Abstract
Background: While dietary recommendations call for greater whole-grain intake and reduced refined grain consumption, there are limited peer-reviewed studies examining the influence of fortified/enriched refined grains on nutrient adequacy.Methods: A modeling analysis using data from National Health and Nutrition Examination Survey (NHANES) 2009–2016 estimated usual daily intake of shortfall nutrients for Dietary Guidelines for Americans (DGA) in the current dietary pattern and when specific percentages of fortified/enriched refined grain foods (bread, ready-to-eat cereals, and all-grained foods) were removed from the diet (19–50-year-old adults, N = 11,169; 51–99-year-old adults, N = 9,641).Results: While American adults are currently falling short of nutrient recommendations, eliminating 25, 50, and 100% of all grains consumed in the US dietary pattern resulted in a greater percentage of adults not meeting recommendations for several shortfall nutrients, including dietary fiber, folate DFE, iron, and magnesium. Removal of all grains led to a reduced energy intake by ~10% in both age groups examined. Currently, ~3.8% of 19–50-year-old adults meet the adequate intake (AI) for dietary fiber. Removal of 25, 50, and 100% of grains from the diet resulted in 2.6 ± 0.3, 1.8 ± 0.2, and 0.7 ± 0.1% of adults exceeded the AI for dietary fiber, respectively. Similarly, 11.0 and 13.8% of younger and older adults, respectively, fall short of folate, DFE recommendations with the current diet. Following the removal of 100% of grains from the diet, 43.4 ± 1.1 and 56.2 ± 1.0%, respectively, were below the estimated average requirement (EAR) for folate DFE. For iron, current dietary pattern consumption shows 8.4% and 0.8% of younger and older adults, respectively, are not meeting iron recommendations, however, removal of 100% of grains from the diet results in nearly 10 and 22% falling short of the EAR. Currently, about 51 and 54% of younger and older adults are below the EAR for magnesium; however, with the removal of 100% of grains, 68 and 73%, respectively, fall below the EAR.Conclusion: Removal of specific refined grains led to an increased percentage of Americans not meeting recommendations for several shortfall nutrients, including dietary fiber, folate, iron, and magnesium.
Highlights
The 2020 Dietary Guidelines for Americans (2020 DGA) provide food and nutrition recommendations for all Americans of 2 years of age and older, with the promotion of dietary patterns emphasizing fruits, vegetables, whole grains, lean protein foods, and low-fat or fat-free dairy products, all of which are based on their contributing nutrient density to the American diet [1]
While American adults are currently falling short of nutrient recommendations, eliminating 25, 50, and 100% of all grains consumed in the US dietary pattern resulted in a greater percentage of adults not meeting recommendations for several shortfall nutrients, including dietary fiber, folate DFE, iron, and magnesium
Current dietary pattern consumption shows 8.4% and 0.8% of younger and older adults, respectively, are not meeting iron recommendations, removal of 100% of grains from the diet results in nearly 10 and 22% falling short of the estimated average requirement (EAR)
Summary
The 2020 Dietary Guidelines for Americans (2020 DGA) provide food and nutrition recommendations for all Americans of 2 years of age and older, with the promotion of dietary patterns emphasizing fruits, vegetables, whole grains, lean protein foods, and low-fat or fat-free dairy products, all of which are based on their contributing nutrient density to the American diet [1]. While dietary guidance encourages increased consumption of whole grains, there are limitations placed on refined grain consumption [1]. Both the 2015 DGA [2] and the 2020 DGA [1] have recommended that half of your daily total grain servings should be derived from whole grains. Shortfall nutrients have been defined as “nutrients that are under-consumed relative to requirement levels set by the Institute of Medicine (IOM) and includes dietary fiber, calcium, magnesium, potassium, vitamins A, C, D, and E, dietary folate, and iron in select female populations.”. While dietary recommendations call for greater whole-grain intake and reduced refined grain consumption, there are limited peer-reviewed studies examining the influence of fortified/enriched refined grains on nutrient adequacy
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