Important Steps in Cancer Prevention: Improving Population Whole-Grain Intake—The Danish Show Case or How Was the Danish Whole-Grain Intake Doubled in Less Than 10 Years?

Abstract

Background and context: Dietary whole grain (WG) intake helps prevent noncommunicable diseases (NCDs) such as cancers. However, 92.4% of the global adult population does not meet WG recommendations, and WG intake even decreased between 1990 and 2010. In Denmark, WG intake was similarly decreasing during the 1990s and 2000s, and the Whole Grain Partnership (WGP) was established in 2009 to counteract this development. Aim: To describe the development of this public-private partnership (PPP), the results achieved so far, lessons learned and implications for future initiatives. Strategy/Tactics: The strategy is twofold: increasing availability of WG and campaigning about the health benefits of WG. Program/Policy process: · Research and documentation of WG health benefits · Initiate partnership and functioning of organization and secretariat · Ensure clear WG definitions and dietary guidelines · Set targets and success criteria and monitor progress · Create incentives for industry to reformulate and develop new WG products and make it easy for consumers to identify WG product by developing and endorsing a WG logo · Gradually enriching all bread and flour with WG · Develop education materials for chefs, waiters, bakers, in-store personnel and health professionals · Yearly consumer campaigns. Outcomes: Mean WG intake has near doubled in less than 10 years (from 32 in 2009 to 61 g/day 2017). The increment in intake were also significant among the population groups eating the least WG. The number of WG products increased in this period from 150 to currently 800. Continuous monitoring of consumer behavior show a high knowledge, trust and use of the WG logo has increased during the period. What was learned: · To make the PPP work effectively it is crucial to work evidence based, set realistic targets, reinforce the reasons and advantages for partnering, measure and celebrate progress · The impact on population dietary habits is primarily due to the increased availability of WG product combined with a long-term campaigning activity promoting WG health benefits.