Whole-grain foods and chronic disease: evidence from epidemiological and intervention studies

Cereal-based foods are key components of the diet and they dominate most food-based dietary recommendations in order to achieve targets for intake of carbohydrate, protein and dietary fibre. Processing (milling) of grains to produce refined grain products removes key nutrients and phytochemicals from the flour and although in some countries nutrients may be replaced with mandatory fortification, overall this refinement reduces their potential nutritional quality. There is increasing evidence from both observational and intervention studies that increased intake of less-refined, whole-grain (WG) foods has positive health benefits. The highest WG consumers are consistently shown to have lower risk of developing CVD, type 2 diabetes and some cancers. WG consumers may also have better digestive health and are likely to have lower BMI and gain less weight over time. The bulk of the evidence for the benefits of WG comes from observational studies, but evidence of benefit in intervention studies and potential mechanisms of action is increasing. Overall this evidence supports the promotion of WG foods over refined grain foods in the diet, but this would require adoption of standard definitions of ‘whole grain’ and ‘whole-grain foods’ which will enable innovation by food manufacturers, provide clarity for the consumer and encourage the implementation of food-based dietary recommendations and public health strategies.

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The Triple Jags of Dietary Fibers in Cereals: How Biotechnology Is Longing for High FiberGrains

Frontiers in Plant Science ◽

10.3389/fpls.2021.745579 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ermelinda Botticella ◽

Daniel Valentin Savatin ◽

Francesco Sestili

Keyword(s):

Human Health ◽

Cell Walls ◽

Chemical Structure ◽

Bioactive Molecules ◽

Whole Grain ◽

Grain Products ◽

Macro And Micronutrients ◽

Main Components ◽

Grain Foods ◽

Significant Health

Cereals represent an important source of beneficial compounds for human health, such as macro- and micronutrients, vitamins, and bioactive molecules. Generally, the consumption of whole-grain products is associated with significant health benefits, due to the elevated amount of dietary fiber (DF). However, the consumption of whole-grain foods is still modest compared to more refined products. In this sense, it is worth focusing on the increase of DF fractions inside the inner compartment of the seed, the endosperm, which represents the main part of the derived flour. The main components of the grain fiber are arabinoxylan (AX), β-glucan (βG), and resistant starch (RS). These three components are differently distributed in grains, however, all of them are represented in the endosperm. AX and βG, classified as non-starch polysaccharides (NSP), are in cell walls, whereas, RS is in the endosperm, being a starch fraction. As the chemical structure of DFs influences their digestibility, the identification of key actors involved in their metabolism can pave the way to improve their function in human health. Here, we reviewed the main achievements of plant biotechnologies in DFs manipulation in cereals, highlighting new genetic targets to be exploited, and main issues to face to increase the potential of cereals in fighting malnutrition.

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

BMJ ◽

10.1136/bmj.m2206 ◽

2020 ◽

pp. m2206 ◽

Cited By ~ 3

Author(s):

Yang Hu ◽

Ming Ding ◽

Laura Sampson ◽

Walter C Willett ◽

JoAnn E Manson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Brown Rice ◽

Whole Grains ◽

Health Study ◽

Whole Grain ◽

Breakfast Cereal ◽

Hazard Ratios ◽

Grain Foods

Abstract Objective To examine the associations between the intake of total and individual whole grain foods and the risk of type 2 diabetes. Design Prospective cohort studies. Setting Nurses’ Health Study (1984-2014), Nurses’ Health Study II (1991-2017), and Health Professionals Follow-Up Study (1986-2016), United States. Participants 158 259 women and 36 525 men who did not have type 2 diabetes, cardiovascular disease, or cancer at baseline. Main outcome measures Self-reports of incident type 2 diabetes by participants identified through follow-up questionnaires and confirmed by a validated supplementary questionnaire. Results During 4 618 796 person years of follow-up, 18 629 participants with type 2 diabetes were identified. Total whole grain consumption was categorized into five equal groups of servings a day for the three cohorts. After adjusting for lifestyle and dietary risk factors for diabetes, participants in the highest category for total whole grain consumption had a 29% (95% confidence interval 26% to 33%) lower rate of type 2 diabetes compared with those in the lowest category. For individual whole grain foods, pooled hazard ratios (95% confidence intervals) for type 2 diabetes in participants consuming one or more servings a day compared with those consuming less than one serving a month were 0.81 (0.77 to 0.86) for whole grain cold breakfast cereal, 0.79 (0.75 to 0.83) for dark bread, and 1.08 (1.00 to 1.17) for popcorn. For other individual whole grains with lower average intake levels, comparing consumption of two or more servings a week with less than one serving a month, the pooled hazard ratios (95% confidence intervals) were 0.79 (0.75 to 0.83) for oatmeal, 0.88 (0.82 to 0.94) for brown rice, 0.85 (0.80 to 0.90) for added bran, and 0.88 (0.78 to 0.98) for wheat germ. Spline regression showed a non-linear dose-response association between total whole grain intake and the risk of type 2 diabetes where the rate reduction slightly plateaued at more than two servings a day (P<0.001 for curvature). For whole grain cold breakfast cereal and dark bread, the rate reduction plateaued at about 0.5 servings a day. For consumption of popcorn, a J shaped association was found where the rate of type 2 diabetes was not significantly raised until consumption exceeded about one serving a day. The association between higher total whole grain intake and lower risk of type 2 diabetes was stronger in individuals who were lean than in those who were overweight or obese (P=0.003 for interaction), and the associations did not vary significantly across levels of physical activity, family history of diabetes, or smoking status. Conclusion Higher consumption of total whole grains and several commonly eaten whole grain foods, including whole grain breakfast cereal, oatmeal, dark bread, brown rice, added bran, and wheat germ, was significantly associated with a lower risk of type 2 diabetes. These findings provide further support for the current recommendations of increasing whole grain consumption as part of a healthy diet for the prevention of type 2 diabetes.

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Whole grain foods for the prevention of type 2 diabetes mellitus

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd006061.pub2 ◽

2008 ◽

Cited By ~ 41

Author(s):

Marion Priebe ◽

Jaap van Binsbergen ◽

Rien de Vos ◽

Roel J Vonk

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Whole Grain ◽

Grain Foods

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Providing evidence to support the development of whole grain dietary recommendations in the United Kingdom

Proceedings of The Nutrition Society ◽

10.1017/s0029665116000793 ◽

2016 ◽

Vol 76 (3) ◽

pp. 369-377 ◽

Cited By ~ 10

Author(s):

Kay D. Mann ◽

Mark S. Pearce ◽

Chris J. Seal

Keyword(s):

Food Composition ◽

Whole Grain ◽

Dietary Recommendations ◽

Nutrition Survey ◽

Reactive Protein ◽

The United Kingdom ◽

Adults And Children ◽

Dietary Fibre Intake ◽

The Uk

Observational evidence suggests that increased whole grain (WG) intake reduces the risks of many non-communicable diseases, such as CVD, type 2 diabetes, obesity and certain cancers. More recently, studies have shown that WG intake lowers all-cause and cause-specific mortality. Much of the reported evidence on risk reduction is from US and Scandinavian populations, where there are tangible WG dietary recommendations. At present there is no quantity-specific WG dietary recommendation in the UK, instead we are advised to choose WG or higher fibre versions. Despite recognition of WG as an important component of a healthy diet, monitoring of WG intake in the UK has been poor, with the latest intake assessment from data collected in 2000–2001 for adults and in 1997 for children. To update this information we examined WG intake in the National Diet and Nutrition Survey rolling programme 2008–2011 after developing our database of WG food composition, a key resource in determining WG intake accurately. The results showed median WG intakes remain low in both adults and children and below that of countries with quantity-specific guidance. We also found a reduction in C-reactive protein concentrations and leucocyte counts with increased WG intake, although no association with other markers of cardio-metabolic health. The recent recommendations by the UK Scientific Advisory Committee on Nutrition to increase dietary fibre intake will require a greater emphasis on consuming more WG. Specific recommendations on WG intake in the UK are warranted as is the development of public health policy to promote consumption of these important foods.

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Comparative whole-grain intake of British adults in 1986–7 and 2000–1

British Journal Of Nutrition ◽

10.1017/s0007114507659078 ◽

2007 ◽

Vol 97 (5) ◽

pp. 987-992 ◽

Cited By ~ 57

Author(s):

Christopher W. Thane ◽

Angela R. Jones ◽

Alison M. Stephen ◽

Christopher J. Seal ◽

Susan A. Jebb

Keyword(s):

Economic Status ◽

Interquartile Range ◽

Whole Grain ◽

Epidemiological Evidence ◽

Nutrition Survey ◽

Dietary Records ◽

Occupational Social Class ◽

Manual Occupation ◽

Grain Foods

Epidemiological evidence suggests that higher consumption of whole-grain foods can significantly reduce the risk of chronic diseases such as CVD, type 2 diabetes and some cancers. The present study compares whole-grain intake of 2086 adults aged 16–64 years from the 1986–7 Dietary and Nutritional Survey of British Adults with that of 1692 adults aged 19–64 years from the 2000–1 National Diet and Nutrition Survey. For each survey, whole-grain intake was estimated from consumption of all foods containing ≥ 10 % whole-grain content (as DM/fresh weight of food) from 7 d weighed dietary records. In 1986–7, median whole-grain intake was 16 (interquartile range 0–45) g/d v. 14 (interquartile range 0–36) g/d in 2000–1 (P < 0·001). In 1986–7, 77 % of adults had less than three 16 g amounts of whole-grain intake/d; 25 % reported no whole-grain intake. In 2000–1, corresponding percentages were 84 and 29 %, respectively. Foods with < 51 % whole-grain content provided 18 % of whole-grain intake in 1986–7 v. 27 % in 2000–1 (P < 0·001). In both surveys, whole-grain intake was significantly lower among adults with a manual v. non-manual occupation (indicative of lower socio-economic status) and among smokers v. non-smokers, independent of occupational social class. In 1986–7, whole-grain breakfast cereals and wholemeal bread contributed 28 and 48 % of whole-grain intake, respectively, v. 45 and 31 % in 2000–1. At each time, one-third of adults consumed neither of these two largest contributors to whole-grain intake. Findings from the present study suggest that whole-grain intake of British adults was low in 1986–7 and became even lower over the subsequent decade.

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Whole-grain dietary recommendations: the need for a unified global approach

British Journal Of Nutrition ◽

10.1017/s0007114516001161 ◽

2016 ◽

Vol 115 (11) ◽

pp. 2031-2038 ◽

Cited By ~ 31

Author(s):

Chris J. Seal ◽

Anne P. Nugent ◽

E-Siong Tee ◽

Frank Thielecke

Keyword(s):

Public Health ◽

Whole Grain ◽

Dietary Recommendations ◽

Public Health Decision ◽

Health Decision Making ◽

Reduced Body ◽

Health Decision ◽

Dietary Fibre Intake ◽

The Impact

AbstractIncreased whole-grain (WG) consumption reduces the risk of CVD, type 2 diabetes and some cancers, is related to reduced body weight and weight gain and is related to improved intestinal health. Definitions of ‘WG’ and ‘WG food’ are proposed and used in some countries but are not consistent. Many countries promote WG consumption, but the emphasis given and the messages used vary. We surveyed dietary recommendations of fifty-three countries for mentions of WG to assess the extent, rationale and diversity in emphasis and wording of any recommendations. If present, recommendations were classified as either ‘primary’, where the recommendation was specific for WG, or ‘secondary’, where recommendations were made in order to achieve another (primary) target, most often dietary fibre intake. In total, 127 organisations were screened, including government, non-governmental organisations, charities and professional bodies, the WHO and European Food Safety Authority, of which forty-nine including WHO provide a WG intake recommendation. Recommendations ranged from ‘specific’ with specified target amounts (e.g. x g WG/d), ‘semi-quantitative’ where intake was linked to intake of cereal/carbohydrate foods with proportions of WG suggested (e.g. x servings of cereals of which y servings should be WG) to ‘non-specific’ based on ‘eating more’ WG or ‘choosing WG where possible’. This lack of a harmonised message may result in confusion for the consumer, lessen the impact of public health messages and pose barriers to trade in the food industry. A science-based consensus or expert opinion on WG recommendations is needed, with a global reach to guide public health decision making and increase WG consumption globally.

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The Influence of Physical Activity on Cardiometabolic Biomarkers in Youths: A Review

Pediatric Exercise Science ◽

10.1123/pes.23.2.169 ◽

2011 ◽

Vol 23 (2) ◽

pp. 169-185 ◽

Cited By ~ 35

Author(s):

Bernard Gutin ◽

Scott Owens

Keyword(s):

Physical Activity ◽

Observational Studies ◽

Intervention Studies ◽

Physical Activity Intervention ◽

Vigorous Physical Activity ◽

Organ Damage ◽

Preventive Interventions ◽

Active Lifestyle ◽

Physically Active

The purposes of this article were to (1): review recent studies of relations between physical activity and cardiometabolic biomarkers of youths (2); highlight areas in which additional research is needed; and (3) make recommendations for preventive interventions. Observational studies show that youths who engage in high amounts of moderate-vigorous physical activity display a more favorable cardiometabolic biomarker profile than youths who engage in lesser amounts of moderate-vigorous physical activity. Intervention studies in obese youths show that favorable changes in biomarkers are produced by moderate-vigorous physical activity doses of 150–180 min/week. However, for nonobese youths, intervention studies suggest that such doses are not effective; higher moderate-vigorous physical activity doses of approximately 300 min/week seem necessary. Continuing a physically active lifestyle from childhood into the adult years will enable people to maintain less end-organ damage and lower rates of morbidity and mortality from cardiovascular disease and type 2 diabetes.

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