropolitan Sydney (January 2018 and September 2020) and Mintel Global New Product Database was used for global markets where a claim is permitted. Categories included breakfast cereals, bread, savoury biscuits, grain-based muesli bars, flour, noodles/pasta and plant-based milk alternatives and information collected included ingredients lists and nutrition and health claims. Products from Australia (n = 2462) and globally (n = 44,894) were examined. In Australia, 37 products (1.5%) made use of the beta glucan claim (84% related to oat beta glucan and 16% related to barley beta glucan, specifically BARLEYmax^®). Of products launched globally, 0.9% (n = 403) displayed beta glucan cholesterol-lowering claims. Despite the number of products potentially eligible to make beta glucan claims, their use in Australia and globally is limited. The value of dietary modification in cardiovascular disease treatment and disease progression deserves greater focus, and health claims are an opportunity to assist in communicating the role of food in the management of health and disease. Further assessment of consumer understanding of the available claims would be of value.