Intake Of Whole-grain Foods Research Articles

Healthy Eating beyond Whole Grains-Insight on Associations between Diet Quality and Arterial Stiffness in the Brisighella Heart Study Cohort.

Although whole grains have well-recognized protective effects against the development of cardiometabolic diseases, whole grain foods are poorly consumed by the general population. The aim of our study was to establish, at a population level, the vascular impact of a low intake of whole grain foods. From the initial cohort of the Brisighella Heart Study, we identified a population sample of 1503 individuals-including 720 men (47.9%) and 783 women (52.1%)-who overall largely consumed refined grain products. Diet quality was estimated by the Short Healthy Eating Index (sHEI), and women were found to have an eating pattern that was overall healthier than men (44.1 ± 8.5 vs. 36.3 ± 8.1, p < 0.001). The development of an age- and blood pressure (BP)-adjusted multiple linear regression model found that carotid-femoral pulse wave velocity (cfPWV) was significantly predicted by the estimated glomerular filtration rate (eGFR, B = -0.148, 95% Confidence Interval (CI) -0.259--0.038, p < 0.001), serum uric acid (SUA, B = 0.220, 95%CI 0.095-0.320, p = 0.001) and sHEI (B = -0.231, 95%CI -327--0.089, p < 0.001) in men, and by eGFR (B = -0.152, 95%CI -0.266--0.052, p < 0.001), body mass index (BMI, B = 0.174, 95%CI 0.111-0.331, p = 0.002), SUA (B = 0.278, 95%CI 0.158-0.354, p < 0.001) and sHEI (B = -0.218, 95%CI -308--0.115, p < 0.001) in women. Ultimately, a low sHEI score was a significant predictor of arterial stiffness also in a population cohort with a high consumption of refined grain products.

Bone Health in Premenopausal Women with Coeliac Disease: An Observational Study.

Low bone mineral density (BMD) is common in adults with coeliac disease (CD), even in individuals adhering to a gluten-free diet (GFD). Women are more likely to have low BMD and have an increased risk of osteoporosis, so women with pre-existing low BMD related to CD are at an even higher risk. BMD assessed by dual X-ray absorptiometry (DXA) and bone quality assessed through quantitative ultrasound (QUS) were investigated in 31 premenopausal women with CD consuming a GFD, and 39 matched healthy controls from the Lower North Island, New Zealand. In addition, bone metabolism and nutrient status were assessed, and four-day diet diaries were used to estimate nutrient intake. No statistically significant differences were found in BMD assessed by DXA between the two groups at the hip, lumbar spine or forearm. However, the parameters measured by the QUS were significantly lower in CD participants. Dietary data indicated significantly lower intakes of energy, dietary fibre, magnesium and phosphorus in women with CD, likely as a result of a reduced intake of wholegrain foods, and suggested that both groups had inadequate intake of calcium. No significant differences were demonstrated in biochemical parameters. BMD and bone biomarkers indicated no differences between coeliac and healthy women in New Zealand. However, these findings suggest that QUS may be more sensitive for the coeliac population, due to the disease's affect on the trabecular bone, and warrant further research.

Influence of Brown or Germinated Brown Rice Supplementation on Fecal Short-Chain Fatty Acids and Microbiome in Diet-Induced Insulin-Resistant Mice.

Intake of whole grain foods is associated with improving metabolic profile compared to refined grain products, but the underlying mechanism remains unclear. The present study examined the effects of brown rice (BRR) or germinated brown rice (GBR) supplementation on fecal short-chain fatty acids (SCFAs), and relationship with gut microbiota, metabolism and inflammation in high fat (HF)-diet-fed mice. The results demonstrated that an HF diet supplemented with BRR or GBR comparably increased the abundance of fecal isobutyric acid compared to that in mice receiving HF+white rice (WHR) diet (p < 0.01). The abundance of valeric acid in HF+GBR-diet-fed mice was higher than those receiving HF+WHR diet (p < 0.05). The abundances of fecal isobutyric acid negatively correlated with fasting plasma glucose, insulin, cholesterol, triglycerides, tumor necrosis factor-α, plasminogen activator inhibit-1, monocyte chemotactic protein-1 and homeostatic model assessment of insulin resistance (p < 0.01). The abundance of valeric acids negatively correlated with insulin resistance (p < 0.05). The abundances of isobutyric acid positively correlated with Lactobacillus, but negatively correlated with Dubosiella genus bacteria (p < 0.05). The findings demonstrated that the increases in SCFAs in the feces of BRR and GBR-treated mice were associated with improvements in gut microbiome, metabolic and inflammatory profile, which may contribute to the antidiabetic and anti-inflammatory effects of the whole grains in HF-diet-fed mice.

Whole-grain food intake among US adults, based on different definitions of whole-grain foods, NHANES 2003–2018

Whole-grain (WG) foods are defined by the Dietary Guidelines for Americans (DGA), FDA, AHA, American Association of Cereal Chemists International (AACCI), and Whole Grains Council (WGC) in different ways with diverse focuses on grain components only, whole foods, or nutrient contents. We aimed to compare estimated WG food intake among US adults using different definitions. For each definition, we estimated the mean intake and trends of WG food consumption using survey-weighted 24-h dietary recalls from nationally representative samples of 39,755 US adults aged 20+y from 8 cycles (2003-2018) of the NHANES. This is an observational study that used deidentified and publicly available datasets. The estimated mean consumption of WG foods (ounces equivalents/2000kcal/d, oz. eq./d) varied by definition. In 2017-2018, the AHA (mean [SEM]: 1.05 [0.07] oz. eq./d) and WGC (0.95 [0.07]) definitions yielded the highest amounts, followed by the DGA (0.81 [0.06]), AACCI (0.73 [0.05]), and FDA (0.53 [0.04]). Using all definitions except for WGC, US adults increased WG food intake from 2003-2004 to 2017-2018 with the largest increase (61.5%) using the AHA (from 0.65 to 1.05 oz. eq./d), followed by DGA (0.50 to 0.81) and AACCI (0.51 to 0.73) definitions. For each definition, the main sources of WG foods consumed by US adults were ready-to-eat cereals, cooked grains and cereals, and breads (including rolls and tortillas). For all definitions except the AHA, non-Hispanic White adults and individuals with college degrees or above consumed higher levels of WG foods than non-Hispanic Blacks and those with lower levels of education. Different definitions affect the determination of WG foods, estimated intakes, and associated trends in WG food consumption among US adults. These findings call for a standardized definition of WG foods to guide consumers, industry, and policymakers in promoting WG intake in the US.Clinical Trial Registration: Not Applicable.

Intake of whole grain foods and risk of coronary heart disease in US men and women

BackgroundEpidemiological studies have demonstrated a favorable association of whole grain intake with coronary heart disease (CHD) risk, although whether such an inverse association holds true for individual whole grain foods that have various nutritional profiles has not been examined.MethodsWe followed 74,244 women from Nurses’ Health Study since 1986, 91,430 women from Nurses’ Health Study II since 1991, and 39,455 men from the Health Professionals Follow-Up Study since 1984, who did not have a history of cardiovascular disease or cancer at baseline. Intake of seven individual whole grain foods was repeatedly assessed using a validated semi-quantitative food frequency questionnaire every 2–4 years since baseline. CHD diagnoses were ascertained through review of medical records or death certificates.ResultsWe documented 9461 CHD cases during an average of 25.8 years’ follow-up. In the multivariable-adjusted model, the pooled hazard ratio (HR) (95% CI) of CHD risk corresponding to each one serving/day consumption of total whole grains was 0.93 (0.90–0.95; p trend <0.0001). Higher consumption of most individual whole grain foods was associated with significantly lower risk of CHD. Comparing participants consuming ≥1 serving/day with those consuming < 1 serving/month, the multivariable-adjusted pooled HRs (95% CIs) of CHD were 0.83 (0.78–0.89) for whole grain cold breakfast cereal, 0.92 (0.86–0.99) for dark bread, and 1.08 (0.96–1.22) for popcorn. For other whole grain foods with lower overall intake levels, comparing intake level of ≥2 servings/week with < 1 serving/month, the pooled hazard ratios (95% CIs) were 0.79 (0.74–0.84) for oatmeal, 0.79 (0.71–0.87) for brown rice, 0.84 (0.78–0.90) for added bran, and 0.87 (0.77–0.99) for wheat germ. Cubic spline regression suggested non-linear associations for certain whole grain foods: the risk reduction plateaued approximately over 2 servings/day for total whole grains, 0.5 serving/day for both cold breakfast cereal and dark bread, 0.5 serving/week for oatmeal, 1 serving/week for brown rice, and 2 serving/week for added bran (p for non-linearity <0.01 for all associations).ConclusionsThese data suggest that higher consumption of total whole grains, as well as individual whole grain foods except popcorn, were significantly associated with lower CHD risk. The inverse associations may plateau at various intake levels for total whole grain and individual whole grain foods. This study provides further evidence in support of increasing whole grain intake for the prevention of CHD in US populations.

Whole Grain and Refined Grains: An Examination of US Household Grocery Store Purchases

BackgroundThe health benefits related to intake of whole grain foods are well established. Consumption of whole grains in the US population is low, and whole grain content can vary greatly depending upon the specific products that are purchased. ObjectivesTo examine the proportion of products purchased by US households containing whole grain and refined grain ingredients using time-specific food composition data, and examine whether purchases differ between income, race or ethnicity, and household make-up. MethodsNationally representative Nielsen Homescan 2018 data were used. Each barcoded product captured in Nielsen Homescan 2018 was linked with ingredient information using commercial nutrition databases in a time-relevant manner. Packaged food products containing whole grain ingredients, refined grain ingredients, neither, or both were identified. The percentage of packaged food products containing whole grain and refined grain ingredients purchased by US households was determined overall, by demographic subgroup, and by food category. ResultsThe proportion of packaged food purchases containing refined grain ingredients was significantly higher than whole grain ingredients (30.9% compared with 7.9%; P < 0.0001). Lower income households and households with children purchased a significantly higher proportion of products containing refined grain ingredients, with no nutritionally meaningful racial or ethnic differences observed. Concerningly, across all demographic subgroups >90% of bread purchases contained refined grain ingredients, and the 5 categories with the largest proportion of whole grain ingredients contributed to <20% of overall US household packaged food purchases. ConclusionsUS households are purchasing a significantly higher proportion of packaged food products containing refined grain ingredients than whole grain ingredients. Future policy changes are needed to provide incentives and information (e.g., front-of-pack labels) to aid in encouraging manufacturers to increase whole grain product offerings while decreasing refined grain offerings, and to encourage consumers to substitute away from refined grain products toward whole grain products.

Type 2 Diabetes-Related Health Economic Impact Associated with Increased Whole Grains Consumption among Adults in Finland.

The prevalence of type 2 diabetes (T2D) is increasing rapidly worldwide. A healthy diet supporting the control of energy intake and body weight has major importance in the prevention of T2D. For example, a high intake of whole grain foods (WGF) has been shown to be inversely associated with risk for T2D. The objective of the study was to estimate the expected health economic impacts of increased WGF consumption to decrease the incidence of T2D in the Finnish adult population. A health economic model utilizing data from multiple national databases and published scientific literature was constructed to estimate these population-level health economic consequences. Among the adult Finnish population, increased WGF consumption could reduce T2D-related costs between 286€ and 989€ million during the next 10-year time horizon depending on the applied scenario (i.e., a 10%-unit increase in a proportion of daily WGF users, an increased number (i.e., two or more) of WGF servings a day, or alternatively a combination of these scenarios). Over the next 20–30 years, a population-wide increase in WGF consumption could lead to much higher benefits. Furthermore, depending on the applied scenario, between 1323 and 154,094 quality-adjusted life years (QALYs) could be gained at the population level due to decreased T2D-related morbidity and mortality during the next 10 to 30 years. The results indicate that even when the current level of daily WGF consumption is already at a relatively high-level in a global context, increased WGF consumption could lead to important health gains and savings in the Finnish adult population.

A hypocaloric diet rich in high fiber rye foods causes greater reduction in body weight and body fat than a diet rich in refined wheat: A parallel randomized controlled trial in adults with overweight and obesity (the RyeWeight study).

A high intake of whole grain foods is inversely associated with body mass index (BMI) and body fat in observational studies, but mixed results have been found in interventional studies. Among whole grains, rye is the richest source of dietary fiber and meals containing high-fiber rye foods have shown increased satiety up to 8h, compared to meals containing refined wheat products. The aim of the study was to determine the effect of consuming high fiber rye products, compared to refined wheat products, on body weight and body fat loss in the context of an energy restricted diet. After a 2-week run-in period, 242 males and females with overweight or obesity (BMI 27-35kg/m2), aged 30-70 years, were randomized (1:1) to consume high fiber rye products or refined wheat products for 12 weeks, while adhering to a hypocaloric diet. At week 0, week 6 and week 12 body weight and body composition (dual energy x-ray absorptiometry) was measured and fasting blood samples were collected. Subjective appetite was evaluated for 14h at week 0, 6 and 12. After 12 weeks the participants in the rye group had lost 1.08kg body weight and 0.54% body fat more than the wheat group (95% confidence interval (CI): 0.36; 1.80, p<0.01 and 0.05; 1.03, p=0.03, respectively). C-reactive protein was 28% lower in the rye vs wheat group after 12 weeks of intervention (CI: 7; 53, p<0.01). There were no consistent group differences on subjective appetite or on other cardiometabolic risk markers. Consumption of high fiber rye products as part of a hypocaloric diet for 12 weeks caused a greater weight loss and body fat loss, as well as reduction in C-reactive protein, compared to refined wheat. The difference in weight loss could not be linked to differences in appetite response. www.clinicaltrials.gov, Identifier: NCT03097237.

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

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.

Cardiovascular Harm From Egg Yolk and Meat: More Than Just Cholesterol and Saturated Fat.

Cardiovascular Harm From Egg Yolk and Meat: More Than Just Cholesterol and Saturated Fat.

Intake of whole grain foods and risk of type 2 diabetes: results from three prospective cohort studies

ObjectiveTo examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes.DesignProspective cohort studies.SettingNurses’ Health Study (1984-2014), Nurses’ Health Study II...

Making every calorie count

AbstractWe live in a world where people are living longer and overweight and obesity are widespread, linked with a calorie intake in excess of the requirements of a sedentary lifestyle. Obesity is known to increase the chance of developing type 2 diabetes and other chronic diseases. But is achieving energy balance the only challenge we face or is the scenario more complex? Evidence from dietary surveys indicates that calories should not be considered in isolation because poor diets are widespread, even in countries such as the UK. The National Diet and Nutrition Survey provides evidence of relatively low intakes of a number of essential vitamins and minerals among UK teenagers and young adults, in particular, and low intakes of fibre in all age groups, associated with low intakes of wholegrain foods, vegetables, fruit and pulses. Despite widespread familiarity with the 5 A DAY message, only 27% of adults eat five portions of fruit and vegetables a day and, on average, teenagers have particularly low intakes. The poor quality of many diets in Britain has been brought into sharp focus by publication of time trend data showing that micronutrient intakes have worsened over the past decade. However, going forward, dietary recommendations need to be considered in the context of delivering a global food supply that is both nutritious and also environmentally sustainable, and takes into account other factors such as equitable access, affordability and acceptability.

Breakfast Choice Is Associated with Nutrient, Food Group and Discretionary Intakes in Australian Adults at Both Breakfast and the Rest of the Day.

Breakfast choice is correlated with daily nutrient intakes, but this association may not be solely explained by the breakfast meal. We profiled breakfast consumer groups among Australian adults and compared the role that breakfast versus the rest of the day had on daily intakes of the Five Food Groups, discretionary foods, and nutrients. Breakfast groups were breakfast cereal consumers, non-cereal breakfast consumers, and breakfast skippers. One-day dietary recall data from the 2011–2012 National Nutrition and Physical Activity Survey were analysed (n = 9341, ≥19 years), as well as socio-demographic and anthropometric measures. Twelve per cent of adults were breakfast skippers, 41% were breakfast cereal consumers, and 47% were non-cereal breakfast consumers. Females were more likely to have a non-cereal breakfast than males, and the non-cereal breakfast was predominantly bread-based. Breakfast skipping decreased with age (p < 0.001), while breakfast cereal consumption increased with age (p < 0.001). Breakfast skippers were more likely to be male, had a lower socio-economic status, and lower physical activity levels (p < 0.001). Breakfast skippers had the highest mean body mass index (BMI) and waist circumference (p < 0.001), the lowest intake of wholegrain foods, fruits and vegetables, and the highest intake of discretionary foods (p < 0.001). Breakfast cereal consumers had the lowest mean BMI and waist circumference (p < 0.001) and had healthier diets at both breakfast and throughout the rest of the day. They were the most likely to meet the daily recommended serves for grain foods, fruit, dairy, and vegetables, had the highest wholegrain food intake, and the lowest discretionary intake (p < 0.001). Additionally, breakfast cereal consumers had the most favourable daily nutrient intakes, including the lowest added sugars intakes. Differences in daily diet between breakfast groups were attributed to differences in food choices both at breakfast and throughout the rest of the day.

The gut microbiota and cardiovascular health benefits: A focus on wholegrain oats

AbstractExisting scientific data suggest that a high intake of wholegrain foods contributes to improved gut health and a reduced risk of cardiovascular disease. Wholegrain oats are rich in dietary fibre and an important source of many bioactive components, including minerals, vitamins and phenolic compounds. The oat β‐glucans have been reported to lower low‐density lipoprotein cholesterol through their ability to increase the viscosity of intestinal chime, change the gut microbiota composition and increase the production of short‐chain fatty acids, which may contribute to the inhibition of hepatic cholesterol synthesis. Oats are also a rich source of phenolic acids, which are predominantly bound to cell wall polysaccharides through ester bonds. This bound state within oats means that phenolic acid bioavailability will largely be determined by interactions with the colonic microbiota in the large intestine. However, results from in vitro, animal and human studies have been inconsistent in relation to the impact of oats on the gut microbiota, possibly due to differences in experimental techniques and because compounds in oats, other than β‐glucans, have not been considered. This review focuses on the interaction of oat β‐glucans and phenolic acids with gut microbiota, and the subsequent link to cardiovascular health.

Dietary fibre and weight loss: Where are we now?

“Dietary fibre” represents a wide spectrum of polysaccharides that escape digestion in the human gastrointestinal tract. The term has been widely associated with positive health outcomes, with the fibre content of food products being a potential basis for nutritional composition claims in many parts of the world. The current review aims to evaluate the current evidence from human trials on the impact of fibre-rich foods and isolated dietary fibre on body weight management.Evidence from observational studies consistently demonstrates that habitual increased intake of fruits, vegetables and whole grains is associated with lower body weight increase over time. Adherence to healthier dietary templates (including incorporation of higher amounts of plant-based foods) in intervention studies also tend to evidence greater weight loss than control diets. This further highlights the importance of fruits, vegetables and whole grains as the foundation of positive dietary habit. In contrast, randomised, controlled trials based on increase of fruit/vegetable or wholegrain food intake alone tend to show no impact on body weight or body fat outcomes, suggesting either that the length of previous studies is not long enough to observe measurable effects or that such dietary changes alone do not benefit these outcomes. While individual intervention studies suggest potential benefits of some fibre isolates on weight loss, there only appears to be reproducible evidence of efficacy for glucomannan. The limited amount of available evidence suggests a need for further, well-designed and appropriately targeted intervention studies in the future.

Lifetime grain consumption and breast cancer risk.

We evaluated individual grain-containing foods and whole and refined grain intake during adolescence, early adulthood, and premenopausal years in relation to breast cancer risk in the Nurses' Health Study II. Grain-containing food intakes were reported on a baseline dietary questionnaire (1991) and every 4years thereafter. Among 90,516 premenopausal women aged 27-44years, we prospectively identified 3235 invasive breast cancer cases during follow-up to 2013. 44,263 women reported their diet during high school, and from 1998 to 2013, 1347 breast cancer cases were identified among these women. Cox proportional hazards regression was used to estimate relative risks (RR) and 95% confidence intervals (95% CI) of breast cancer for individual, whole and refined grain foods. After adjusting for known breast cancer risk factors, adult intake of whole grain foods was associated with lower premenopausal breast cancer risk (highest vs. lowest quintile: RR 0.82; 95% CI 0.70-0.97; P trend=0.03), but not postmenopausal breast cancer. This association was no longer significant after further adjustment for fiber intake. The average of adolescent and early adulthood whole grain food intake was suggestively associated with lower premenopausal breast cancer risk (highest vs lowest quintile: RR 0.74; 95% CI 0.56-0.99; P trend=0.09). Total refined grain food intake was not associated with risk of breast cancer. Most individual grain-containing foods were not associated with breast cancer risk. The exceptions were adult brown rice which was associated with lower risk of overall and premenopausal breast cancer (for each 2servings/week: RR 0.94; 95% CI 0.89-0.99 and RR 0.91; 95% CI 0.85-0.99, respectively) and adult white bread intake which was associated with increased overall breast cancer risk (for each 2servings/week: RR 1.02; 95% CI 1.01-1.04), as well as breast cancer before and after menopause. Further,pasta intake was inversely associated with overall breast cancer risk. Our results suggest that high whole grain food intake may be associated with lower breast cancer risk before menopause. Fiber in whole grain foods may mediate the association with whole grains.

Eating wholegrain foods may reduce the risk of cancer.

A higher intake of wholegrain foods may lower the risk of developing cardiovascular disease and cancer, a new study suggests. A growing body of evidence has emerged on the health benefits of wholegrain foods over the past 10 to 15 years, but recommendations on the daily amount and types have often been unclear or inconsistent.

Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001-2012.

BackgroundThe purpose of this study was (1) to describe intakes of total grain and whole grain in the United States over the past 12 years and major dietary sources, and (2) to determine the relationship between whole grain intake and adiposity measures for children and adults.MethodsCross-sectional dietary data from the continuous National Health and Nutrition Examination Survey 2001–12 (6 2-year cycles) for children 6–18 years (n = 15,280) and adults 19+ years (n = 29,683) were linked to the My Pyramid and Food Patterns Equivalents Databases to assess daily intake of total grain and whole grain. These populations were classified into groups based on average whole grain intake: 0 ounce equivalents (oz eq)/day, > 0 and <1 oz eq/day, and ≥1 oz eq/day. Within these classifications, body mass index, waist circumference, and percent overweight/obese were identified. Regression and logistic regression analyses were used to assess associations between these dependent variables and whole grain intake.ResultsAdults consumed a mean 0.72 whole grain oz eq/day in 2001–02 and 0.97 oz eq/day in 2011–12 and children consumed a mean 0.56 whole grain oz eq/day in 2001–02 and 0.74 oz eq/day in 2011–12. While over 70 % of children and 60 % of adults met daily intake recommendations for total grain, less than 1.0 and 8.0 % percent of children and adults, respectively, met whole grain recommendations in 2011–12. Adults and children who consumed whole grain had significantly better intakes of nutrients and dietary fiber compared to non-consumers. From 2001 to 2012, grain mixed dishes and yeast breads were the leading sources of total grain, while yeast breads and ready to eat cereals were the leading sources of whole grain for both children and adults. Multiple regression analysis showed a significant, inverse relationship between body mass index and waist circumference with respect to whole grain intake after adjustment for covariates in both children and adults (p < 0.05). Similarly, logistic regression analysis showed a significant inverse relationship between percent overweight/obese and whole grain intake (p < 0.05).ConclusionsAlthough most children and adults meet daily intake goals for grain foods overall, whole grain as a portion of total grain intake continues to be consumed at levels well below recommendations. The data from the current study suggest that greater whole grain consumption is associated with better intakes of nutrients and healthier body weight in children and adults. Continued efforts to promote increased intake of whole grain foods are warranted.

Abstract 18: Whole Grain Intake and Risk of All-Cause and Cause-Specific Mortality in US Men and Women

Background: Whole grains are rich in fiber, vitamins, minerals, and antioxidants that have favorable effects on health through multiple pathways. Although epidemiologic studies have suggested that whole grain intake may reduce risk of type 2 diabetes, hypertension and cardiovascular disease (CVD), limited evidence exists regarding whole grains’ associations with mortality in prospective studies. Methods: Whole grain consumption was measured using a validated food frequency questionnaire every 2-4 years among 74,341 women in the Nurses’ Health Study (1984-2010) and 43,990 men in the Health Professionals Follow-Up Study (1986-2010) who were free of CVD, diabetes, and cancers at baseline. Intake of whole grain foods including brown rice, dark breads, whole-grain ready-to-eat cereals, cooked cereal, popcorn, wheat germ, bran and other grains. We used the cumulative average of whole grain intake from all available dietary questionnaires from baseline through the end of follow-up were used to better represent long-term or habitual intake, and to minimize within-person variation. Cox regression models were used to evaluate the associations between whole grain intake and mortality. Results: We documented 26,918 deaths in these two cohorts during 2,731,264 person-years of follow-up through 2010. After multivariate adjustment for potential confounders, including age, smoking, BMI, physical activity, and alternate healthy eating index, the hazard ratios (HRs) of total mortality comparing the highest with the lowest quintile of whole grain intake was 0.89 (95% confidence interval [CI] 0.84, 0.94, P for trend &lt; 0.0001) in NHS and 0.92 (95%CI 0.87, 0.98, P for trend = 0.01) in HPFS; and the pooled HR was 0.91 (95% CI 0.85, 0.95). An inverse association was observed for CVD mortality: the pooled HRs (95% CIs) comparing extreme quintiles were 0.85 (95%CI 0.78, 0.92, P for trend &lt; 0.0001). Whole grain intake was not significantly associated with cancer mortality, the pooled HR was 0.98 (95% CI 0.91, 1.04, P for trend = 0.49). In addition, total bran intake was observed to be significantly inversely associated with CVD mortality, with pooled HR 0.80 (95% CI 0.73, 0.87, P for trend &lt; 0.0001), while total germ intake was not associated with risk of mortality after adjustment for bran intake. These associations did not change materially among men and women who had a healthful lifestyle or diet. In sensitivity analysis, to minimize reverse causation, we used a 4-year lagged analysis or further stopped updating diet after participants reported occurrence of hypertension and high cholesterol, and all these sensitivity analysis indicated the robustness of our results. Conclusions: Our data support the hypothesis that higher whole grain consumption may have beneficial effects on lowering total and CVD mortality in US men and women.

Impact of an undergraduate course on medical students’ self-perceived nutrition intake and self-efficacy to improve their health behaviours and counselling practices

Doctors are increasingly involved in the management of chronic disease and counsel patients about their lifestyle behaviours, including nutrition, to improve their health outcomes. This study aimed to assess the impact of a medical undergraduate course containing nutrition content on medical students' self-perceived nutrition intake and self-efficacy to improve their health behaviours and counselling practices. A total of 239 medical students enrolled in a 12-week nutrition-related course at The University of Auckland were invited to complete an anonymous questionnaire before and after the course. The questionnaire was adapted from a previous evaluation of a preventive medicine and nutrition course at Harvard Medical School. Sixty-one medical students completed both pre- and post-course questionnaires (25.5%). At baseline, medical students described their eating habits to be more healthy than non-medical students (p=0.0261). Post-course, medical students reported a higher frequency of whole-grain food intake (p=0.0229). Medical students also reported being less comfortable making nutrition recommendations to family and friends post-course (p=0.008). Most medical students (63.9%) perceived increased awareness of their own dietary choices, and some (15.3%) reported an increased likelihood to counsel patients on lifestyle behaviour post-course. Students can increase awareness of their own nutrition behaviour after undertaking a course that includes nutrition in the initial phase of their medical degree. Further investigation of how medical students' confidence to provide nutrition advice evolves throughout their training and in future practice is required.