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Whole-grain intake is associated with reduced risk of non-communicable diseases. Greater understanding of major food sources of whole grains globally, and how intake has been quantified, is essential to informing accurate strategies aiming to increase consumption and reduce non-communicable disease risk. Therefore, the aim of this review was to identify the primary food sources of whole-grain intake globally and explore how they are quantified and reported within literature, and their recommendation within respective national dietary guidelines. A structured scoping review of published articles and grey literature used a predefined search strategy across electronic databases. Data were extracted and summarised based on identified outcomes (e.g. primary sources of whole-grain intake and quantification methods). Dietary intake values were noted where available. Thirteen records across twenty-four countries identified bread and bread rolls, and ready-to-eat cereals as primary sources of whole-grain intake in Australia, New Zealand, Europe, the UK and Northern America. Elsewhere, sources vary and for large parts of the world (e.g. Africa and Asia), intake data are limited or non-existent. Quantification of whole grain also varied across countries, with some applying different whole-grain food definitions, resulting in a whole-grain intake based on only consumption of select ‘whole-grain’ foods. National dietary guidelines were consistent in promoting whole-grain intake and providing examples of country-specific whole-grain foods. Consistency in whole-grain calculation methods is needed to support accurate and comparative research informing current intake evidence and promotional efforts. National dietary guidelines are consistent in promoting whole-grain intake; however, there is variability in recommendations.

Phenolic acids, essential compounds in whole grains, are renowned for their health-enhancing antioxidant and anti-inflammatory properties. Variations in concentration, particularly of hydroxybenzoic and hydroxycinnamic acids, are observed among grain types. Their antiobesity and antidiabetes effects are linked to their modulation of key signaling pathways like AMPK and PI3K, crucial for metabolic regulation and the body's response to inflammation and oxidative stress. Processing methods significantly influence phenolic acid content and bioavailability in whole grains. Thermal techniques like boiling, baking, or roasting can degrade these compounds, with loss influenced by processing conditions. Nonthermal methods such as germination, fermentation, or their combination, can protect or enhance phenolic acid content under ideal conditions. Novel nonthermal approaches like ultrahigh pressure (UHP), irradiation, and pulsed electric fields (PEF) show promise in preserving these compounds. Further research is needed to fully comprehend the impact mechanisms of these innovative methods on the nutritional and sensory attributes of cereals.

The objective was to examine the association between the intakes of whole grains, refined grains, and whole/refined ratio with periodontitis. Data from 7,753 adults participating in NHANES 2009-2014 were used. The intakes of whole grains, refined grains, and whole/refined ratio were collected and calculated. Periodontitis was defined according to the CDC. The relationship between periodontitis and grains intakes were evaluated by using multivariate models. Dose-response relationship was modelled by restricted cubic spline regression. In the fully adjusted model, the whole grains intake (Q4 ORs: 0.70 (0.56,0.89)) and whole/refined grain ratio (Q4 ORs: 0.75 (0.60,0.93)) were negatively associated with periodontitis. The results of restricted cubic spline regression showed an OR of 0.89 (95% CI: 0.84,0.95) for per 28.3 g/d increase in whole grain intake, and the whole/refined grain ratio had a J-shaped association with periodontitis. Increased intake of whole grains was associated with lower prevalence of periodontitis.

Randomized controlled trials (RCT) demonstrate that whole wheat consumption improves glycemia. However, substantial inter-individual variation is often observed, highlighting that dietary whole grain recommendations may not support the health of all persons. The objective of this report is to describe the rationale and design of a planned RCT aimed at establishing the gut microbiota and metabolome signatures that predict whole wheat-mediated improvements in glucose tolerance in adults with prediabetes. It is hypothesized that a controlled diet containing wheat bread (WHEAT; 160 g/day) compared with refined bread (WHITE) will improve glucose tolerance in a gut microbiota-mediated manner. Biospecimens will be collected before and after each 2-week study arm. Testing for oral glucose tolerance and gastrointestinal permeability will be performed post-intervention. Assessments will include oral glucose tolerance (primary outcome) and secondary outcomes including gut microbiota, targeted and untargeted metabolomics of fecal and plasma samples, intestinal and host inflammatory responses, and intestinal permeability. WHEAT is predicted to alleviate glucose intolerance by shifting microbiota composition to increase short-chain fatty acid-producing bacteria while reducing populations implicated in intestinal inflammation, barrier dysfunction, and systemic endotoxemia. Further, benefits from WHEAT are anticipated to correlate with gut-level and systemic metabolomic responses that can help to explain the expected inter-individual variability in glucose tolerance. Thus, knowledge gained from integrating multi-omic responses associating with glucose tolerance could help to establish a precision nutrition-based framework that can alleviate cardiometabolic risk. This framework could inform novel dietary whole grain recommendations by enhancing our understanding of inter-individual responsiveness to whole grain consumption., Competing Interests: Author declarations RSB is the Editor-in-Chief and JZ is a Guest Editor of Nutrition Research. Manuscript handling was performed by a designated staff person from Elsevier to blind RSB and JZ to the peer review process. None of the other authors have any relevant conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Adequate diet and lifestyle practices are postulated to improve health and enhance wellbeing of cancer survivors. Despite the heavy cancer burden in Lebanon, little is known about the diet quality of survivors. This cross-sectional study assessed the compliance of survivors in remission with the American Cancer Society/American Institute Research Fund (ACS/AICR) diet and physical activity guidelines., Methods: Cancer survivors in remission for at least 3 months and attending oncology clinics in two referral centers in Beirut, Lebanon were recruited. Adherence to the ACS/AICR was assessed by examining the compliance to guidelines promoting fruits, vegetables and whole grain and discouraging elevated alcohol, meat and energy dense foods intake. Dietary data was assessed through food frequency and lifestyle questionnaires administered face to face and through phone interviews. Anthropometrics, food security and sociodemographic data was also collected. Univariate and bivariate descriptive and logistic regressions were used to determine predictors of adherence rates to the ACS/AICR score., Results: A total of 268 participants were recruited (mean age = 59 ± 23 years, 83% females, 70% breast cancer). Mean time since remission was 3.2 ± 4 years and the majority (72%) had food insecurity. Low physical activity and overweight/obesity were present in 65% and 67% of the survivors, respectively. Median adherence score with the ACS/AICR score was 9.0 out of 15. The majority of survivors had complete adherence to the moderate meat and alcohol consumption guidelines. However, 98% were noncompliant with the whole grains' consumption guidelines. Cancer type, site of recruitment and education were the significant predictors of the ACS/AICR diet adherence score., Conclusion: This study highlights the elevated rates of overweight/obesity, physical inactivity and the alarmingly low adherence with the whole grains consumption guideline among cancer survivors in remission. Policy makers ought to use study findings to redirect government subsidization and educational interventions in the country and physicians should stress the importance of adherence to a healthy diet during remission through counseling and timely referral., (© 2024. The Author(s).)

Background and Aims: Whole grain consumption is widely recognized as a vital component of a balanced diet. Dietary fiber has been well-documented to play a crucial role in these health benefits attributed to whole grain intake. However, population-based evidence directly linking whole grain consumption to anti-inflammatory effects, especially in the context of immune-mediated inflammation, remains limited. We hypothesized that whole grain consumption promotes health by modulating immune-mediated inflammation., Methods and Results: This study was designed as a real-world, population-based randomized controlled trial. We compared the effects of whole grain versus refined grain consumption on immune-mediated inflammation through staple food substitution, while participants maintained their usual dietary practices. The results demonstrated that whole grain consumption significantly reduced circulating levels of pro-inflammatory cytokines IL-22 and IL-23 compared to refined grain consumption. These reductions were associated with optimized short-chain fatty acid profiles and changes in CD4 + T cell subset distributions., Conclusions: The findings suggest that the anti-inflammatory effects of whole grain consumption in middle-aged and elderly populations are mediated by targeting specific CD4 + T cell subsets, in addition to modulating both upstream short-chain fatty acid composition and downstream expression of the pro-inflammatory cytokines IL-22 and IL-23., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Importance: Epidemiological evidences regarding the association between whole grain intake and the risk of new-onset hypertension are still controversial., Objective: We aimed to investigate the relationship between whole grain intake and new-onset hypertension and examine possible effect modifiers in the general population., Methods: A total of 10,973 participants without hypertension from the China Health and Nutrition Survey were enrolled, with follow-up beginning in 1997 and ending in 2015. Whole grain intake was assessed by 3 consecutive 24-h dietary recalls combined with a household food inventory. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression model after adjusting for potential risk factors., Results: During a median follow-up of 7.0 years, 3,733 participants developed new-onset hypertension. The adjusted HRs (95% CIs) were as follows: for quartile 2 (HR: 0.52; 95% CI: 0.47-0.57), quartile 3 (HR: 0.46; 95% CI: 0.42-0.51), and quartile 4 (HR: 0.35; 95% CI: 0.31-0.38), compared with quartile 1. Different types of whole grain types, including wheat (adjusted HR, 0.35; 95% CI, 0.32-0.39), maize (adjusted HR, 0.50; 95% CI, 0.42-0.59), and millet (adjusted HR, 0.38; 95% CI, 0.30-0.48), showed significant associations with a reduced risk of hypertension. The association between whole grain intake and new-onset hypertension was stronger in individuals with older age (P for interaction < 0.001) and higher BMI (P for interaction < 0.001)., Conclusion: Higher consumption of whole grains was significantly associated with a lower risk of new-onset hypertension. This study provides further evidence supporting the importance of increasing whole grain intake for hypertension prevention among Chinese adults., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Whole-grain pearl millet is a nutritious cereal source of dietary fiber, vitamins, minerals, and bioactive compounds. It offers health benefits such as glycemic control and satiety. Extrusion cooking for diverse formulations, including beverages, can alter its chemical composition, impacting the nutritional value. This study aimed to evaluate the sensory acceptability of an extruded millet flour beverage and its acute effects on glycemic index (GI), glycemic and insulinemic response, food intake, and subjective appetite sensations in euglycemic and eutrophic adults., Methods: This is an acute, single-blind, randomized, controlled, cross-over clinical study comprising 14 euglycemic and eutrophic adults. Initially, beverages based on whole extruded millet flour were developed, and sensorially and chemically analyzed. Next, a clinical trial was conducted with participants undergoing four sessions and consuming one of the following options: extruded millet beverage, a maltodextrin control beverage, or a glucose solution administered in two separate sessions. Blood glucose, insulin, and appetite responses were assessed over a 2-h period, in addition to determining the GI of the beverages and analyzing food intake in the 24 h following each session., Results: The extruded millet flour strawberry-flavored beverage had the best sensory acceptance and was classified as having as high GI. Consumption of the extruded millet beverage showed similar glycemic and insulinemic responses, as well as appetite control and food intake of the subjects, when compared with consumption of the maltodextrin control beverage., Conclusions: Intake of the extruded millet beverage maintained glycemic and insulinemic responses, appetite control, and food intake in euglycemic and eutrophic subjects., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

Whole grain diet is considered to be related to the improvement of obesity, dyslipidemia, hypertension, hyperglycemia, diabetes, and other metabolic diseases. Many studies indicate that these active ingredients in grains can act as prebiotics to improve intestinal integrity and host metabolism, preventing obesity. In this review, the physiological role of gut microbiota (GM) in the human body and its relationship with obesity were first introduced. Subsequently, the interaction between naturally derived bioactive ingredients in grains and GM was discussed, and the research progress of different grains was made in improving obesity and related metabolic diseases by regulating GM. This article provides fundamental explanations for the regulation of whole grains on obesity by GM and novel potential for the development of whole grain functional foods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Health benefits of whole grain (WG) consumption are well documented. Current Dietary Guidelines for Americans recommend at least half of total grains consumed be WG; however, Americans consume less than one serving of WG per day. Inferior taste of whole grain products as compared with refined grain products has been reported as one of the main barriers to acceptability and consumption of whole grains. In this pilot study, we aimed to determine if mere exposure to WG foods in self-reported low WG consumers would improve their implicit associations between WG and pleasant taste., Methods: Healthy adults ( n =45) were provided a variety of WG or refined grain (RG) products for home use for 6 weeks. Intake was measured by calculating disappearance and verified by a daily log. At the beginning and end of the intervention, we administered an Implicit Association Test (IAT), a computer test designed to measure indirectly the strength of association between pairs of concepts: (a) two contrasted target categories (WG and RG food images) and (b) two contrasted attribute categories (words relating to pleasant or unpleasant taste) via a classification task. Response time was used to calculate IAT D scores, indicating the strength of implicit associations between WG and RG and positive or negative taste., Results: ANCOVA showed that average D scores at the end of the study shifted significantly toward a positive implicit association between WG and good taste ( p <0.05) in participants whose baseline D scores indicated an initial preference for RG over WG. No significant differences were found between the WG and RG groups in overall consumption of provided grain products., Conclusion: These findings suggest that mere exposure to WG products over an extended period of time in a free-living situation can improve automatic attitudes toward WG, potentially leading to increased consumption of WG foods., Clinical Trial Registration: Clinicaltrials.Gov, identifier NCT01403857., Competing Interests: ML was employed by the VTT Technical Research Centre of Finland Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 De Leon, Burnett, Rust, Lyly and Keim.)

Background & aims : Although previous observational studies have suggested an association between whole grain consumption (including breakfast cereals) and a reduced risk of death, no study has explored in detail the association between consumption of cereal with or without added sweeteners and death. We therefore aimed to evaluate the association between unsweetened, sugar-sweetened, and artificially sweetened cereals and all-cause and cause-specific mortality. Methods : We conducted a prospective cohort study of 186 419 UK Biobank participants who met the inclusion criteria for this study. Participants with baseline demographic, lifestyle, dietary, and clinical data were recruited from 2006 to 2010 and followed up until 2023. The intake of unsweetened, sugar-sweetened, or artificially sweetened cereals was estimated through repeated 24 hour dietary recalls. The non-linear relationships between daily dosage of cereal and all-cause, cancer-specific, and cardiovascular disease (CVD)-specific mortality were calculated using a restricted cubic spline curve. Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality were calculated using Cox regression models. Results : During a median follow-up of 13.6 years, 11 351 all-cause deaths were recorded, including 6176 cancer deaths and 2126 CVD deaths. Cox regression models with restricted cubic splines showed a non-linear association between unsweetened cereals and all-cause and cancer-specific mortality. Compared with non-consumers, consumers of different amounts of unsweetened cereals (0 to 0.5, 0.5 to 1.5, and >1.5 bowls per day) had lower risks of all-cause mortality in the multivariate Cox models, with respective HRs of 0.89 (95%CI: 0.84-0.95), 0.90 (95%CI: 0.86-0.94), and 0.89 (95%CI: 0.82-0.97). However, no association was observed between consumption of sugar or artificially sweetened cereals and the risk of mortality. When cereals were divided into those with or without dried fruit, the findings were consistent with our primary results. Conclusions : Moderate consumption of unsweetened cereals was associated with a reduced risk of all-cause mortality, suggesting caution in consuming cereals with added sugar or artificial sweeteners.

Objective : The aim of the present study was to conduct a meta-analysis of observational studies to explore the latest evidence on the influence of whole grain and fiber consumption on total chronic liver diseases. Methods : We searched the PubMed and Web of Science online databases and reference lists of eligible articles up to June, 2024. Results : The odds ratio (OR) between whole grain intake and total chronic liver disease risk was 0.90 (95% confidence interval (CI): 0.81 to 0.99, p < 0.001) and indicated an OR of 0.65 (95% CI: 0.57 to 0.74, p < 0.001) between fiber intake and total chronic liver disease risk when comparing the highest and lowest total intake, both indicating a significant negative correlation. Furthermore, subgroup analysis revealed that the protective effect of whole grains on chronic liver diseases was the most significant in cirrhosis (OR = 0.65; 95% CI: 0.57 to 0.74) and mortality (OR = 0.37; 95% CI: 0.29 to 0.47). Conclusion : Whole grain and fiber intake has a protective effect on the risk of chronic liver diseases.

Background: Cereal grains are rich in carbohydrates and could trigger a hyperglycemic response which is closely linked to blood pressure status. We aim to examine the associations between the consumption of cereals with different cooking methods and hypertension risk., Methods: We conducted a prospective analysis utilizing the nationwide data of 11,080 adult participants who were free of hypertension at baseline. Cereal intake was assessed using 3-day 24 h dietary recalls with a weighing technique. Hypertension incidence was identified in adherence with the Seventh Joint National Commission guidelines during the follow-up. Cox proportional hazards regression models were used to extrapolate hazard ratios associated with hypertension risk., Results: Over an average follow-up span of 7 years (77,560 person-years), we identified 3643 new hypertension cases. The intake of total, fried, and baked cereals was associated with 15%, 20%, and 20% higher risk of hypertension, respectively. Whole grain consumers had an 8% lower risk of hypertension compared with non-consumers, while total refined grain consumers showed no significant association. Replacing one daily serving of fried or baked cereals with an equivalent serving of boiled cereals was related to a 28% or 14% lower risk, respectively., Conclusions: Total, fried, and baked cereal consumption was positively associated with hypertension risk, while consuming whole grains was related to a lower risk. Modifying cooking methods from frying or baking to boiling for cereals may be beneficial to lower risk. The current study underscores the significance of considering both the degree of processing and cooking methods applied to cereals in addressing hypertension prevention and management.

Purpose of Review: The aim of this systematic review was to investigate the effects of whole grain Avena sativa and Hordeum vulgare L., or their isolated fractions, on immune and inflammatory functions, as well as their influence on gut microbiota. A structured literature search was undertaken in line with PRISMA guidelines. Randomized controlled trials (RCTs) that investigated the effects of oats or barley consumption in adults and reported ≥ 1 of the following: C-reactive protein (CRP), tumor necrosis factor (TNF-α), interleukin-6 (IL-6), IL-2, IL-8, IL-18, lipopolysacharide binding protein (LBP) or gut microbiota-related outcomes, were included., Recent Findings: A total of 16 RCTs were included, among which 6 studies recruited metabolically at-risk population, including individuals with overweight and obesity, metabolic syndrome or hypercholesterolemia. Additionally, 3 trials involved young healthy population, 5 trials targeted older individuals (aged over 50 years), and 2 studies encompassed populations with other disease states. A total of 1091 individuals were included in the evaluation of short-term (up to 14 days) and long-term (beyond 14 days, up to 90 days) supplementation with oats or barley-based products. 9 studies measured inflammatory biomarkers and 5 of them reported significant reductions, specifically in long-term studies. Notably, no evidence of anti-inflammatory benefits was found in healthy individuals, whereas studies involving metabolically at-risk populations showed promising reductions in inflammation. 13 studies measured the impact on gut microbiota, and collectively suggest that oats and barley food products can influence the composition of gut microbiota, associated in some cases with metabolic improvements. Oats and barley consumption may confer anti-inflammatory effects in metabolically at-risk populations and influence gut microbiota outcomes. However, no anti-inflammatory benefits were observed in healthy individuals. Results from this systematic review suggests caution in interpreting findings due to limited trials and variations in interventions and health conditions., (© 2024. The Author(s).)

Purpose: Front-of-pack labelling systems, such as the Health Star Rating (HSR), aim to aid healthy consumer dietary choices and complement national dietary guidelines. Dietary guidelines aim to be holistic by extending beyond the individual nutrients of food, including other food components that indicate diet quality, including whole grains. We aimed to test the feasibility of including whole grains in the HSR algorithm, to better inform dietary guidance in Australia coherent with existing dietary guidelines., Methods: We assigned whole-grain points as a favourable component of the HSR based on the whole-grain content of foods. We compared the original, and three modified HSR algorithms (including altered thresholds for star ratings) using independent-samples median tests. Finally, we used Spearman's correlation to measure the strength of association between an item's nutritional composition (all components of the HSR algorithm including all favourable and unfavourable components) and their HSR using each algorithm., Results: Up to 10 points were added for products with ≥ 50% whole-grain content, with no points for products with < 25%. Adjusting the HSR score cut-off by 3 points for grain products created the greatest difference in median HSR between refined and whole-grain items (up to 2 stars difference), compared to the original algorithm (a maximum of 1 star)., Conclusions: The addition of whole grains to the HSR algorithm improved the differentiation of refined and whole-grain items, and therefore better aligned with dietary guidelines. Holistic approaches to food guidance systems are required to provide consistent messaging and inform positive food choices., (© 2024. The Author(s).)

Scope: This study aims to identify the gut enterotypes that explain differential responses to intervention with whole grain rye by proposing an "enterotype - metabolic" model., Methods and Results: A 12-week randomized controlled trial is conducted in Chinese adults, with 79 subjects consuming whole grain products with fermented rye bran (FRB) and 77 consuming refined wheat products in this exploratory post-hoc analysis. Responders or non-responders are identified according to whether blood glucose decreased by more than 10% after rye intervention. Compared to non-responders, responders in FRB have higher baseline Bacteroides (p < 0.001), associated with reduced blood glucose (p < 0.001), increased Faecalibacterium (p = 0.020) and Erysipelotrichaceae&#95;UCG.003 (p = 0.022), as well as deceased 7β-hydroxysteroid dehydrogenase (p = 0.033) after intervention. The differentiated gut microbiota and metabolites between responders and non-responders after intervention are enriched in aminoacyl-tRNA biosynthesis., Conclusion: The work confirms the previously suggested importance of microbial enterotypes in differential responses to whole grain interventions and supports taking enterotypes into consideration for improved efficacy of whole grain intervention for preventing type 2 diabetes. Altered short-chain fatty acids and bile acid metabolism might be a potential mediator for the beneficial effects of whole grain rye on glucose metabolism., (© 2024 Wiley‐VCH GmbH.)

Background and Aims: The association between fiber or whole grain intakes and the risk of liver cancer remains unclear. We assessed the associations between fiber or whole grain intakes and liver cancer risk among 2 prospective studies, and systematically reviewed and meta-analyzed these results with published prospective studies., Approach and Results: A total of 111,396 participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) and 26,085 men from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study were included. Intakes of total fiber and whole grains were estimated from validated food frequency questionnaires. Study-specific HRs and 95% CI with liver cancer risk were estimated using multivariable-adjusted Cox regression. We systematically reviewed existing literature, and studies were combined in a dose-response meta-analysis. A total of 277 (median follow-up = 15.6 y) and 165 (median follow-up = 16.0 y) cases of liver cancer were observed in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, respectively. Dietary fiber was inversely associated with liver cancer risk in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (HR 10g/day : 0.69; 95% CI: 0.55-0.86). No significant associations were observed between whole grain intakes and liver cancer risk in either study. Our meta-analysis included 2383 incident liver cancer cases (7 prospective cohorts) for fiber intake and 1523 cases (5 prospective cohorts) for whole grain intake; combined HRs for liver cancer risk were 0.83 (0.76-0.91) per 10 g/day of fiber and 0.92 (0.85-0.99) per 16 g/day (1 serving) of whole grains., Conclusions: Dietary fiber and whole grains were inversely associated with liver cancer risk. Further research exploring potential mechanisms and different fiber types is needed., (Copyright © 2024 American Association for the Study of Liver Diseases.)

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., Competing Interests: The authors declare no conflicts of interest.

This study aimed to investigate whether psychological distress, whole-grain consumption and tryptophan metabolism are associated with participants undergoing weight management intervention. Seventy-nine women and men (mean age 49·7 (sd 9·0) years; BMI 34·2(sd 2·5) kg/m 2 ) participated in a 7-week weight-loss (WL) period and in a 24-week weight maintenance (WM) intervention period. Whole-grain consumption was measured using 4 d food diaries. Psychological distress was assessed with the General Health Questionnaire-12 (GHQ), and participants were divided into three GHQ groups based on the GHQ scores before WL. Tryptophan metabolites were determined from the participants' fasting plasma using liquid chromatography-MS. GHQ scores were not associated with the whole-grain consumption. A positive association was observed between the whole-grain consumption and indole propionic acid (IPA) during the WM ( P = 0·033). Serotonin levels were higher after the WL in the lowest GHQ tertile ( P = 0·033), while the level at the end of the WM was higher compared with other timepoints in the highest GHQ tertile ( P = 0·015 and P = 0·001). This difference between groups was not statistically significant. Furthermore, levels of several tryptophan metabolites changed within the groups during the study. Tryptophan metabolism changed during the study in the whole study group, independently from the level of psychological distress. The association between whole-grain consumption and IPA is possibly explained by the effects of dietary fibre on gut microbiota. This broadens the understanding of the pathways behind the health benefits associated with the intake of whole grains.

Aims : Epidemiological studies that use dietary biomarkers to investigate the association between whole grain intake and the risk of obesity are sparse. We assessed the association between urinary alkylresorcinol metabolites including 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA) and 3,5-dihydroxybenzoic acid (DHBA), biomarkers of whole grain wheat and rye intake, and body fat measures. Methods : We measured urinary excretion of DHPPA and DHBA, body weight, height, and circumferences of the waist and hip at the baseline and again after 1-year in a representative sample of 306 community-dwelling adults in Huoshan, China. We also measured liver fat accumulation [indicated by the controlled attenuation parameter (CAP)] and other body composition after 1 year. Multivariate-adjusted linear models and linear mixed-effects models were used to analyze single measurement and repeated measurements, respectively. Results : Each 1 μg g -1 creatinine increase in urinary DHPPA levels was associated with 0.21%, 0.23%, 3.64%, and 4.80% decrease in body weight, body mass index (BMI), body fat mass (BFM) and visceral fat level (VFL), respectively (all P < 0.05). Higher DHBA levels were inversely associated with CAP (percentage difference per 1 μg g -1 creatinine increment: -1.98%, P < 0.05). Higher total urinary alkylresorcinol metabolite (DHPPA + DHBA) levels were associated with lower body weight, BMI, BFM, VFL, and CAP, with the percentage differences per 1 μg g -1 creatinine increment of -0.27%, -0.27%, -3.79%, -5.12%, and -2.24%, respectively (all P < 0.05). Conclusions : Our findings suggest that the intake of whole grain wheat and rye, reflected by urinary DHPPA and DHBA, is favorably associated with liver fat and other fat measures.

Purpose: Growing elderly populations worldwide have sparked interest in factors promoting healthy aging. Diet and other lifestyle patterns are key factors for healthy ageing; however, evidence is sparse for specific dietary guidelines that are easily implemented in everyday life. Whole grains constitute specific dietary components with unexplored potential in healthy ageing., Methods: We applied an illness-death multistate model to assess the association between whole-grain intake and life expectancy, both with and without disease, over a 20-year period. Healthy ageing was defined as absence of cancer, ischemic heart disease, stroke, type 2 diabetes, asthma, chronic obstructive pulmonary disease, and dementia during follow-up., Results: Based on information from 22,606 men and 25,468 women in the Danish Diet, Cancer and Health cohort, followed for an average of 13.8 and 17.5 years, respectively, a doubling in whole-grain intake was associated with 0.43 (95% CI: 0.33-0.52) and 0.15 (0.06-0.24) additional years without disease for men and women, respectively. Comparing the highest and lowest quartiles of whole-grain intake, with a special emphasis on men, we found that those with the highest intake lived, on average, one year longer without disease compared to those with the lowest intake. Additionally, although a high intake of whole grains yielded longer life expectancy, the duration of living with disease was shorter., Conclusion: Intake of whole grains in mid-life was associated with healthy ageing looking 20 years ahead., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Purpose: To investigate the associations between dietary/serum branched-chain amino acids (BCAAs) and cardiometabolic risk markers., Methods: In a cohort of 2791 participants, diet and cardiometabolic risk markers were measured twice at baseline in overall participants and after 1-year in a subset of 423 participants. We assessed serum BCAAs at baseline and arterial stiffness after 1-year. The cross-sectional associations between dietary/serum BCAAs and cardiometabolic risk markers were analyzed using baseline measurements by linear regression, while the 1-year longitudinal association were analyzed using repeated measurements by linear mixed-effects regression., Results: Higher BCAA intake from poultry was associated with lower triglycerides (β=-0.028, P = 0.027) and higher high-density lipoprotein cholesterol (HDL-C, β = 0.013, P = 0.006), while BCAAs in red and processed meat or fish were inversely associated with low-density lipoprotein cholesterol (β = 0.025, P = 0.001) and total cholesterol (β = 0.012, P = 0.033), respectively. BCAAs in whole grains and nuts were associated with higher HDL-C (β = 0.011, P = 0.016), and lower TG (β=-0.021, P = 0.041) and diastolic blood pressure (β=-0.003, P = 0.027). Also, BCAAs from soy or vegetables and fruits were inversely associated with arterial stiffness (β=-0.018, P = 0.047) and systolic blood pressure (β=-0.011, P = 0.003), respectively. However, BCAAs in refined grains were positively associated with triglycerides (β = 0.037, P = 0.014). Total serum BCAAs were unfavorably associated with multiple cardiometabolic risk markers (all P < 0.05)., Conclusion: Dietary BCAAs in poultry, whole grains and nuts, soy, and vegetables and fruits may be favorably, while BCAAs in red and processed meat, fish, and refined grains were unfavorably associated with cardiometabolic health. Serum BCAAs showed a detrimental association with cardiometabolic risk markers., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Existing research shows an inconsistent correlation between whole-grain intake and obesity risk, with limited study on the dose-response relationship. Here, we aimed to examine this association and dose-response relationship among U.S. adults who participated in a NHANES (2003-2018). The intake of whole grain was collected and calculated from two rounds of 24 h dietary recall. Obesity was categorized based on body mass index (BMI) and waist circumference (WC). Weighted multivariable logistic regression models were used to calculate the odds of obesity according to whole-grain intake, and the dose-response relationship was modeled by restricted cubic spline regression. Among the 27,862 participants, 38.3% had general obesity, while 58.3% had abdominal obesity. After multivariate adjustment of potential confounders, the participants in the highest quintile of whole-grain intake had a lower prevalence of general obesity (OR 0.79; 95% CI 0.72-0.88) and abdominal obesity (OR 0.80; 95% CI 0.73-0.89) compared with those in the lowest category. Spline regression showed an inversely linear dose-response association between whole-grain intake and the prevalence of general obesity and abdominal obesity. In conclusion, a higher whole-grain intake was associated with lower odds of obesity, both general and abdominal. Our findings highlight the importance of increasing the whole-grain intake to prevent and manage obesity.

The association of Healthy Eating Index 2020 (HEI-2020), especially its components with systemic inflammatory biomarkers, has not been examined. The aim of this study was to investigate the relationship between HEI-2020 and its components with systemic inflammatory biomarkers, and to provide a dietary pattern suggestion to combat systemic inflammation. Participants aged 20 years and older with complete information on two reliable dietary recalls, blood cell counts and demographic characteristics, were recruited from six NHANES cycles from 2007 to 2018. Weighted general linear methods showed that HEI-2020 was negatively associated with systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI). Weighted quantile regression (WQS) models and quantile g-computation (QGC) models supported the negative association between the mixed components and systemic inflammation. High intakes of whole fruits, whole grains, greens and beans, and seafood and plant proteins, along with a low intake of added sugars, were associated with reduced systemic inflammation. In contrast, the scores of sodium, dairy, total protein, and refined grains showed no significant effect. Briefly, our study provides an anti-inflammatory dietary pattern suggestion based on the 13 components of HEI-2020 and Dietary Guidelines for Americans., Competing Interests: The authors declared that no competing interest existed., (© 2024 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.)

Excessive dietary phosphorus is a concern among patients with kidney failure undergoing dialysis treatment because it may contribute to hyperparathyroidism and hyperphosphatemia. A long-standing but untested component of the low-phosphorus diet is the promotion of refined grains over whole grains. This paper reviews the scientific premise for restricting whole grains in the dialysis population and estimates phosphorus exposure from grain products based on three grain intake patterns modeled from reported intakes in the general US population, adjusting for the presence of phosphorus additives and phosphorus bioavailability: (1) standard grain intake, (2) 100% refined grain intake, and (3) mixed (50/50 whole and refined grain) intake. Although estimated phosphorus exposure from grains was higher with the mixed grain pattern (231 mg/day) compared to the 100% refined grain pattern (127 mg/day), the amount of additional phosphorus from grains was relatively low. Given the lack of strong evidence for restricting whole grains in people with CKD, as well as the potential health benefits of whole grains, clinical trials are warranted to address the efficacy and health impact of this practice., (© 2024 Wiley Periodicals LLC.)

With emerging Asian-derived diet quality indices and data-driven dietary patterns available, we aimed to synthesize the various dietary patterns and quantify its association with cardiovascular diseases (CVDs) among Asian populations. We systematically searched PubMed, Embase, Scopus, and Web of Science for observational studies in South, Southeast, and East Asia. Dietary patterns were grouped "high-quality," which included high intakes of three or more of the following food groups: 1) fruits and vegetables, 2) whole grains, 3) healthy protein sources (legumes and nuts, fish and seafood, low-fat dairy, and lean meat and poultry), and 4) liquid plant oils. High-quality patterns were further subcategorized based on their derivation methods: non-Asian indices, Asian indices, data-driven patterns, and plant-based indices. Dietary patterns were grouped "low-quality," which included high intakes of two or more of the following: 5) ultraprocessed food, 6) beverages and foods with added sugars, 7) foods high in salt, and 8) alcoholic beverages. Data-driven dietary patterns characterized by animal food sources were labeled "animal-based," and studies using dietary diversity scores were labeled "diet diversity indices." Dietary patterns that could not be meaningfully categorized were summarized narratively. Study-specific effect estimates were pooled using a random-effects model. Forty-one studies were included in this review. Higher adherence to high-quality dietary patterns in the top compared with bottom tertile defined by non-Asian indices (RR: 0.78; 95% CI: 0.69, 0.88; GRADE: moderate), Asian indices (RR: 0.84; 95% CI: 0.79, 0.90; GRADE: low), and data-driven patterns (RR: 0.81; 95% CI: 0.74, 0.89; GRADE: moderate) were associated with lower CVD risk. Plant-based, low-quality, animal-based, and diet diversity indices dietary patterns were not associated with CVD. Associations of Asian diet quality indices and CVD risk were weaker than those with non-Asian indices, highlighting the need for current Asian diet quality criteria to be updated to better capture the impact of diet on CVD. The systematic review and meta-analysis was registered at PROSPERO as CRD42021244318., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The field of nutrigenomics studies the interaction between nutrition and genetics, and how certain dietary patterns can impact gene expression and overall health. The Mediterranean diet (MedDiet), characterized by a high intake of fruits, vegetables, whole grains, and healthy fats, has been linked to better cardiovascular health (CVH) outcomes. This review summarizes the current state of research on the effects of nutrigenomics and MedDiet on cardiovascular health. Results suggest that MedDiet, through its impact on gene expression, can positively influence CVH markers such as blood pressure, lipid profile, and inflammation. However, more research is needed to fully understand the complex interactions between genetics, nutrition, and CVH, and to determine the optimal dietary patterns for individualized care. The aim of this scientific review is to evaluate the current evidence on the effects of nutrigenomics and MedDiet on cardiovascular health. The review summarizes the available studies that have investigated the relationship between nutrition, genetics, and cardiovascular health, and explores the mechanisms by which certain dietary patterns can impact CVH outcomes. The review focuses on the effects of MedDiet, a dietary pattern that is rich in whole foods and healthy fats, and its potential to positively influence CVH through its impact on gene expression. The review highlights the limitations of current research and the need for further studies to fully understand the complex interplay between nutrition, genetics, and cardiovascular health.

Low wholegrain food consumption is a leading dietary risk for avoidable morbidity and mortality globally, with limited sensory acceptability suggested to be a challenge for changing behaviour. This study aimed to evaluate the sensory acceptability of both wholegrain (brown) and refined (white) rice in common preparations. Four brown- and white-rice-containing dishes (Garlic Rice, Rice and Beans, Jollof Rice, and Rice Pudding) were tested. Quantitative (five-point scales) and qualitative (open question responses) sensory information were collected for dish appearance, aroma, taste, and texture. All four characteristics were scored equally acceptable in Rice and Beans and Rice Pudding ( p > 0.05) between paired comparisons for brown and white rice. Scores were significantly lower for all characteristics for Jollof Rice ( p ≤ 0.002), and lower for Aroma (median (lower quartile-upper quartile)) for brown (3.5 (3-4)) vs. white rice (4 (4-5)), p = 0.006). Appearance (brown (3 (3-4)) vs. white rice (4 (3.25-5)), p = 0.012), and Texture (brown 3 (2.25-4) vs. white rice (4 (4-5)), p < 0.001) for Garlic Rice. Familiarity and appealingness were qualitative themes aligned with the higher acceptability of white-rice-containing dishes. Certain dishes appear to mask key negative sensory attributes of wholegrain foods, possibly representing a means to increase wholegrain ingredient acceptability, thereby potentially improving individual/population-level intake.

Polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) is a traditional non-culture technique that can provide a fingerprint of the microbial community. In the field of gut microbiota analysis, PCR-DGGE still holds potential for development. In the present study, we utilized an improved nested PCR-DGGE approach targeting the V3 region of 16S ribosomal DNA to investigate the impact of whole grain highland hull-less barley (WHLB), a cereal known for its significant hypocholesterolemic effect, on the gut microbiota profiles of high-fat diet rats. Seventy-two male Sprague-Dawley rats were divided into four groups and fed a normal control diet, a high-fat diet, or a high-fat diet supplemented with a low or high dose of WHLB for 4 or 8 weeks. The results revealed that the dominant bands varied among different dose groups and further changed with different treatment times. The compositions of bacterial communities in feces and cecal content were similar, but the dominant bacterial bands differed. After performing double DGGE, extracting the bands, sequencing the DNA, and aligning the sequences, a total of 19 bands were classified under the Firmicutes and Bacteroidetes phyla, while two bands were identified as unclassified uncultured bacteria. The relative abundance of Lactobacillus gasseri , Uncultured Prevotella sp., and Clostridium sp. increased following the administration of WHLB. Illumina-based sequencing was employed to assess the reliability of DGGE, demonstrating its reliability in analyzing the dominant taxonomic composition, although it may have limitations in accurately detecting the alpha diversity of bacterial species., Importance: While next-generation sequencing has overshadowed polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE), the latter still holds promise for advancing gut microbiota analysis due to its unique advantages. In this study, we used optimized nested PCR-DGGE to investigate the gut microbiota profile of high-fat diet rats after administering whole grain highland hull-less barley. High-throughput sequencing was employed to validate the DGGE results. Our results proved the reliability of PCR-DGGE for analyzing the dominant taxonomic composition while also providing visual evidence of a notable relationship between the composition of cecal and fecal microbial communities, highlighting substantial differences in both richness and abundance., Competing Interests: The authors declare no conflict of interest.

Improving the quality of diet is known as one of the practical ways to reduce cardio-metabolic risk factors (CMRFs). The carbohydrate quality index (CQI) is a relatively new index to evaluate diet quality. It is calculated based on the ratio of solid carbohydrates to total carbohydrates, dietary fibre intake, glycemic index and the ratio of whole grains to total grains. This systematic review and meta-analysis was designed to investigate the association between dietary CQI and CMRFs. Introduction: Improving the quality of diet is known as one of the practical ways to reduce cardio-metabolic risk factors (CMRFs). The carbohydrate quality index (CQI) is a relatively new index to evaluate diet quality. It is calculated based on the ratio of solid carbohydrates to total carbohydrates, dietary fibre intake, glycemic index and the ratio of whole grains to total grains. This systematic review and meta-analysis was designed to investigate the association between dietary CQI and CMRFs. Methods: In this systematic review, some international databases, including Scopus, PubMed, EMBASE, Web of Science, and Google Scholar up to July 2022, were searched according to appropriate keywords. All observational studies with an English full text assessing the association between the dietary CQI and CMRFs were included. Two researchers independently extracted the data and assessed the quality of the articles with the Newcastle-Ottawa Scale. Random/fixed-effect meta-analysis was used to pool standardized mean difference (SMD) as an effect size. Results: 11 studies with a total of 63962 subjects were found to be eligible and included in the qualitative synthesis; only BMI, WC and metabolic syndrome reached the threshold of 3 reports with the same effect size and thus only 5 were included in the meta-analysis. The main finding of the included studies was that there were inverse associations between CQI and CMRFs, mainly obesity, glucose metabolism indices, and blood pressure. In the five studies included in the random effect meta-analysis, the association between CQI and body mass index (SMD: 0.45, 95%CI: -0.12, 1.01), waist circumference (SMD: -0.09, 95%CI: -0.34, 0.15) and metabolic syndrome (SMD: 0.63, 95%CI: -0.01, 1.28) was not statistically significant. Conclusion: Although the qualitative findings support the positive association of CQI with CMRFs, the evidence is insufficient to conclude robust findings. Further observational and interventional studies are needed to clearly elucidate this association.

Objective: To compare diet and the modified dietary inflammatory index (mDII) between individuals with pediatric-onset multiple sclerosis (PoMS), monophasic acquired demyelinating syndromes (monoADS), and controls., Methods: The association between diet, mDII, and disease status was examined in 131 individuals with PoMS/monoADS/controls (38/45/48) using logistic regression., Results: The associations between diet and PoMS were modest, reaching significance for whole grain intake (adjusted odds ratio, aOR=0.964, 95 % confidence intervals, CI:0.934-0.995) but not mDII (aOR=1.20, 95 %CI:0.995-1.46) versus controls. No findings for monoADS reached significance versus controls., Conclusions: Individuals with PoMS, but not monoADS, had lower dietary whole grain intake than controls., Competing Interests: Declaration of competing interest Helen Tremlett has, in the last five years, received research support from the Canada Research Chair Program, the National Multiple Sclerosis Society, the Canadian Institutes of Health Research, the Multiple Sclerosis Society of Canada, the Multiple Sclerosis Scientific Research Foundation and the EDMUS Foundation (‘Fondation EDMUS contre la sclérose en plaques’). In addition, in the last five years, has had travel expenses or registration fees prepaid or reimbursed to present at CME conferences from the Consortium of MS Centres (2018, 2023), the Canadian Neurological Sciences Federation (2023), National MS Society (2018, 2022), ECTRIMS/ ACTRIMS (2017–2023), American Academy of Neurology (2019). Speaker honoraria are either declined or donated to an MS charity or to an unrestricted grant for use by HT's research group. Sama Bitarafan has nothing to declare. Feng Zhu was funded through research grants held by HT, including The Multiple Sclerosis Scientific and Research Foundation (PI: Tremlett, EGID: 2636). Charles N Bernstein is supported by the Bingham Chair in Gastroenterology. Dr. Bernstein has served on advisory Boards for AbbVie Canada, Amgen Canada, Bristol Myers Squibb Canada, Eli Lilly Canada, Ferring Canada, JAMP Pharmaceuticals, Pendopharm Canada, Roche Canada, Janssen Canada, Sandoz Canada, Takeda Canada, and Pfizer Canada; Consultant for Takeda; Educational grants from Abbvie Canada, Amgen Canada, Bristol Myers Squibb Canada, Eli Lilly Canada, Pfizer Canada, Takeda Canada, and Janssen Canada. Speaker's panel for Abbvie Canada, Janssen Canada, Pfizer Canada, and Takeda Canada. Received research funding from Abbvie Canada, Amgen Canada, Pfizer Canada, Sandoz Canada, and Takeda Canada. Ruth Ann Marrie receives research funding from: CIHR, Research Manitoba, MS Canada, Crohn's and Colitis Canada, National Multiple Sclerosis Society, CMSC, the Arthritis Society and the US Department of Defense, and is a co-investigator on studies receiving funding from Biogen Idec and Roche Canada. She holds the Waugh Family Chair in Multiple Sclerosis. Yinshan Zhao has nothing to declare. Emmanuelle Waubant has grants or contracts from NMSS, NIH, PCORI, Race to Erase MS, Octave, Payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or Gary Van Domselaar receives research funding from Canadian Institutes of Health Research, Multiple Sclerosis Society of Canada, Genome Canada, and the National Science and Engineering Research Council., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Previous studies on whole grain consumption had inconsistent findings and lacked quantitative assessments of evidence quality. Therefore, we aimed to summarize updated findings using the Burden of Proof analysis (BPRF) to investigate the relationship of whole grain consumption on type 2 diabetes (T2D), colorectal cancer (CRC), stroke, and ischemic heart disease (IHD)., Methods: We conducted a literature search in the Medline and Web of Science up to June 12, 2023, to identify related cohort studies and systematic reviews. The mean RR (relative risk) curve and uncertainty intervals (UIs), BPRF function, risk-outcome score (ROS), and the theoretical minimum risk exposure level (TMREL) were estimated to evaluate the level of four risk-outcome pairs., Results: In total, 27 prospective cohorts were included in our analysis. Consuming whole grain at the range of TMREL (118.5-148.1 g per day) was associated with lower risks: T2D (declined by 37.3%, 95% UI: 5.8 to 59.5), CRC (declined by 17.3%, 6.5 to 27.7), stroke (declined by 21.8%, 7.3 to 35.1), and IHD (declined by 36.9%, 7.1 to 58.0). For all outcomes except stroke, we observed a non-linear, monotonic decrease as whole grain consumption increased; For stroke, it followed a J-shaped curve (the greatest decline in the risk of stroke at consuming 100 g whole grain for a day). The relationships between whole grain consumption and four diseases are all two-star pairs (ROS: 0.087, 0.068, 0.062, 0.095 for T2D, CRC, stroke, and IHD, respectively)., Conclusion: Consuming 100 g of whole grains per day offers broad protective benefits. However, exceeding this threshold may diminish the protective effects against stroke. Our findings endorse replacing refined grains with whole grains as the main source of daily carbohydrates. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: We have registered our research in PROSPERO, and the identifier of our meta-analyses is CRD42023447345., (© 2024. The Author(s).)

Background: Whole grain (WG) consumption is linked with a reduced risk of chronic disease. However, the recommendations of the Nova classification system tend to contradict this evidence as high WG-containing foods, such as bread and cereals, are considered ultraprocessed, and intake is discouraged., Objectives: This study aimed to explore associations of cardiometabolic risk measures with ultraprocessed food (UPF) intake as classified by Nova compared with when foods with ≥25% and ≥50% WG are removed from the Nova UPF category., Methods: A cross-sectional analysis of the 2015-18 National Health and Nutrition Examination Survey. Nova was used to identify UPFs, and the WG Initiative's definition of a WG food and front-of-pack labeling requirements was used to identify high WG foods. Regression models were used to explore impacts on the association of UPF intake (quintiles) and cardiometabolic risk measures when high WG foods were excluded from the Nova UPF category., Results: Participants in the highest quintile of UPF intake had significantly higher weight [83.6 kg (0.8)], BMI (in kg/m 2 ) [30.6 (0.3)], waist circumference [103.1 cm (0.6)], and weight-to-height ratio [0.63 (0.003)] compared to those in the lowest quintile (P < 0.0001 for all). The same was found when foods with ≥25% and ≥50% WG were removed. Positive associations for C-reactive protein were found when ≥25% and ≥50% WG-containing foods were removed only [2.32 mg/L (0.1), P = 0.0209; 2.37 mg/L (0.1), P = 0.0179, respectively]. Participants in the highest quintile had significantly lower total cholesterol after adjustment when foods with ≥50% WG were removed [4.98 mmol/L (0.04), P = 0.0292]. Adjusted R 2 values remained relatively unchanged across each approach for all outcomes., Conclusions: Foods high in WG may not significantly contribute to the deleterious associations previously observed between UPF intake and cardiometabolic risk factors. Consideration of their contribution to healthful dietary patterns and diet quality in the United States population should be made prior to the endorsement of Nova., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Whole-grain rice noodles are a kind of healthy food with rich nutritional value, and their product quality has a notable impact on consumer acceptability. The quality evaluation model is of great significance to the optimization of product quality. However, there are few methods that can establish a product quality prediction model with multiple preparation conditions as inputs and various quality evaluation indexes as outputs. In this study, an artificial neural network (ANN) model based on a backpropagation (BP) algorithm was used to predict the comprehensive quality changes of whole-grain rice noodles under different preparation conditions, which provided a new way to improve the quality of extrusion rice products., Results: The results showed that the BP-ANN using the Levenberg-Marquardt algorithm and the optimal topology (4-11-8) gave the best performance. The correlation coefficients (R 2 ) for the training, validation, testing, and global data sets of the BP neural network were 0.927, 0.873, 0.817, and 0.903, respectively. In the validation test, the percentage error in the quality prediction of whole-grain rice noodles was within 10%, indicating that the BP-ANN could accurately predict the quality of whole-grain rice noodles prepared under different conditions., Conclusion: This study showed that the quality prediction model of whole-grain rice noodles based on the BP-ANN algorithm was effective, and suitable for predicting the quality of whole-grain rice noodles prepared under different conditions. © 2024 Society of Chemical Industry., (© 2024 Society of Chemical Industry.)

Purpose: Whole grains have recently been promoted as beneficial to diabetes prevention. However, the evidence for the glycemic benefits of whole grains seems to conflict between the cohort studies and randomized control trials (RCTs). To fill the research gap, we conducted a meta-analysis to determine the effects of whole grains on diabetes prevention and to inform recommendations., Methods: We searched PubMed, Clarivate Web of Science, and Cochrane Library until March 2024. We used the risk ratio (RR) of type 2 diabetes to represent the clinical outcomes for cohort studies, while the biomarkers, including fasting blood glucose and insulin, HbA 1C , and HOMA-IR, were utilized to show outcomes for RCTs. Dose-response relationships between whole grain intakes and outcomes were tested with random effects meta-regression models and restricted cubic splines models. This study is registered with PROSPERO, CRD42021281639., Results: Ten prospective cohort studies and 37 RCTs were included. Cohort studies suggested a 50 g/day whole grain intake reduced the risk of type 2 diabetes (RR = 0.761, 95% CI: 0.700 to 0.828, I 2  = 72.39%, P < 0.001) and indicated a monotonic inverse relationship between whole grains and type 2 diabetes rate. In RCTs, whole grains significantly reduced fasting blood glucose (Mean difference (MD) = -0.103 mmol/L, 95% CI: -0.178 to -0.028; I 2  = 72.99%, P < 0.01) and had modest effects on HbA 1C (MD = -0.662 mmol/mol (-0.06%), 95% CI: -1.335 to 0.010; I 2  = 64.55%, P = 0.05) and HOMA-IR (MD = -0.164, 95% CI: -0.342 to 0.013; I 2  = 33.38%, P = 0.07). The intake of whole grains and FBG, HbA 1C , and HOMA-IR were significantly dose-dependent. The restricted spline curves remained flat up to 150 g/day and decreased afterward. Subgroup analysis showed that interventions with multiple whole-grain types were more effective than those with a single type., Conclusion: Our study findings suggest that a daily intake of more than 150 g of whole grain ingredients is recommended as a population approach for diabetes prevention., (© 2024. The Author(s).)

Inflammation is an important biological response to any tissue injury. The immune system responds to any stimulus, such as irritation, damage, or infection, by releasing pro-inflammatory cytokines. The overproduction of pro-inflammatory cytokines can lead to several diseases, e.g., cardiovascular diseases, joint disorders, cancer, and allergies. Emerging science suggests that whole grains may lower the markers of inflammation. Whole grains are a significant source of dietary fiber and phenolic acids, which have an inverse association with the risk of inflammation. Both cereals and pseudo-cereals are rich in dietary fiber, e.g., arabinoxylan and β-glucan, and phenolic acids, e.g., hydroxycinnamic acids and hydroxybenzoic acids, which are predominantly present in the bran layer. However, the biological mechanisms underlying the widely reported association between whole grain consumption and a lower risk of disease are not fully understood. The modulatory effects of whole grains on inflammation are likely to be influenced by several mechanisms including the effect of dietary fiber and phenolic acids. While some of these effects are direct, others involve the gut microbiota, which transforms important bioactive substances into more beneficial metabolites that modulate the inflammatory signaling pathways. Therefore, the purpose of this review is twofold: first, it discusses whole grain dietary fiber and phenolic acids and highlights their potential; second, it examines the health benefits of these components and their impacts on subclinical inflammation markers, including the role of the gut microbiota. Overall, while there is promising evidence for the anti-inflammatory properties of whole grains, further research is needed to understand their effects fully.

Background: The relationship between whole grain intake and chronic kidney disease (CKD) remains uncertain., Objective: This study aimed to evaluate the association between whole grain intake and risk of CKD in Chinese adults., Methods: The present cross-sectional study used data from the China Health and Nutrition Survey conducted in 2009. Whole grain intake was measured using 3 consecutive 24-h dietary recalls and a household food inventory. A multivariable logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of CKD. In addition, a restricted cubic spline was used to investigate the dose‒response relationship between whole grain and risk of CKD., Results: A total of 6747 participants were included, 728 of whom had CKD. Compared with those in the lowest whole grain intake group, those in the higher grain intake group had an inverse association with risk of CKD (Q2: adjusted OR 0.70, 95% CI: 0.54, 0.89; Q3: adjusted OR 0.54, 95% CI: 0.42, 0.69; and Q4: adjusted OR 0.29, 95% CI: 0.21, 0.41). The association between whole grain intake and CKD seems to be stronger for individuals who were male (P for interaction = 0.008) or smokers (P for interaction = 0.013). In addition, the restricted cubic spline suggested an obvious L-shaped correlation., Conclusions: Increased whole grain intake was associated with a decreased risk of CKD in Chinese adults., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Objectives: Shifting from animal-based to plant-based diets could reduce colorectal cancer (CRC) incidence. Currently, the impacts of these dietary shifts on CRC risk are ill-defined. Therefore, we examined partial substitutions of red or processed meat with whole grains, vegetables, fruits or a combination of these in relation to CRC risk in Finnish adults., Methods: We pooled five Finnish cohorts, resulting in 43 788 participants aged ≥ 25 years (79% men). Diet was assessed by validated food frequency questionnaires at study enrolment. We modelled partial substitutions of red (100 g/week) or processed meat (50 g/week) with corresponding amounts of plant-based foods. Cohort-specific hazard ratios (HR) for CRC were calculated using Cox proportional hazards models and pooled together using random-effects models. Adjustments included age, sex, energy intake and other relevant confounders., Results: During the median follow-up of 28.8 years, 1124 CRCs were diagnosed. We observed small risk reductions when red meat was substituted with vegetables (HR 0.97, 95% CI 0.95 - 0.99), fruits (0.97, 0.94 - 0.99), or whole grains, vegetables and fruits combined (0.97, 0.95 - 0.99). For processed meat, these substitutions yielded 1% risk reductions. Substituting red or processed meat with whole grains was associated with a decreased CRC risk only in participants with < median whole grain intake (0.92, 0.86 - 0.98; 0.96, 0.93 - 0.99, respectively; p interaction =0.001)., Conclusions: Even small, easily implemented substitutions of red or processed meat with whole grains, vegetables or fruits could lower CRC risk in a population with high meat consumption. These findings broaden our insight into dietary modifications that could foster CRC primary prevention., (© 2024. The Author(s).)

Background: Products fermented with lactic acid bacteria based on whole grain flours of red or white sorghum (Sorghum bicolor (L.) Moench) added with malted sorghum flour, or with skim milk (SM) were developed. Composition, protein amino acid profile, total acidity, pH, prebiotic potential, and bio-functional properties after simulation of gastrointestinal digestion were evaluated., Results: In all cases, a pH of 4.5 was obtained in approximately 4.5 h. The products added with SM presented higher acidity. Products made only with sorghum presented higher total dietary fiber, but lower protein content than products with added SM, the last ones having higher lysine content. All products exhibited prebiotic potential, white sorghum being a better ingredient to promote the growth of probiotic bacteria. The addition of malted sorghum or SM significantly increased the bio-functional properties of the products: the sorghum fermented products added with SM presented the highest antioxidant (ABTS •+ inhibition, 4.7 ± 0.2 mM Trolox), antihypertensive (Angiotensin converting enzyme-I inhibition, 57.3 ± 0.5%) and antidiabetogenic (dipeptidyl-peptidase IV inhibition, 31.3 ± 2.1%) activities, while the products added with malted sorghum presented the highest antioxidant (reducing power, 1.6 ± 0.1 mg ascorbic acid equivalent/mL) and antidiabetogenic (α-amylase inhibition, 38.1 ± 0.9%) activities., Conclusion: The fermented whole grain sorghum-based products could be commercially exploited by the food industry to expand the offer of the three high-growth markets: gluten-free products, plant-based products (products without SM), and functional foods. © 2023 Society of Chemical Industry., (© 2023 Society of Chemical Industry.)

Objectives: Better diet quality of whole grain consumers could contribute to the associations between whole grain intake and chronic disease risk factors. We examined whole grain intake in relation to diet quality and chronic disease risk factors (anthropometrics, blood pressure, cholesterol, triglycerides, C-reactive protein and glucose) and the role of diet quality in whole grains' associations with each risk factor., Methods: Our data included 5094 Finnish adults who completed a validated food frequency questionnaire and participated in a health examination within the National FinHealth 2017 Study. We assessed diet quality by the modified Baltic Sea Diet Score. P trends were calculated across whole grain intake quintiles by linear regression analysis. Interactions were assessed by including an interaction term in the analyses., Results: Higher whole grain intake was associated with slightly better diet quality compared with lower intakes in both sexes (P < 0.001). Whole grain intake was inversely associated with body mass index (P < 0.001), waist circumference (P < 0.001) and total cholesterol (P = 0.02) in men. Adjusting for medication use attenuated the inverse associations with diastolic blood pressure (P = 0.06) and HDL cholesterol (P = 0.14) in men. We observed no associations in women. Diet quality did not modify the associations between whole grain intake and chronic disease risk factors., Conclusions: Our results suggest that whole grain intake was associated with small improvements in the chronic disease risk factors in men, regardless of diet quality. The sex differences may arise from varying health associations of whole grains from different cereal sources., (© 2023. The Author(s).)

The potential for healthier consumer food substitutions is an important factor in the study of food environments, dietary choices, and population nutrition promotion. The burden of diet-related non-communicable diseases is unevenly distributed across Canada and variation in the food environment sub-nationally may be an important explanation. We used population-based 24 h dietary recall data from the 2015 Canadian Community Health Survey-Nutrition for Canadian adults ( n  = 13 919) to examine dietary intakes of two food group pairings (whole grains/refined grains and legumes/red meats) where consumer substitutions have been recognized to be of importance in promoting healthy and sustainable population diet. We used an ANOVA followed by pairwise comparisons with Bonferroni correction to estimate differences in intakes between provinces for daily weight and proportion of total energy consumed. Based on the Global Burden of Disease Study, Canadians consumed below the average daily requirements of legumes and whole grains and well above the required range of red meat, suggesting room for broad improvements to population diet. Findings also demonstrate that there is potential for targeted shifts in dietary intakes among non-consumers of certain foods (e.g., legumes). This study may inform intervention development for the consumer nutrition environment including food accessibility and affordability to reduce non-communicable disease risk., Competing Interests: The authors declare there are no competing interests.

Diets deficient in fibre are reported globally. The associated health risks of insufficient dietary fibre are sufficiently grave to necessitate large-scale interventions to increase population intake levels. The Danish Whole Grain Partnership (DWP) is a public-private enterprise model that successfully augmented whole-grain intake in the Danish population. The potential transferability of the DWP model to Slovenia, Romania and Bosnia-Herzegovina has recently been explored. Here, we outline the feasibility of adopting the approach in the UK. Drawing on the collaborative experience of DWP partners, academics from the Healthy Soil, Healthy Food, Healthy People (H3) project and food industry representatives (Food and Drink Federation), this article examines the transferability of the DWP approach to increase whole grain and/or fibre intake in the UK. Specific consideration is given to the UK's political, regulatory and socio-economic context. We note key political, regulatory, social and cultural challenges to transferring the success of DWP to the UK, highlighting the particular challenge of increasing fibre consumption among low socio-economic status groups - which were also most resistant to interventions in Denmark. Wholesale transfer of the DWP model to the UK is considered unlikely given the absence of the key 'success factors' present in Denmark. However, the DWP provides a template against which a UK-centric approach can be developed. In the absence of a clear regulatory context for whole grain in the UK, fibre should be prioritised and public-private partnerships supported to increase the availability and acceptability of fibre-rich foods.

As a non-coding RNA, microRNA (miRNA) has been proven to play an important role in the development and progression of type 2 diabetes mellitus (T2DM). Highland barley is a whole grain from the Tibetan areas of China. Our previous studies have demonstrated its hypoglycemic effect. To further explore the underlining molecular mechanism, we investigated the effect of highland barley intervention on liver miRNA expression profiles in diabetic mice. Our results showed that ten differentially expressed miRNA among different groups were identified and their target genes were predicted. Remarkably, many glycometabolism-associated genes, including Foxo3, Nras, Rptor, Igf1r, Tsc2 and Braf, were negatively regulated by miR-122-5p, miR-503-5p, miR-455-5p and miR-210-3p, respectively. Pathway enrichment analysis revealed these target genes were mainly involved in AMPK, MAPK and FOXO signaling pathways. Thereby, these miRNA and mRNA were validated using qRT-PCR, and the results were consistent with the small RNA-seq and expectations. Highland barley could regulate the MAPK, AMPK, and FOXO signaling pathways by regulating critical miRNA-mRNA pairs, e.x. miR-210-3p-Tsc2/Braf, miR-122-5p-Foxo3, and miR-455-5p-Igf1r, thereby improving blood glucose metabolism in diabetic mice. The present study preliminarily explored the hypoglycaemic effects of highland barley based on transcriptomics, and more detailed and in-depth studies on this topic are needed in the future., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Cereals and cereal products have traditionally been staple foods in many countries including in the Nordics and Baltics. Cereals can be consumed with their entire grain kernel and are then referred to as whole grains or can be consumed after removal of the bran or germ and are then referred to as refined grains. The terms cereals and grains are often used interchangeably. In this scoping review, we examine the associations between intake of cereals and cereal products and major health outcomes to contribute to up-to-date food-based dietary guidelines for the Nordic and Baltic countries in the Nordic Nutrition Recommendations 2023 project. Five qualified systematic reviews that covered non-communicable diseases, mortality, and risk factors were identified, and a supplementary literature search was performed in the MEDLINE and Cochrane databases for more recent studies and other endpoints. Compared to other high-income countries, the Nordic populations have a high consumption of whole grain foods. In some of the countries, rye constitutes a substantial fraction of the cereal consumption. However, few studies are available for specific cereals, and most of the research has been performed in predominantly wheat-consuming populations. The evidence suggests clear dose-response associations between a high intake of whole grains and lower risks of cardiovascular disease, colorectal cancer, type 2 diabetes, and premature mortality. The lowest risks of morbidity and mortality were observed for 3-7 servings of whole grains per day, equivalent of 90-210 g/day (fresh weight or ready-to-eat whole grain products, such as oatmeal or whole grain rye bread). Evidence from randomized trials indicates that a high intake of whole grains is beneficial for reducing weight gain. There is less evidence for refined grains, but the available evidence does not seem to indicate similar beneficial associations as for whole grains. It is suggested that replacing refined grains with whole grains would improve several important health outcomes. Cereals are plant foods that can be grown in most of the Nordic and Baltic regions., Competing Interests: The authors have not received any funding or benefits from industry to conduct this study, and report no conflicts of interests. The authors received a small reimbursement from the Norwegian Directorate of Health for work associated with this article., (© 2024 Guri Skeie and Lars T. Fadnes.)

This review aims to investigate the relationship between the health impact of whole grains mediated via the interaction with intestinal microbiota and intestinal barrier function with special interest on tryptophan metabolism, focusing on the role of the intestinal microbiota and their impact on barrier function. Consuming various types of whole grains can lead to the growth of different microbiota species, which in turn leads to the production of diverse metabolites, including those derived from tryptophan metabolism, although the impact of whole grains on intestinal microbiota composition results remains inconclusive and vary among different studies. Whole grains can exert an influence on tryptophan metabolism through interactions with the intestinal microbiota, and the presence of fibre in whole grains plays a notable role in establishing this connection. The impact of whole grains on intestinal barrier function is closely related to their effects on the composition and activity of intestinal microbiota, and SCFA and tryptophan metabolites serve as potential links connecting whole grains, intestinal microbiota and the intestinal barrier function. Tryptophan metabolites affect various aspects of the intestinal barrier, such as immune balance, mucus and microbial barrier, tight junction complexes and the differentiation and proliferation of epithelial cells. Despite the encouraging discoveries in this area of research, the evidence regarding the effects of whole grain consumption on intestine-related activity remains limited. Hence, we can conclude that we are just starting to understand the actual complexity of the intestinal factors mediating in part the health impacts of whole grain cereals.

Hyperlipidemia is a common clinical disorder of lipid metabolism in modern society and is considered to be one of the major risk factors leading to cardiovascular-related diseases. Germinated brown rice (GBR) is a typical whole grain food. The lipid-lowering effect of GBR has received increasing attention, but its mechanism of action is not fully understood. The gut microbiota has been proposed as a novel target for the treatment of hyperlipidemia. The aim of this study was to investigate the effects of GBR on the gut microbiota and lipid metabolism in high-fat diet (HFD)-fed C57BL/6J mice. The effect of GBR on hyperlipidemia was evaluated by measuring blood lipid levels and by pathological examination. The gut microbiota was detected by 16S rRNA sequencing, and the protein and mRNA expression levels involved in cholesterol metabolism were detected by western blotting and RT-qPCR to find potential correlations. The results showed that GBR supplementation could effectively reduce the levels of TC, TG, LDL-C and HDL-C in the serum and alleviate the excessive accumulation of fat droplets caused by HFD. Moreover, GBR intervention improved HFD-fed gut microbiota disorder via increasing the diversity of the gut microbiota, reducing the Firmicutes/Bacteroidetes ratio, and improving gut barrier damage. In addition, GBR could inhibit endogenous cholesterol synthesis and promote cholesterol transport and excretion. These findings suggest that GBR may be a competitive candidate for the development of functional foods to prevent abnormal lipid metabolism.

Whole-grain foods are good choices for a nutritious diet and play an important role in lowering the risk of chronic diseases. China is a large cereal-consuming country that is experiencing rapid economic growth and an increased burden of noncommunicable diseases. Studies have shown that insufficient intake of whole grains has increased the burden on public health to some extent. Therefore, we aimed to analyze the characteristics and trends of whole-grain consumption in China to contribute to the development of a healthy Chinese population. We searched for important policies, standards, and dietary recommendations related to whole grains through the official websites of the China State Council and its affiliated ministries. Official and public databases, such as the National Bureau of Statistics and the China Health and Nutrition Survey (CHNS), were utilized to obtain data on whole grains and different foods. This approach was employed to gain insight into changes in whole-grain intake levels and dietary structure. Since 2010, the development of whole grains in China has received significant attention. Supportive policies have been continuously introduced on both the supply and demand sides. Numerous whole-grain standards have been developed, and terms and definitions related to whole grains have been preliminarily defined. The consumption of whole grains has fluctuated among Chinese residents since 2000, with a downward trend from 2000 to 2009, followed by an upward trend from 2009 to 2018. However, despite this increasing trend, the whole-grain intake of 80% of the adult residents was still lower than the minimum recommended dietary intake (50[Formula: see text]g/day). Furthermore, the dietary structure of Chinese residents has undergone a significant transformation, characterized by high consumption of high-fat foods, excessive consumption of meat, low intake of dietary fiber, and insufficient consumption of whole grains. These findings highlight the need for further monitoring of whole-grain intake in China. In addition, a sound whole-grain standardization system should be established, and the availability and consumer awareness of whole grains should be improved, with the goal of increasing the intake of whole grains.

Type 2 diabetes mellitus (T2DM) is characterized by the dysregulation of glucose homeostasis, resulting in hyperglycemia. However, concerns have been raised about the safety and efficacy of current hypoglycemic drugs due to undesirable side effects. Increasing studies have shown that whole grains (WG) consumption is inversely associated with the risk of T2DM and its subsequent complications. Thus, dietary strategies involving functional components from the WG provide an intriguing approach to restoring and maintaining glucose homeostasis. This review provides a comprehensive understanding of the major functional components derived from WG and their positive effects on glucose homeostasis, demonstrates the underlying molecular mechanisms targeting hepatic glucose metabolism, and discusses the unclear aspects according to the latest viewpoints and current research. Improved glycemic response and insulin resistance were observed after consumption of WG-derived bioactive ingredients, which are involved in the integrated, multi-factorial, multi-targeted regulation of hepatic glucose metabolism. Promotion of glucose uptake, glycolysis, and glycogen synthesis pathways, while inhibition of gluconeogenesis, contributes to amelioration of abnormal hepatic glucose metabolism and insulin resistance by bioactive components. Hence, the development of WG-based functional food ingredients with potent hypoglycemic properties is necessary to manage insulin resistance and T2DM.