Trends in Whole-Grain Food Intake Among Adult Americans, Based on Different Definitions of Whole-Grain Foods, NHANES 2003–2018

Abstract

ObjectivesWhole-grain (WG) foods have been defined in various ways, contributing to the challenge in guiding consumers and formulating nutrition policies to improve whole grain consumption. We aimed to compare the mean WG food consumption estimated using different definitions proposed by USDA, FDA, American Heart Association (AHA), American Association of Cereal Chemists International (AACCI), and Whole Grain Council (WGC). MethodsBased on different WG food definitions, we estimated the survey-weighted, energy-adjusted mean intake of WG foods (ounces equivalent/day, oz. eq./d) and associated trends using 24-hour dietary recalls from a nationally representative sample of 39,726 U.S. adults aged 20 + years from 2003–2018 National Health and Nutrition Examination Survey (NHANES). ResultsThe mean WG food consumption among US adults in 2017–2018 varied by the WG food definition, with the highest amount (oz. eq./day) estimated using the AHA (mean [SE]:1.05 [0.07]) and WGC (0.95 [0.07]) definitions, followed by USDA Dietary Guidelines for Americans (DGA) (0.81 [0.06]) and AACCI (0.73 [0.05]) definitions, whereas the FDA (0.53 [0.04]) and USDA School Meals (0.29 [0.02]) definitions gave the lowest estimates. US adults increased WG food consumption from 2003–2004 to 2017–2018 with all definitions except for WGC, with the largest increase (61.5%) estimated by the AHA definition (from 0.65 to 1.05 oz. eq./day), followed by USDA DGA (from 0.50 to 0.81) and AACCI (from 0.52 to 0.73) definitions. Using USDA DGA definition, the most frequently consumed WG foods (oz. eq./day) in 2017–2018 were breads, rolls, and tortillas (mean [SE]: 0.31 [0.04]), followed by ready-to-eat cereals (0.14 [0.01]), and savory snacks and crackers (0.12 [0.02]). Based on the same definition, the largest increase in WG foods (oz. eq./day) consumed by US adults were breads, rolls, and tortillas (mean change [95% CI]: 0.26 [0.18 to 0.34]). ConclusionsThe definitions used to define WG foods affect the estimated mean and trends of WG foods consumed by US adults. This finding calls for a standard definition of WG foods across the nation to guide consumers and inform policy formulation to promote whole grain intake among Americans. Funding SourcesNIH/NIMHD R01 MD011501.