Abstract
Many dietary guidelines emphasise “mostly” whole grain food choices as part of an overall healthy eating pattern based on evidence for enhancing nutritional status and reducing chronic disease. Still, countries including Australia fall short of their consumption targets. Furthermore, healthcare cost savings associated with increasing the consumption of whole grains in alignment with the Daily Target Intake (DTI) recommendation of 48 g are unknown. The aim of this study was to assess the potential savings in costs of healthcare and lost productivity associated with a reduction in the incidence of Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD) through meeting the 48 g DTI recommendation for whole grains among the Australian adult population (>20 years). A three-step cost-of-illness analysis was conducted using input parameters from: 1) estimates of proportions of consumers (5%, 15%, 50%, and 100%) who would increase their current intake of whole grains to meet the recommended DTI in Australia; 2) relative reductions in risk of T2DM and CVD associated with specific whole grain consumption, as reported in meta-analysis studies; and 3) data on costs of healthcare and productivity loss based on monetary figures by national healthcare authorities. A very pessimistic (5% of the population) through to universal (100% of the population) adoption of the recommended DTI was shown to potentially yield AUD 37.5 (95% CI 22.3–49.3) to AUD 750.7 (95% CI 445.7–985.2) million, and AUD 35.9 (95% CI 8.3–60.7) to AUD 717.4 (95% CI 165.5–1214.1) million in savings on annual healthcare and lost productivity costs for T2DM and CVD, respectively. Given such economic benefits of the recommended consumption of whole grains, in exchange for refined grains, there is a real opportunity to facilitate relevant socioeconomic cost-savings for Australia and reductions in disease. These results are suggestive of a much greater opportunity to communicate the need for dietary change at all levels, but particularly through food-based dietary guidelines and front-of-pack labelling initiatives.
Highlights
Grains and grain-based foods are a key food category in dietary recommendations, as they provide 60% of global energy intake [1] with a range of important nutrients, including dietary fibre, folate, thiamin, magnesium, and iron [2]
Since 1979, the Australian Dietary Guidelines have promoted whole grain choices [3], which have been described by Food Standards Australia New Zealand (FSANZ) [4] as the intact grain or the dehulled, ground, milled, cracked or flaked grain where the constituents—endosperm, germ and bran—are present in such proportions that represent the typical ratio of those fractions occurring in the whole cereal, and includes wholemeal
70% of grains consumed in Australia are refined grains, such that a 160% increase in current whole grain consumption and a 30% decrease in refined grain food consumption has been recommended by the Australian Dietary Guidelines [10]
Summary
Grains and grain-based foods are a key food category in dietary recommendations, as they provide 60% of global energy intake [1] with a range of important nutrients, including dietary fibre, folate, thiamin, magnesium, and iron [2]. Research ranks diets low in whole grain as second only to diets high in sodium in causing greatest risks of morbidity and mortality [7]. This is the case in Australia, where 27,500 preventable deaths are due to diet, with 7400 due to diets low in whole grain annually [8]. The most recent National Nutrition and Physical Activity Survey (NNPAS), based on single 24 h dietary recall data (n = 12,153) [6], demonstrated a median daily whole grain intake of 21 g in adults (19–85 years), indicating a mean gap of 27 g/day between current and targeted consumption. 70% of grains consumed in Australia are refined grains, such that a 160% increase in current whole grain consumption and a 30% decrease in refined grain (cereal) food consumption has been recommended by the Australian Dietary Guidelines [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
