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.

Jessica Smith,Yong Zhu,Neha Jain,Norton Holschuh,Jimmy Louie

doi:10.1371/journal.pone.0253052

Abstract

Whole grains have been associated with numerous beneficial health outcomes and are recommended in Canada's Food Guide; however, there is little research on whole grains specific to Canada. Therefore, the objective of this study was to characterize the association between Canadians' WG intake and nutrients, food groups and diet quality and to understand top sources of WG in the diets of Canadians. We used data from the Canadian Community Health Survey 2015: a cross-sectional survey that collected information on diet (using a 24-hour recall) and health from 20,487 Canadians 1 year and older. We classified study participants according to their WG intake: non-WG (n = 10,883) and three groups based on age-specific tertiles of WG intake, low-WG (n = 3,322), mid-WG (n = 3,180), and high-WG (n = 3,102). Results were analyzed using population-based survey methods and were adjusted for energy, age, gender, overweight/obesity, income, and supplement use. We found differences in nutrients and food groups by WG group: there was a significant linear trend across groups of increasing WG for increased fiber (children and adults), vitamin B6 (children), thiamin (adults), potassium (children and adults), zinc (adults), calcium (children and adults), iron (children and adults), magnesium (children and adults), fruit (adults), and legumes, nuts and seeds (adults); and decreased total fat (adults), saturated fat (adults), folate (children and adults), refined grains (adults and children), and meat and poultry (adults) intake. We found that there were no differences in total sugar or sodium intake across WG intake groups. The high WG intake group for both children and adults had higher diet quality, measured by the Nutrient Rich Food Index 9.3, compared to non-WG eaters. The top 2 food sources of WG across WG intake groups for children and adults were whole grain oat and high fiber breakfast cereal and whole grain and whole wheat bread. Other top sources of WG included rice, bread products, other breakfast cereals, salty snacks, cereal grains and flours, pasta, and sweet snacks. This research supports recommendations to increase WG foods intake as a means to improve diet quality of Canadians.

Highlights

Canada’s Dietary Guidelines recommend consumption of whole grain foods as part of healthy dietary patterns [1]
This study used the publicly available data from the 2015 Canadian Community Health Survey (CCHS)–Nutrition: Public Use Microdata File (PUMF), which can be accessed through Statistics Canada [20]
We reported the average number of servings of whole grain foods, as defined in the CCHS 2015 database, and the percent of grain foods intake from whole grain foods, calculated as the mean of the ratios of grams of total grain food tiers 1–4 to whole grain food tiers 1–4

Summary

Introduction

Canada’s Dietary Guidelines recommend consumption of whole grain foods as part of healthy dietary patterns [1]. Consumption of whole grains may be a marker of higher overall diet quality and be associated with beneficial intake of numerous food groups, nutrients, and dietary compounds [6,10,11]. Despite these benefits, intakes of whole grain remain below recommendations in the US and Europe [12,13,14,15,16]. Few global policies have been directed toward increasing whole grain intake despite potentially large impacts on decreasing mortality and disability [17]

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Discussion

Conclusion