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Review indicates positive health impacts from diverse diets that include not more than 50% carbohydrates and the right mix of grain-based foods.
Grain-based foods — both whole-grain and refined, from which the bran has been removed — are a key part of healthy diets, according to a study published in the science journal Advances in Nutrition.
The study, co-authored by Julie Miller Jones of St. Catherine University, Carlos Guzman of the Universidad de Córdoba and Hans-Joachim Braun of the International Maize and Wheat Improvement Center (CIMMYT), reviewed findings of more than 100 research papers from nutrition and medical journals as well as national health recommendations. It presents evidence for positive health impacts from diverse diets that include not more than 50% carbohydrates and the right mix of grain-based foods.
“Epidemiological studies consistently show that eating three 30-gram portions of whole-grain foods — say, half a cup of oats — per day is associated with reduced chronic disease risk,” said Miller Jones, Professor Emerita at St. Catherine University and first author of the study. “But refined-grain foods — especially staple, enriched or fortified ones of the ‘non-indulgent’ type — also provide key vitamins and minerals that are otherwise lacking in people’s diets.”
“Cereal grains help feed the world by providing millions of calories per hectare and large amounts of plant-based protein,” said Braun, director of CIMMYT’s Global Wheat Program and the CGIAR Research Program on Wheat. “They are affordable, shelf stable, portable, versatile, and popular, and will play a key role as the world transitions to plant-based diets to meet future food needs.”
Folate fortification of refined grains has helped reduce the incidence of spina bifida, anencephaly, and other birth defects, according to Miller Jones. “And despite contributing to high sugar intake, ready-to-eat breakfast cereals are typically consumed with nutritious foods such as milk, yogurt, and fruit,” she added.
All grain-based foods, refined and whole, are good sources of dietary fiber, which is essential for sound health but critically lacking in modern diets. “Only 4 percent of the U.S. population, for example, eats recommended levels of dietary fiber,” she said.
Obesity, Type 2 diabetes, high blood pressure, and other illnesses from unbalanced diets and unhealthy habits are on the rise in countries such as the U.S., driving up health care expenditures. The annual medical costs of obesity alone there have been estimated at nearly $150 billion.
“Dietary choices are determined partly by lifestyle but also co-vary with daily habits and personal traits,” Miller Jones explained. “People who eat more whole-grain foods are more likely to exercise, not smoke, and have normal body weights, as well as attaining higher levels of education and socioeconomic status.”
According to the study, recommendations for grain-based foods need to encourage a healthy number of servings and replacing half of refined-grain foods with whole-grain products, as well as providing clearer and unbiased definitions of both types of grain-based foods.
Association between Grain Intake, Nutrient Intake, and Diet Quality of Canadians: Evidence from the Canadian Community Health Survey–Nutrition 2015
This study examined whether higher shares of whole-grain consumption, beyond the recommended levels (i.e., above half) of the daily grain intake, are linked with optimal diet quality and intakes of some key nutrients, for both children and adolescents and adults in Canada.
Nutrients in the US Diet: Naturally Occurring or Enriched/Fortified Food and Beverage Sources, Plus Dietary Supplements: NHANES 2009–2012
New study concludes fortification / enrichment constitutes a meaningful contribution to reducing the percentage of individuals with less than the EAR for their demographic. These data underscore the need to encourage better dietary patterns to improve the intake of nutrients at risk of low intake.
Extensive analyses of the existing body of published studies show that refined grain consumption is not associated with any of the chronic diseases to which it usually is attributed. This study illustrates that current dietary recommendations to reduce refined grain consumption conflict with the substantial body of published scientific evidence.
This study more precisely quantifies the predictive potential of several markers, to determine which markers are most useful, and to establish an evidence base for quantitative recommendations for intakes of dietary fibre.
Grains Contribute Shortfall Nutrients and Nutrient Density to Older US Adults: Data from NHANES, 2011–2014
Previous data demonstrate grain foods contribute shortfall nutrients to the diet of U.S. adults. The 2015–2020 Dietary Guidelines for Americans have identified several shortfall nutrients in the U.S. population, including fiber, folate, and iron (women only).
Folic acid fortification significantly reduced the prevalence of neural tube defects (NTDs) in the United States. The popularity of “low carb” diets raises concern that women who intentionally avoid carbohydrates, thereby consuming fewer fortified foods, may not have adequate dietary intake of folic acid.
Grain Foods Are Contributors of Nutrient Density for American Adults and Help Close Nutrient Recommendation Gaps: Data from the National Health and Nutrition Examination Survey, 2009–2012
In this study, researchers looked closely at what American adults are eating – or not – to contribute to the growing issue of shortfall nutrients. Shortfall nutrients are very important nutrients – defined by the 2015 DGA Committee – that, when under-consumed, cause public health concerns.
Certain Grain Foods Can Be Meaningful Contributors to Nutrient Density in the Diets of U.S. Children and Adolescents: Data from the National Health and Nutrition Examination Survey, 2009–2012
The current analyses showed that certain grain foods, in particular breads, rolls and tortillas, ready-to-eat cereals and quick breads and bread products, are meaningful contributors of folate, iron, thiamin, niacin and dietary fiber, a nutrient of public health concern as outlined by the 2015–2020 DGA.
Several grain dietary patterns are associated with better diet quality and improved shortfall nutrient intakes in US children and adolescents: a study focusing on the 2015–2020 Dietary Guidelines for Americans
The study identified the most commonly consumed grain food patterns in US children and adolescents (2–18 years-old; N = 8,367) relative to those not consuming grains and compared diet quality and nutrient intakes, with focus on 2015–2020 DGA shortfall nutrients.
This long-term observational cohort study aimed to investigate the potential impact of dietary patterns on death. The study population, comprised of 960 men, found that consumption of certain food groups, including bread, was independently predictive of lower risk of death.
An extensive study by The National Academies of Sciences, Engineering, and Medicine found no substantiated evidence of a difference in risks to human health between current commercially available genetically engineered (GE) crops and conventionally bred crops, nor did it find conclusive cause-and-effect evidence of environmental problems from the GE crops.
CIMMYT Series on Carbohydrates, Wheat, Grains, and Health: Carbohydrates, Grains, and Wheat in Nutrition and Health: Their Relation to Digestion, Digestive Disorders, Blood Glucose, and Inflammation
In part three of the series, the authors take a closer look at how different carbohydrates affect insulin levels, inflammation, the gut microbiome, and gut-related diseases such as irritable bowel syndrome. This report also covers celiac disease and food allergies.
CIMMYT Series on Carbohydrates, Wheat, Grains, and Health: Carbohydrates, Grains and Wheat in Nutrition & Health: An Overview. Part II: Grain Terminology and Nutritional Contributions
In part two of this series, the authors cover topics regarding grain terminology, including definitions of milling, enrichment, whole grains and various other processing terms. (more…)
Prebiotic consumption and the incidence of overweight in a Mediterranean cohort: the Seguimiento Universidad de Navarra Project
In this cohort study, researchers looked at consumption of prebiotics (fructans and GOS) over nine years. They found that the risk of becoming overweight was 15-17% lower in participants in the highest quartile of fructan and GOS consumption. (more…)
It is the position of the Academy of Nutrition and Dietetics that the public should consume adequate amounts of dietary fiber from a variety of plant foods.
CIMMYT Series on Carbohydrates: Wheat, Grains and Health: Carbohydrates, Grains and Wheat in Nutrition and Health: An Overview Part 1. Role of Carbohydrates in Health
Cereal grains provide a wide variety of nutrients, dietary fibers and phytochemicals. The combination uniquely positions them as a source of nutrition to both sustain and nourish a global population.
Despite health claims for gluten-free eating from celebrities and the media, there is no evidence indicating the general population would be better off avoiding gluten for weight loss in individuals without celiac disease, non-celiac gluten sensitivity and wheat allergy.
There is increasing evidence from both observational and intervention studies that increased intake of whole grain foods has positive health benefits, including lower risk of developing cardiovascular disease, type 2 diabetes and some cancers. Whole grain consumers may also have better digestive health and are likely to have lower BMI and gain less weight over time.
Whole-grain products and whole-grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort
A study following a Scandinavian cohort demonstrated intake of whole grains was associated with a lower risk of mortality, indicating whole grain consumption is an important aspect of preventing early death.
In a study examining data on anemia in countries that fortify flour (and those that do not), researchers found that every year a flour fortification program was in place was associated with a 2.4% decrease in anemia prevalence among non-pregnant women.
Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies
Fibre intake is inversely related to the risk of developing type 2 diabetes and cereal fibre found in grain foods, such as bread, rice and pasta, was found to be the most protective. Researchers found the protective effect of fibre intake on diabetes risk may be partially explained by body weight.
Genetic gains in agronomic and selected end-use quality traits over a century of plant breeding of Canada Western Red Spring Wheat
Researchers compared wheat grown from wheat seeds dating from 1860 to present day. They found that wheat grown today remains similar to ancient wheat in terms of protein and carbohydrate quality and concentration. This refutes critics claims that modern wheat has “changed” and is the cause of modern-day diseases such as obesity and type 2 diabetes.
A short-term gluten-free diet had no overall effect on performance, GI symptoms, well-being, and a select indicator of intestinal injury or inflammatory markers in non-celiac endurance athletes.
Cost of Nutrients Analyses Using the National Health and Nutrition Examination Survey: A Focus on Grain Foods
The objective of the present study was to assess the cost of energy, nutrients, and related substances in the American diet and to define some of the most cost effective foods for providing these food components.
Consumption of Certain Grain Food Patterns is Associated With Improved Diet Quality and Nutrient Intakes in US Adults: A NHANES 2005-2010 Analysis
We identified the most commonly consumed grain food patterns in US adults and compared nutrient intakes, diet quality (via Healthy Eating Index), anthropometric and physiological parameters of those consuming various grain foods patterns to those not consuming grains.
Modeling Changes in Daily Grain Foods Intake: An Analysis to Determine the Impact on Nutrient Intakes in Comparison to the USDA Ideal Food Pattern
Dietary Guidelines for Americans (DGA) encourage increased whole grains (WG) and dietary fiber intake while limiting refined grains (RG). We identified how changes in DGA recommendations for grain intake could impact nutrient/energy intake for US adults.
Refined grains plays a role in a healthy diet providing many benefits including B vitamins and folic acid, nutrients which may be lacking in some diets.
Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study
A greater intake of dietary fiber after a heart attack, especially cereal fiber, was inversely associated with all cause mortality. In addition, increasing consumption of fiber from before to after experiencing a heart attack was significantly associated with lower all cause and cardiovascular mortality.
Women adhering to a “prudent” dietary pattern during pregnancy were at lower risk of preterm delivery compared with other women. Although these findings cannot establish causality, they support dietary advice to pregnant women to eat a balanced diet including vegetables, fruit, whole grains, and fish and to drink water.
Total dietary fiber intakes in the US population are related to whole grain consumption: Results from the National Health and Nutrition Examination Survey 2009 to 2010
Whole grain foods make a substantial contribution to total dietary fiber intake and should be promoted to meet recommendations.
Enriched and fortified foods, like enriched grain products, prove to be a major contributor of key nutrients like iron, riboflavin, niacin, vitamin B6, and zinc in the diets of US children.
Prospective study of Dietary Approaches to Stop Hypertension– and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging
Higher levels of accordance with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an 11-y period.
An updated evidence-based position statement from the American Diabetes Association (ADA) recommends all adults living with diabetes seek nutrition counsel as a part of a managed care plan. The ADA reinforces there is no “one size fits all” approach to diabetes and the focus should be on eating patterns as a whole, rather than strict diet plans.
Despite suggestions wheat consumption has adverse effects on health, these arguments cannot be substantiated by science. In fact, consuming foods containing whole wheat in recommended amounts has been associated with significant reductions in risks for type 2 diabetes and heart disease as well as more favorable long-term weight management.
As part of a series of articles dedicated to providing unified grains health messaging, this piece overviews the research on the impact of grain consumption on health, with a focus on enriched grains’ nutritional contributions.
This study supports the hypothesis that adherence to a diet comprised of vegetables, fruits, whole grains, fish and legumes may protect against the development of depressive symptoms in older age.
This study examined the relationship between cardiovascular risk factors and cognitive decline in people ages 35-44. A worse overall cardiovascular profile was associated with poorer cognitive function, revealing cognitive decline occurs earlier than previously realized.
A prospective, population-based, cohort finds higher adherence to Mediterranean diet was associated with a lower likelihood of incident cognitive impairment independent of potential confounders. This association was moderated by the presence of diabetes mellitus.
Type 2 Diabetic And Alzheimer’s Disease Mice Present Similar Behavioral, Cognitive, And Vascular Anomalies
Type 2 diabetes is considered a major risk factor for Alzheimer’s disease. To elucidate the links between both pathological conditions, the behavioral and cognitive functions in mice were compared.
In Parkinson’s disease, the redistribution of macronutrient intake by limiting fat intake and introducing high-quality carbohydrates as a main source of calories may help relieve associated gastrointestinal symptoms associated with the condition.
Blood markers of whole-grain intake confirm a previously observed inverse relationship between whole-grain intake and Body Mass Index (BMI).
Despite the health claims for gluten-free diets, there is no published experimental evidence to support such claims for the general population. In fact, data suggests that gluten may provide health benefits, and that avoidance may not be justified for healthy individuals.
Consuming a low-carbohydrate diet is associated with greater likelihood of being overweight or obese among healthy adults. Lowest risk may be obtained by consuming 47% to 64% energy from carbohydrates.
Following a low-carbohydrate, high-fat diet may lead to increased cholesterol levels, which could increase risk for developing heart disease.
Maternal Periconceptional Folic Acid Intake And Risk Of Autism Spectrum Disorders And Developmental Delay
Mothers who consume the recommended amount of folic acid during the first month of pregnancy may be at a lower risk of having a child who develops autism spectrum disorder.
Higher intake of folate in young adulthood was associated with a decreased risk of developing high blood pressure later in life.
Since fortification of enriched grains began in the U.S. in 1998, there has been a decrease in the incidence of certain types of childhood cancers.
In the Australian Raine study, the relationship between dietary patterns and ADHD was examined in a population-based cohort of live births followed to age 14. Two major dietary patterns were identified, according to foods considered the main contributors.
Relationship between Whole-Grain Intake, Chronic Disease Risk Indicators, and Weight Status among Adolescents
Whole-grain intake in adolescents was related to positive nutrient profiles and chronic disease risk factors, which supports current recommendations to promote greater intake of whole grains among adolescents.