scholarly journals Do Refined Grains Have a Place in a Healthy Dietary Pattern: Perspectives from an Expert Panel Consensus Meeting

2020 ◽  
Vol 4 (10) ◽  
Author(s):  
Yanni Papanikolaou ◽  
Joanne L Slavin ◽  
Roger Clemens ◽  
J Thomas Brenna ◽  
Dayle Hayes ◽  
...  
Keyword(s):  
Dietary Pattern ◽  
Expert Panel ◽  
Scientific Evidence ◽  
Whole Grains ◽  
Overweight And Obesity ◽  
Published Data ◽  
Refined Grains ◽  
Nutrient Density ◽  
Grain Foods ◽  
Healthy Dietary Pattern

ABSTRACT Although dietary guidance recommends increasing consumption of whole grains and concurrently limiting consumption of refined and/or enriched grain foods, emerging research suggests that certain refined grains may be part of a healthy dietary pattern. A scientific expert panel was convened to review published data since the release of 2015 dietary guidance in defined areas of grain research, which included nutrient intakes, diet quality, enrichment/fortification, and associations with weight-related outcomes. Based on a 1-d roundtable discussion, the expert panel reached consensus that 1) whole grains and refined grains can make meaningful nutrient contributions to dietary patterns, 2) whole and refined grain foods contribute nutrient density, 3) fortification and enrichment of grains remain vital in delivering nutrient adequacy in the American diet, 4) there is inconclusive scientific evidence that refined grain foods are linked to overweight and obesity, and 5) gaps exist in the scientific literature with regard to grain foods and health.

scholarly journals Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association?

2019 ◽  
Vol 10 (3) ◽  
pp. 361-371 ◽  
Author(s):  
Glenn A Gaesser
Keyword(s):  
Health Outcomes ◽  
Whole Grains ◽  
Processed Meat ◽  
Refined Grains ◽  
Adverse Health Outcomes ◽  
Western Dietary Pattern ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Grain Foods ◽  
Red And Processed Meat

ABSTRACT Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6–7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains.

scholarly journals Epidemiological support for the protection of whole grains against diabetes

2003 ◽  
Vol 62 (1) ◽  
pp. 143-149 ◽  
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.

scholarly journals Association of dietary pattern with carotid intima media thickness among children with overweight or obesity

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Assa Akbari-Sedigh ◽  
Golaleh Asghari ◽  
Emad Yuzbashian ◽  
Pooneh Dehghan ◽  
Hossein Imani ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Primary Schools ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Overweight And Obesity ◽  
Z Score ◽  
Media Thickness ◽  
Healthy Dietary Pattern

Abstract Background Since there is no evidence demonstrating the relationship between dietary patterns and subclinical atherosclerosis in children and adolescents, we aimed to examine the association between dietary patterns and carotid intima-media thickness (cIMT) in children and adolescents with overweight and obesity. Methods Data were collected on individuals, aged 6–13 years (n = 339) recruited from primary schools with age- and sex-specific body mass index (BMI) Z-score > 1, based on WHO criteria. Dietary intake was assessed using a valid and reliable food frequency questionnaire and dietary patterns were derived by factor analysis. Measurement of cIMT was performed by means of ultrasonography for the wall of common carotid artery. Results The mean ± SD age, BMI Z-score and cIMT of study participants were 9.3 ± 1.7 years, 2.5 ± 0.7 and 0.403 ± 0.057 mm, respectively. Three dietary patterns were identified, which accounted for 23.0% of the total variance, including the healthy, the traditional, and the unhealthy patterns. After adjusting for age, sex, pubertal status, smoking exposure, physical activity, body fat percentage, and intake of magnesium and energy, a significant inverse association was observed between the healthy dietary pattern and cIMT (β = − 0.131, P = 0.019), whereas none were found between cIMT and the traditional (β = − 0.004, P = 0.932) and the unhealthy dietary (β = 0.004, P = 0.942) patterns. Conclusions Results of the present study indicate that adherence to healthy dietary pattern could prevent increased cIMT in children and adolescents with overweight and obesity. Further cohort design research is required to elucidate the association between dietary patterns and cIMT in children and adolescents.

scholarly journals Dietary Patterns as a Predictive Factor for Overweight and Obesity Among Secondary School Children in Mashhad, Iran

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Secondary School ◽  
School Children ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Principal Component ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Principal Component Factor Analysis ◽  
Cross Sectional ◽  
Healthy Dietary Pattern

This cross-sectional study was carried out to determine the prevalence of overweight and obesity among secondary school children in the city of Mashhad, Iran and its association with dietary patterns. A total of 1189 secondary school children (579 males and 610 females) aged 12- 14 years old were selected through a stratified multistage random sampling. All adolescents were measured for weight and height. Household socio-demographic information were self-reported by parents. Adolescents were classified as overweight or obese based on BMI-for age Z-score. Dietary patterns were assessed using a validated Iranian food frequency questionnaire (FFQ) included 121 food items. The principal component factor analysis (PCA) was applied to derive dietary patterns, and Logistic Regression (LR) was applied to examine the association between dietary pattern and adolescents BMI. The overall prevalence of overweight and obesity among the study population was 17.2% and 11.9%, respectively. The PCA analysis revealed the presence of two dietary patterns that were labeled as ‘Healthy dietary pattern’ (HP), and ‘Unhealthy dietary pattern’ (UP). LR analysis showed that HP was significantly associated with BMI (OR: 1.28, 95% CI: 1.124-1.47). Similarly, UP was significantly associated with BMI (OR: 0.861, 95% CI: .725-.968). In Iran, nutritional transition has taken place in the context of urbanization and has changed lifestyle, and dietary patterns. Policies must be formulated and circulated in the society to reach every family in the form of healthy dietary pattern.

scholarly journals Plasma metabolomics profiles suggest beneficial effects of a low–glycemic load dietary pattern on inflammation and energy metabolism

2019 ◽  
Vol 110 (4) ◽  
pp. 984-992 ◽  
Author(s):  
Sandi L Navarro ◽  
Aliasghar Tarkhan ◽  
Ali Shojaie ◽  
Timothy W Randolph ◽  
Haiwei Gu ◽  
...  
Keyword(s):  
Dietary Pattern ◽  
Fruits And Vegetables ◽  
Glycemic Load ◽  
Whole Grains ◽  
Data Driven ◽  
Metabolic Profiles ◽  
Plasma Samples ◽  
Refined Grains ◽  
Added Sugars ◽  
Beneficial Effects

ABSTRACT Background Low–glycemic load dietary patterns, characterized by consumption of whole grains, legumes, fruits, and vegetables, are associated with reduced risk of several chronic diseases. Methods Using samples from a randomized, controlled, crossover feeding trial, we evaluated the effects on metabolic profiles of a low-glycemic whole-grain dietary pattern (WG) compared with a dietary pattern high in refined grains and added sugars (RG) for 28 d. LC-MS-based targeted metabolomics analysis was performed on fasting plasma samples from 80 healthy participants (n = 40 men, n = 40 women) aged 18–45 y. Linear mixed models were used to evaluate differences in response between diets for individual metabolites. Kyoto Encyclopedia of Genes and Genomes (KEGG)–defined pathways and 2 novel data-driven analyses were conducted to consider differences at the pathway level. Results There were 121 metabolites with detectable signal in >98% of all plasma samples. Eighteen metabolites were significantly different between diets at day 28 [false discovery rate (FDR) < 0.05]. Inositol, hydroxyphenylpyruvate, citrulline, ornithine, 13-hydroxyoctadecadienoic acid, glutamine, and oxaloacetate were higher after the WG diet than after the RG diet, whereas melatonin, betaine, creatine, acetylcholine, aspartate, hydroxyproline, methylhistidine, tryptophan, cystamine, carnitine, and trimethylamine were lower. Analyses using KEGG-defined pathways revealed statistically significant differences in tryptophan metabolism between diets, with kynurenine and melatonin positively associated with serum C-reactive protein concentrations. Novel data-driven methods at the metabolite and network levels found correlations among metabolites involved in branched-chain amino acid (BCAA) degradation, trimethylamine-N-oxide production, and β oxidation of fatty acids (FDR < 0.1) that differed between diets, with more favorable metabolic profiles detected after the WG diet. Higher BCAAs and trimethylamine were positively associated with homeostasis model assessment-insulin resistance. Conclusions These exploratory metabolomics results support beneficial effects of a low–glycemic load dietary pattern characterized by whole grains, legumes, fruits, and vegetables, compared with a diet high in refined grains and added sugars on inflammation and energy metabolism pathways. This trial was registered at clinicaltrials.gov as NCT00622661.

scholarly journals The Mediterranean Diet and Cancer: What Do Human and Molecular Studies Have to Say about It?

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2155 ◽  
Author(s):  
Álvaro Hernáez ◽  
Ramón Estruch
Keyword(s):  
Olive Oil ◽  
Mediterranean Diet ◽  
Dietary Pattern ◽  
Dairy Products ◽  
Whole Grains ◽  
White Meat ◽  
Tree Nuts ◽  
Molecular Studies ◽  
Diet And Cancer ◽  
Healthy Dietary Pattern

Mediterranean diet (MD) is a well-known healthy dietary pattern, linked to: (1) high intakes of olive oil as main the culinary fat, plant-based foods (fruits, vegetables, legumes, whole grains, tree nuts, and seeds), and fish; and (2) a moderate consumption of white meat, eggs, dairy products such as yogurt and cheese, and wine always with meals [...]

scholarly journals Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3756
Author(s):  
Glenn A. Gaesser
Keyword(s):  
Cancer Risk ◽  
Lower Risk ◽  
Whole Grains ◽  
Whole Grain ◽  
Site Specific ◽  
Refined Grains ◽  
Specific Cancer ◽  
Total Cancer ◽  
Meta Analyses ◽  
Grain Foods

PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched for meta-analyses that provided risk estimates (±95% confidence intervals) for associations between intakes of whole and refined grains and risk of total and site-specific cancer. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Only meta-analyses that included whole grains and refined grains as separate food groups, and not as part of dietary patterns, were included. A total of 17 publications were identified that met inclusion criteria. Within these, results from a total of 54 distinct meta-analyses were reported for whole grains and 5 meta-analyses for refined grains. For total cancer mortality, 7 meta-analyses of cohort studies indicated that whole grain intake was associated with 6% to 12% lower risk in comparison of highest vs. lowest intake groups, and 3% to 20% lower risk for doses ranging from 15 to 90 g/day. For site-specific cancers, meta-analyses indicated that whole grain intake was consistently associated with lower risks of colorectal, colon, gastric, pancreatic, and esophageal cancers. Limited data were available for refined grains, with only 4 publications providing risk estimates, and only 1 of the meta-analyses included more than 3 studies. High intake of refined grains was associated with increased risk of colon and gastric cancer. By contrast, in the only dose-response meta-analysis, each 90 g/day consumption of refined grains was associated with a 6% lower risk of total cancer. In addition to the limited number of published meta-analyses on refined grains, results were also weakened due to the fact that refined grains were frequently defined to include both staple grain foods and indulgent grain foods, and the majority of studies included in the meta-analyses provided no specific definition of refined grains. Overall, meta-analyses of cohort and case-control studies consistently demonstrate that whole grain intake is associated with lower risk of total and site-specific cancer, and support current dietary recommendations to increase whole grain consumption. By contrast, the relationship between refined grain intake and cancer risk is inconclusive.

Cardiorespiratory fitness is positively associated with both healthy and western dietary pattern in Iranian middle-aged

2020 ◽  
pp. 1-10
Author(s):  
Hossein Shahinfar ◽  
Farhang Djafari ◽  
Nadia Babaei ◽  
Samira Davarzani ◽  
Mojdeh Ebaditabar ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Principal Component ◽  
Total Sample ◽  
Linear Regression Models ◽  
Middle Aged ◽  
Anthropometric Measures ◽  
Western Dietary Pattern ◽  
Healthy Dietary Pattern

Abstract. Background: The association between dietary patterns and cardiorespiratory fitness (CRF) is not well established. Objective: We sought to investigate association between a posteriori dietary pattern and CRF in middle-aged adults. Design: Adults (n = 276), aged 20–74 years, who were residents of Tehran, Iran were recruited. Diet was assessed by using a validated 168-item semi-quantitative food frequency questionnaire. Principal component analysis was used to derive dietary patterns. Socio-economic status, anthropometric measures, body composition, and blood pressure were recorded. CRF was assessed by using a graded exercise treadmill test. Analysis of variance and linear regression models were used to discern the association between dietary patterns and CRF. Results: Higher scores of the healthy dietary pattern had no association with VO2max (p = 0.13 ). After controlling for potential confounders, VO2max was positively associated across tertiles of healthy dietary patterns (p < 0.001). Higher adherence to the “mixed” dietary pattern was inversely related to VO2max (p < 0.01). After adjusting for confounders, the significant association disappeared (p = 0.14). Higher scores of the “Western” dietary pattern was not associated with VO2max (p = 0.06). However, after controlling for potential confounders, VO2max was positively associated with the “Western” dietary pattern (p = 0.01). A positive linear association between the “healthy” dietary pattern and CRF for the total sample (R2 = 0.02; p < 0.01) were presented. Conclusions: Overall, our findings suggest that higher adherence to a “healthy” and “Western” dietary pattern was positively associated with CRF. However, further studies are required to examine and clarify the causal relationship between dietary patterns and CRF.

Association of Major Dietary Patterns with General and Abdominal Obesity in Iranian Patients with Type 2 Diabetes Mellitus

2015 ◽  
Vol 85 (3-4) ◽  
pp. 145-155 ◽  
Author(s):  
Marjan Ghane Basiri ◽  
Gity Sotoudeh ◽  
Mahmood Djalali ◽  
Mohammad Reza Eshraghian ◽  
Neda Noorshahi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Abdominal Obesity ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Diabetic Patients ◽  
General Obesity ◽  
Healthy Dietary Pattern

Abstract. Background: The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. Methods: We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. Results: The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors. Conclusion: This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.

Sign in / Sign up

Export Citation Format

Share Document