Investigating the impact of replacing refined grain foods with whole-grain foods on fibre intake in the UK

Previous (mainly population-based) studies have suggested the health benefits of the elective, lifelong inclusion of whole-grain foods in the diet, forming the basis for public health recommendations to increase whole grain consumption. Currently, there is limited evidence to assess how public health recommendations can best result in longer-term improvements in dietary intake. The present study aimed to assess the impact of a previous 16-week whole-grain intervention on subsequent, elective whole grain consumption in free-living individuals. Participants completed a postal FFQ 1, 6 and 12 months after the end of the whole-grain intervention study period. This FFQ included inputs for whole-grain foods commonly consumed in the UK. Whole grain consumption was significantly higher (approximately doubled) in participants who had received whole-grain foods during the intervention (P< 0·001) compared with the control group who did not receive whole-grain foods during the intervention. This increased whole grain consumption was lower than whole grain intake levels required by participants during the intervention period between 60 and 120 g whole grains/d. Aside from a significant increase (P< 0·001) in NSP consumption compared with control participants (mean increase 2–3 g/d), there were no obvious improvements to the pattern of foods of the intervention group. The results of the present study suggest that a period of direct exposure to whole-grain foods in non-habitual whole-grain food consumers may benefit subsequent, elective dietary patterns of whole grain consumption. These findings may therefore aid the development of future strategies to increase whole grain consumption for public health and/or food industry professionals.

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Mechanisms for the Impact of Whole Grain Foods on Cancer Risk

Journal of the American College of Nutrition ◽

10.1080/07315724.2000.10718964 ◽

2000 ◽

Vol 19 (sup3) ◽

pp. 300S-307S ◽

Cited By ~ 131

Author(s):

Joanne L. Slavin

Keyword(s):

Cancer Risk ◽

Whole Grain ◽

The Impact ◽

Grain Foods

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Wholegrain health claims in Europe

Proceedings of The Nutrition Society ◽

10.1079/pns2002226 ◽

2003 ◽

Vol 62 (1) ◽

pp. 161-169 ◽

Cited By ~ 48

Author(s):

David P. Richardson

Keyword(s):

Public Health ◽

Protective Effect ◽

Health Claims ◽

Whole Grain ◽

Health Implications ◽

Joint Health ◽

The Usa ◽

The Uk ◽

Grain Foods ◽

The Eu

Wholegrain foods are important sources of nutrients and phyto-protective components, which are in short supply in many member states of the EU, including the UK. Encouraging the public to increase consumption of whole-grain foods is a positive health message that has critical public health implications. In February 2002 the UK Joint Health Claims Initiative (JHCI) published its authoritative endorsement that whole-grain foods are associated with a healthy heart (Joint Health Claims Initiative, 2002). This new health claim reflects a similar one in the USA based on the accumulation of epidemiological evidence between 1996 and 2001 from several very large cohort studies in the USA, Finland and Norway, which show a consistent protective effect of whole grain and reduced risk of CHD. The JHCI code of practice on health claims requires that the claimed benefit must be scientifically valid, with evidence supporting efficacy of the food in human consumers, under typical conditions of use. The evidence-based approach consists of the identification of studies, an evaluation of individual references, a critical evaluation of the totality of the evidence and a statement that there is significant scientific agreement to establish the validity of the claim. The studies suggest that an intake of three servings per d may have an important cardio-protective effect. The development of a process for the substantiation of health claims in the UK and in the EU is important to underpin regulatory developments, which should protect the consumer, promote fair trade and encourage innovation in the food industry. The present paper sets out the format of the scientific dossier that was presented to the JHCI and includes a call to promote further research to identify the important protective components in the whole grain ‘package’ and the biological mechanisms behind the observed beneficial effects on health. The major sources of whole grain in the UK are bread and breakfast cereals, and >90% of adults in the UK consume less than three servings per d. Increasing the variety and availability of acceptable whole-grain foods could lead to greater consumption levels, which has important public health implications and offers an attractive and food-based dietary strategy for targeting the whole population.

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Epidemiological support for the protection of whole grains against diabetes

Proceedings of The Nutrition Society ◽

10.1079/pns2002223 ◽

2003 ◽

Vol 62 (1) ◽

pp. 143-149 ◽

Cited By ~ 95

Author(s):

Maureen A. Murtaugh ◽

David R. Jacobs ◽

Brenda Jacob ◽

Lyn M. Steffen ◽

Leonard Marquart

Keyword(s):

Type 2 Diabetes ◽

Glucose Control ◽

Whole Grains ◽

Overweight And Obesity ◽

Whole Grain ◽

Incident Type ◽

Fibre Intake ◽

Incident Type 2 Diabetes ◽

Grain Foods

The epidemic of type 2 diabetes among children, adolescents and adults is increasing along with the increasing prevalence of overweight and obesity. Overweight is the most powerful modifiable risk factor for type 2 diabetes. Intake of whole-grain foods may reduce diabetes risk. Three prospective studies in 160 000 men and women examined the relationship of whole-grain or cereal-fibre intake with the risk of type 2 diabetes. Each study used a mailed Willett food-frequency questionnaire and similar methods of quantifying whole-grain foods and cereal fibre. The self-reported incident diabetes outcome was more reliably determined in the two studies of health-care professionals than in the study of Iowa women. Risk for incident type 2 diabetes was 21–27% lower for those in the highest quintile of whole-grain intake, and 30–36% lower in the highest quintile of cereal-fibre intake, each compared with the lowest quintile. Risk reduction persisted after adjustment for the healthier lifestyle found among habitual whole-grain consumers. Observations in non-diabetic individuals support an inverse relationship between whole-grain consumption and fasting insulin levels. In feeding studies in non-diabetic individuals insulin resistance was reduced using whole grains or diets rich in whole grains. Glucose control improved with diets rich in whole grains in feeding studies of subjects with type 2 diabetes. There is accumulating evidence to support the hypothesis that whole-grain consumption is associated with a reduced risk of incident type 2 diabetes; it may also improve glucose control in diabetic individuals.

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Growing the Business of Whole Grain in the Australian Market: A 6-Year Impact Assessment

Nutrients ◽

10.3390/nu12020313 ◽

2020 ◽

Vol 12 (2) ◽

pp. 313 ◽

Cited By ~ 4

Author(s):

Felicity Curtain ◽

Alexandra Locke ◽

Sara Grafenauer

Keyword(s):

New Zealand ◽

Impact Assessment ◽

Whole Grain ◽

Breakfast Cereals ◽

Code Of Practice ◽

Food Standards ◽

Grain Products ◽

The Impact ◽

Grain Foods ◽

Very High

The Australia New Zealand Food Standards Code does not regulate on-pack claims describing the amount of whole grain in foods. In July 2013, The Grains & Legumes Nutrition Council™ (GLNC) established a voluntary Code of Practice for Whole Grain Ingredient Content Claims (the Code) providing guidance for whole grain claims, with cut-off values and suggested wording ≥8 g, ≥16 g, and ≥24 g per manufacturer serve (contains; high and very high in whole grain), based on a 48 g whole grain daily target intake. The aim of this impact assessment was to report the uptake of the Code by manufacturers, changes in numbers of whole grain products, and claims on-pack since 2013, including compliance. The impact assessment was undertaken in August 2019, comparing current registered manufacturers (“users”) and their products to the total number of products in the market deemed eligible for registration through GLNC product audits since 2013. Reporting included breakfast cereals, bread products, crispbreads, crackers, rice/corn cakes, rice, pasta, noodles, couscous, other grains (e.g., quinoa, buckwheat, freekeh), and grain-based muesli bars. As of 30 June 2019, there were 33 registered users and 531 registered products in Australia and New Zealand representing 43% of the eligible manufacturers and 65% of the eligible whole grain foods. Three-quarters (78% and 74%) of the eligible breakfast cereals and bread products were registered with the Code in 2019, followed by 62% of grain-based muesli bars. Only 39% of crispbread, crackers, rice/corn cakes, and rice, pasta, noodles, couscous, and other grains were registered. From 2013 there has been a 71% increase in the number of whole grain foods making claims, demonstrating strong uptake by industry, with clearer, more consistent, and compliant on-pack communication regarding whole grain content.

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Effects of Whole Grain, Compared to Refined Grain, Intake on Subjective Measures of Appetite: A Systematic Review and Meta-Analysis

Current Developments in Nutrition ◽

10.1093/cdn/nzaa049_050 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 657-657

Author(s):

Lisa Sanders ◽

Yong Zhu ◽

Meredith Wilcox ◽

Orsolya Palacios ◽

Katie Koecher ◽

...

Keyword(s):

Systematic Review ◽

Weight Gain ◽

Food Intake ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Whole Grain ◽

Subjective Measures ◽

Meta Analyses ◽

The Impact ◽

Grain Foods

Abstract Objectives Results from observational studies indicate that whole grain intake is inversely associated with BMI and risk of weight gain. Whole grain intake may influence energy balance and body composition through effects on appetite and thus, energy intake. To evaluate the impact of whole grain food consumption on appetite, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing whole grain food intake and subjective measures of appetite in adults. Methods A search of PubMed, Scopus and Food Science and Technology abstracts yielded 34 RCTs measuring hunger ratings after consuming whole grain foods compared to refined grain controls. Seventeen of these studies (598 subjects), with a total of 33 unique whole grain treatments, reported areas under the curve (AUC) for subjective hunger and were included in the meta-analysis. Pooled estimates from meta-analyses are expressed as standardized mean differences (SMD). Results Intake of whole grain foods resulted in significantly lower subjective hunger AUC (range for AUC times ranged from 120 to 270 min) compared to refined grain foods [SMD −0.36, P < 0.001, 95% CI (−0.48, −0.24)]. Sensitivity analyses were also completed in which studies with AUC values for < and ≥ 180 min were evaluated separately, as well as hunger ratings at the 180 min timepoint alone, and the results were similar to those for the main analysis (SMDs −0.33 to −0.54, all P ≤ 0.03). Conclusions These results support the view that consumption of whole grain foods, compared to refined grain controls, significantly reduces subjective hunger, and this may provide at least part of the explanation for the inverse associations between whole grain food intake and risks for overweight, obesity and weight gain over time. Funding Sources This study was funded by the Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN and registered with PROSPERO.

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Low whole grain intake in the UK: results from the National Diet and Nutrition Survey rolling programme 2008–11

British Journal Of Nutrition ◽

10.1017/s0007114515000422 ◽

2015 ◽

Vol 113 (10) ◽

pp. 1643-1651 ◽

Cited By ~ 53

Author(s):

Kay D. Mann ◽

Mark S. Pearce ◽

Brigid McKevith ◽

Frank Thielecke ◽

Chris J. Seal

Keyword(s):

Economic Status ◽

Dietary Assessment ◽

Dry Weight ◽

Dietary Guidelines ◽

Whole Grain ◽

Nutrition Survey ◽

Total Study Population ◽

Younger Adults ◽

The Uk ◽

Grain Foods

Increased whole grain intake has been shown to reduce the risk of many non-communicable diseases. Countries including the USA, Canada, Denmark and Australia have specific dietary guidelines on whole grain intake but others, including the UK, do not. Data from 1986/87 and 2000/01 have shown that whole grain intake is low and declining in British adults. The aim of the present study was to describe whole grain intakes in the most current dietary assessment of UK households using data from the National Diet and Nutrition Survey rolling programme 2008–11. In the present study, 4 d diet diaries were completed by 3073 individuals between 2008 and 2011, along with details of socio-economic status (SES). The median daily whole grain intake, calculated for each individual on a dry weight basis, was 20 g/d for adults and 13 g/d for children/teenagers. The corresponding energy-adjusted whole grain intake was 27 g/10 MJ per d for adults and 20 g/10 MJ per d for children/teenagers. Whole grain intake (absolute and energy-adjusted) increased with age, but was lowest in teenagers (13–17 years) and younger adults up to the age of 34 years. Of the total study population, 18 % of adults and 15 % of children/teenagers did not consume any whole-grain foods. Individuals from lower SES groups had a significantly lower whole grain intake than those from more advantaged classifications. The whole grain intake in the UK, although higher than in 2000/01, remains low and below that in the US and Danish recommendations in all age classes. Favourable pricing with increased availability of whole-grain foods and education may help to increase whole grain intake in countries without whole-grain recommendations. Teenagers and younger adults may need targeting to help increase whole grain consumption.

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Comparing Whole Grain with Cereal Fibre – Associations to Markers of Cardiovascular Disease Risk in the UK National Diet and Nutrition Survey and the Australian Health Survey (P08-079-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz044.p08-079-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Eden Barrett ◽

Birdem Amoutzopoulos ◽

Marijka Batterham ◽

Sumantra Ray ◽

Eleanor Beck

Keyword(s):

Cardiovascular Disease ◽

Health Survey ◽

Whole Grains ◽

Whole Grain ◽

Nutrition Survey ◽

Cvd Risk ◽

Fibre Intake ◽

Australian Health ◽

Waist Hip Ratio ◽

The Uk

Abstract Objectives Whole grain intake is associated with lower risk of cardiovascular disease (CVD) and related risk factors. Cereal fibre content of whole grains may be responsible, although it is not clear to what extent. Inconsistent definitions of whole grains used within previous studies, such as including bran as a whole grain source, confound findings and limit the ability to separate the two exposures. We compared how intakes of whole grain and cereal fibre were separately associated with markers of CVD risk in adult participants within the UK National Diet and Nutrition Survey (NDNS) and the Australian Health Survey (AHS). Methods Cross-sectional analyses of the NDNS Rolling Programme 2008–14 and the 2011–13 AHS examined associations between whole grain and cereal fibre intakes and markers of CVD risk using multivariate linear regression analysis. Whole grain was defined as containing the endosperm, germ and bran components in the expected proportions, and food composition databases were used to estimate intakes. Results Within the NDNS, participants in the highest quartile (Q4) of whole grain intake had lower waist-hip ratio (Q1 0.872; Q4 0.857; P = 0.04), HbA1c (Q1 5.66%; Q4 5.47%; P = 0.01) and homocysteine (Q1 9.95 µmol/L; Q4 8.76 µmol/L; P = 0.01) compared to participants in the lowest quartile (Q1) after adjustment for cereal fibre intake. Participants in the highest tertile of whole grain intake within the AHS had lower waist circumferences (P = 0.03), HbA1c (P = 0.03) and fasting blood glucose (P = 0.048) compared to non-whole grain consumers after adjustment for cereal fibre intake. Cereal fibre intake, when analysed separately, was inversely associated with waist-hip ratio (P = 0.03) and homocysteine (P = 0.002) in the NDNS, and BMI (P < 0.0001) and waist circumference (P = 0.0008) in the AHS. Conclusions Similar inverse associations between whole grain and cereal fibre intakes to multiple markers of CVD risk suggest cereal fibre may play a role in protective associations of whole grains. However, whole grain associations often remained significant after adjustment for cereal fibre intake, suggesting additional constituents may be relevant. Future research should ensure use of consistent definitions when examining health associations of whole grains and their specific constituents. Funding Sources Nil funding.

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185 Associations between Diet and Sleep Health in the UK Biobank Study

SLEEP ◽

10.1093/sleep/zsab072.184 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A75-A75

Author(s):

Piril Hepsomali ◽

John Groeger

Keyword(s):

Dietary Pattern ◽

Healthy Diet ◽

Processed Meat ◽

Food Groups ◽

Uk Biobank ◽

Sleep Health ◽

Fibre Intake ◽

The Uk ◽

The Impact ◽

Healthy Dietary Pattern

Abstract Introduction It is well known that the prevalence of clinical and subclinical sleep issues is quite high, with a great economic and social burden on the society. As it is expected that the numbers of people suffering from clinical and subclinical sleep problems will increase in the coming years, new primary and/or complementary methods to improve and prevent poor sleep health across the population are urgently needed. In the current study, we aimed to conduct the largest investigation of diet and sleep health to date, through systematically examining the UK Biobank (UKB) data to find out whether diet quality and food groups play a role on sleep health. Methods This cross-sectional population-based study involved 502,494 participants. UKB food frequency and sleep questionnaires at baseline were used. Also, healthy diet, healthy sleep, and partial fibre intake scores were created. ANCOVA and regression models were used to examine the associations of healthy diet and dietary fibre intake scores with sleep health. Adjusted models included age, sex, BMI, and mental health symptomatology. Results We showed that both healthy diet and high partial fibre intake scores were associated with increased healthy sleep scores. Also, higher intakes of vegetables, fruits, fish, and unprocessed red meat were found to be associated with increased healthy sleep scores. On the other hand, processed meat intake was inversely associated with sleep health. Conclusion A healthy dietary pattern, and food groups (vegetables, fruits, fish, water) and nutrients (fibre) that are consumed as a part of a healthy dietary pattern were associated with better sleep health. Further work is needed to identify underlying mechanisms behind the impact of diet on sleep health. Support (if any) Acknowledgements: This research has been conducted using the UK Biobank Resource under Application Number ‘61818’. Funding: Funds received from Unilever UK Central Resources Limited to cover application fees.

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