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本文目的是回顾全球膳食纤维和全谷物(whole grain, WG)的定 义和法规现状，并讨论居民达到相应推荐摄入量的影响因素 膳食指 南中普遍推荐富含膳食纤维的植物性食物，如全谷物，但全谷物和膳 食纤维的推荐摄入量取决于定义和法规规定 美国和加拿大官方对 膳食纤维的推荐摄入量是采用医学研究所的膳食参考摄入量(dietary reference intakes, DRIs)所规定的 膳食纤维的适宜摄入量(adequate intake, AI)是依据前瞻性队列研究所得出的膳食纤维摄入对心血管疾 病风险影响而确定的 研究发现每1000 kcal 能量的食物中含14 g 膳食 纤维即对心血管疾病(cardiovascular disease, CVD)有保护作用 因此，当根据能量建立推荐膳食摄入量时，这一数值(14 g/1000 Kcal)是整 个生命周期膳食纤维适宜摄入量的基础 然而，膳食纤维实际摄入量 约为推荐摄入量的一半 全谷物推荐摄入量的制定和全谷物食品的定 义具有同样的挑战性，因为全谷物推荐摄入量需要依据全谷物的定义 来制定 2005 年《美国居民膳食指南》建议，全谷物食品应占所有谷 类食品的一半，但每天实际摄入量一般少于一份，而远没有达到推荐 的三份 制定全谷物推荐摄入量的科学依据是基于相同的前瞻性队列 研究结果和指南中已知的膳食纤维的心血管疾病保护作用 因此，膳 食纤维是北美和世界各国膳食指南推荐摄入的营养素，全谷物则是相 应推荐的膳食模式 实现膳食纤维和全谷物推荐摄入量的挑战包括低 碳水化合物饮食、低谷物蛋白饮食和避免加工食品的公共卫生学建议

Inadequate dietary fiber intake contributes to irregular bowel movements and may contribute to difficulty with defecation in children. Whole grain foods, such as oatmeal, may improve stool consistency and stool frequency in children; however, no studies have examined its effects. The purpose of this study was to investigate if 2 weeks of oatmeal consumption in children (ages 7–12 years) increases stool frequency, improves stool consistency, and gastrointestinal (GI) symptoms. In this single-arm intervention study, children who reported ≤5 bowel movements per week during screening, consumed two servings of instant oatmeal daily for 2 weeks. The primary outcome was stool frequency and secondary outcomes included stool consistency and GI symptoms. Participants recorded bowel movements daily, food intake, and GI symptoms during baseline and 2 intervention weeks. Photos of the children's stool were taken at three timepoints during the study to assess stool consistency. In total, 33 children (15 female and 18 male) completed the study. Linear mixed models were used to detect change between baseline and the intervention weeks and accounted for repeated measures within subjects. No statistical differences in stool frequency or consistency were observed between the intervention weeks vs. baseline; however, dietary fiber intake significantly increased during the 2 weeks of oatmeal consumption (P = .008). The addition of oatmeal to children's diets is an effective way to increase fiber consumption and may reduce some GI symptoms such as gas, straining, and feeling of incomplete evacuation. Trial identification number: NCT02868515.

Acacia gum (AG) is a non-viscous soluble fiber that is easily incorporated into beverages and foods. To determine its physiological effects in healthy human subjects, we fed 0, 20, and 40 g of acacia gum in orange juice along with a bagel and cream cheese after a 12 h fast and compared satiety, glycemic response, gastrointestinal tolerance, and food intake among treatments. Subjects (n = 48) reported less hunger and greater fullness at 15 min (p = 0.019 and 0.003, respectively) and 240 min (p = 0.036 and 0.05, respectively) after breakfast with the 40 g fiber treatment. They also reported being more satisfied at 15 min (p = 0.011) and less hungry with the 40 g fiber treatment at 30 min (p = 0.012). Subjects reported more bloating, flatulence, and GI rumbling on the 40 g fiber treatment compared to control, although values for GI tolerance were all low with AG treatment. No significant differences were found in area under the curve (AUC) or change from baseline for blood glucose response, although actual blood glucose with 20 g fiber at 30 min was significantly less than control. Individuals varied greatly in their postprandial glucose response to all treatments. AG improves satiety response and may lower peak glucose response at certain timepoints, and it is well tolerated in healthy human subjects. AG can be added to beverages and foods in doses that can help meet fiber recommendations.

The aim of this article is to review the definitions and regulations for dietary fiber and whole grains worldwide and to discuss barriers to meeting recommended intake levels. Plant foods, such as whole grains, that are rich in dietary fiber are universally recommended in dietary guidance. Foods rich in dietary fiber are recommended for all, but dietary recommendations for whole grains and dietary fiber depend on definitions and regulations. Official recommendations for dietary fiber in the United States and Canada are denoted by dietary reference intakes (DRIs), which are developed by the Institute of Medicine. An adequate intake (AI) for dietary fiber was based on prospective cohort studies of dietary fiber intake and cardiovascular disease risk that found 14 grams of dietary fiber per 1000 kilocalories protected against cardiovascular disease (CVD). This value was used to set AIs for dietary fiber across the life cycle based on recommended calorie intakes. Actual intakes of dietary fiber are generally about half of the recommended levels. Recommendations for whole grain intake are equally challenging, as definitions for whole grain foods are needed to set recommendations. The 2005 Dietary Guidelines for Americans recommended that half of all grain servings be whole grains, but usual intakes are generally less than 1 serving per day, rather than the recommended 3 servings per day. Scientific support for whole grain recommendations is based on the same prospective cohort studies and links to CVD protection used to inform dietary fiber guidance. Thus, dietary fiber is a recommended nutrient and whole grains are a recommended dietary pattern in dietary guidance in North America and around the world. Challenges for attaining recommended intakes of dietary fiber and whole grains include low-carbohydrate diets, low-gluten diets, and public health recommendations to avoid processed foods.

Claims made in the popular press allege that grain-based foods, and the carbohydrates (CHOs) they contain, cause or worsen various neurological disorders, including headache, attention deficit hyperactivity disorder (ADHD), and depression. This article reviews the scientific literature to assess the role of these foods in nutrition and their impact on headache, ADHD, and depression. The bulk of the scientific literature shows that nearly all grain-based products are listed as nonoffending foods and are not thought to increase the risk of most types of headaches. When grain-based foods, and their CHOs, are consumed as part of balanced dietary patterns emphasizing an optimal mix of whole and refined grains, such as DASH (Dietary Approaches to Stop Hypertension) or Mediterranean Diets, they are associated with reduced headache risk. Although there are a number of food triggers for headache, grain-based foods are not listed as likely triggers. Evidence linking specific grain-based foods to headache is either ...

Incidence of mild cognitive impairment (MCI), Alzheimer's disease, and Parkinson's disease is increasing as the mean age of Western populations rises. This article, the second article of a two-part review, assesses the existing scientific literature addressing the role of minerals, phytochemicals, specific grain-based foods, and dietary patterns, with and without grains, to determine whether these foods and their constituents affect the onset or course of these common dementias, as has been alleged in various books, blogs, and other media. Intakes and serum markers of mineral and phytonutrient intakes in many cases have been documented as low or below recommended levels in elderly individuals and patients with MCI, Alzheimer's disease, or Parkinson's disease. However, it is not clear whether adequate intake of these minerals and phytonutrients from all sources, including grains, can impact the onset or course of these dementias. There are few published studies on specific grain-based foods and their relat...

Oats are uniquely nutritious, owing to their composition of bioactive compounds, lipids, and β-glucan. Scientific research has established that oats can improve diet quality, reduce cholesterol, regulate satiety, and protect against carcinogenesis in the colon; however, determining the effects of oats on gastrointestinal health and the gut microbiome is a newer, evolving area of research. To better understand the effects of oats on gastrointestinal health in humans, a literature review with predefined search criteria was conducted using the PubMed database and keywords for common gastrointestinal health outcomes. Moreover, to examine the gastrointestinal effects of oats across the scientific spectrum, a similar search strategy was executed to identify animal studies. In vitro studies were identified from the reference lists of human and animal studies. A total of 8 human studies, 19 animal studies, and 5 in vitro studies met the inclusion criteria for this review. The evidence in humans shows beneficial effects of oats on gastrointestinal health, with supportive evidence provided by in vitro and animal studies. The effective dose of oats varies by type, although an amount providing 2.5 to 2.9 g of β-glucan per day was shown to decrease fecal pH and alter fecal bacteria. For oat bran, 40 to 100 g/d was shown to increase fecal bacterial mass and short-chain fatty acids in humans. Differences in study design, methodology, and type of oats tested make valid comparisons difficult. The identification of best practices for the design of oat studies should be a priority in future research, as the findings will be useful for determining how oats influence specific indices of gastrointestinal health, including the composition of the human gut microbiome.

To address current claims that discourage ingestion of carbohydrates (CHOs), wheat, and cereal grains, as well as to celebrate the versatility, nutritional and health benefits, and contribution of these foods to the world food supply, we felt compelled to defend their role in the diet and write a series of reviews. The eighth review in this series examines scientific research findings on the impact of whole and refined grains and the CHOs they contain on three common cancers: lung, prostate, and stomach. The totality of the data indicates total CHO intake is not related in most cohorts to risk for these cancers. The few studies conducted on the role of dietary fiber in lung cancer show that low CHO and dietary fiber intakes may increase risk. For prostate and stomach cancers, cereal fiber intake specifically has been associated with reduced risk. The effects of refined grains or specific grain-based foods on lung cancer are unclear. For prostate cancer there may be a weak association between increased ris...

Definitions for whole grain (WG) have been published by governments, the food industry, and grain organizations and generally fall into 2 categories: WG and WG food. WG definitions focus on the principal components of the WGs and their proportions, whereas WG-food definitions describe the quantity of WGs present in food. In the United States, widespread agreement exists on the main parts of a definition for a WG, with a definition for a WG food still in its early stages; a standard definition that has been universally accepted does not exist. Furthermore, nutrition policy advises consumers to eat WGs for at least one-half of their total grain intake (2010 and 2015 Dietary Guidelines for Americans), but confusion exists over which foods are considered WGs and how much is needed to achieve health benefits. In December 2014, a workshop sponsored by the subcommittee on collaborative process of the US Government's Interagency Committee on Human Nutrition Research convened in Washington, DC, and recognized WG definitions as a key nutrition and public health-related issue that could benefit from further collaboration. As a follow-up to that meeting, an interdisciplinary roundtable meeting was organized at the Whole Grains Summit on 25 June 2015 in Portland, Oregon, to help resolve the issue. This article summarizes the main opportunities and challenges that were identified during the meeting for defining WGs and WG foods internationally. Definitions of WGs and WG foods that are uniformly adopted by research, food industry, consumer, and public health communities are needed to enable comparison of research results across populations.

To address many current claims that discourage the ingestion of carbohydrates (CHOs), wheat, and cereal grains, as well as to celebrate the versatility, nutritional and health benefits, and contribution of these foods to the world food supply, we felt compelled to defend their role in the diet and write a series of reviews. The seventh review in this series assesses the scientific literature with respect to the impact of whole, refined, and enriched grains and the CHOs they contain, including starch, dietary fiber, and resistant starch, on two of the most common cancers worldwide: breast and colon/rectal cancers. Included in this review is an overview on the relationship between cancer risk and diet. The totality of the data from most large prospective cohorts indicates that total CHO intake is not related to breast or colorectal cancers. Dietary fiber intake appears to be inversely related to colon cancer and to have either no or an inverse association with breast cancer. Most studies show only a slight ...

Recent claims suggesting whole and refined grain-based foods should be omitted from the diet because the carbohydrates (CHOs) they contain negatively impact the brain's long-term health and functioning need to be evaluated in light of the scientific literature. This review reveals that grain-based foods are important sources of glucose for the brain, which preferentially uses glucose as a source of energy. The lipid-rich brain is very metabolically active and, therefore, requires a lot of energy. Further, CHO-rich foods such as whole grains contain a variety of antioxidant and bioactive compounds that counter oxidative stress and inflammation, helping to prevent damage to brain tissue and maintain optimal cognitive functioning. Such compounds become more important with aging because the brain becomes more susceptible to oxidative stress and inflammation—conditions that promote the development of neurological diseases and disorders. An overview of studies on the relationship between CHO-rich, grain-based f...

To address many current claims that discourage the ingestion of carbohydrates (CHOs), wheat, and cereal grains, as well as to celebrate the versatility, nutritional and health benefits, and contribution of these foods to the world food supply, we felt compelled to defend their role in the diet and write a series of reviews. The fifth review in the series assesses the health effects of consumption and overconsumption of CHOs, grains, and wheat and focuses on their roles in blood pressure, stroke, glucose tolerance, metabolic syndrome (MetS), and diabetes. In terms of blood pressure and MetS, CHOs and grain-based foods included as part of a balanced diet do not appear to elevate blood pressure or increase the risk of MetS, even though grain-based foods are major contributors of dietary sodium. Both the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes consumption of whole grain breads and cereals as part of its healthy dietary pattern, and dietary fibers, especially viscous ones, have be...

To address many current claims that discourage the ingestion of carbohydrates (CHOs), wheat, and cereal grains, as well as to celebrate the versatility, nutritional and health benefits, and contribution of these foods to the world food supply, we felt compelled to defend their role in the diet and write a series of reviews. The fourth review in the series assesses the health effects of consumption and overconsumption of CHOs, grains, and wheat and focuses on body weight maintenance and loss. In terms of weight gain, no one macronutrient is responsible. Overconsumption of any macronutrient can contribute to overweight by contributing to the intake of more calories than are expended. In addition, several prominent organizations have stated that the charge that diets higher in total CHO cause weight gain is not supported by the scientific evidence. A review of the literature discussing the findings from numerous epidemiological and intervention studies shows that grains and grain-based foods, when consumed a...

PURPOSE OF REVIEW Dietary fiber may play a role in obesity prevention through reduction of body weight and control of appetite, however, not all fibers are created equally, and characteristics of fiber such as viscosity, fermentability and solubility may affect appetite differently. RECENT FINDINGS Although early studies supported that fructan fibers, including inulin, fructooligosaccharides, and oligofructose affected satiety, more recent studies are less supportive. We found that a higher dose of fiber such as oligofructose (16 g/day) is needed and for a longer duration (12-16 weeks) to detect differences in appetite and subsequent energy intake, whereas, practical amounts of fructooligosaccharides, less than 10 g/day, generally do not affect satiety or food intake. It should be noted that there are many sources of fructan fibers, both in native foods, chicory roots, agave, and Jerusalem artichokes and isolated forms that vary in chain length. SUMMARY Fructan fibers, which include fructooligosaccharides, oligofructose, and inulin, provided in low doses (

To address many current claims that disparage and discourage the ingestion of carbohydrates (CHOs), wheat, and cereal grains, as well as to celebrate the versatility, nutritional and health benefits, and contribution of these foods to the world food supply, we felt compelled to defend their role in the diet and write a series of reviews. This third review of CHOs, grains, and whole grains looks at their digestion and absorption, their impact on the microbiome, and how they influence gut function and health and gut-related diseases such as irritable bowel syndrome. Their impact on glycemic response, insulin resistance and inflammation, and the immune system is discussed, and wheat, gluten and grain allergies, and gluten-related disorders, including celiac disease, are addressed. Much of the information on inflammation, glycemic response, and immunity provides a basis for assessing the relationship between CHOs, including starch, dietary fiber, and resistant starch, provided by grains and whole grains and l...

To address many current claims that disparage and discourage the ingestion of carbohydrates (CHOs), wheat, and cereal grains, even whole grains, as well as to celebrate the versatility, nutritional and health benefits, and contribution of these foods to the world food supply, we felt compelled to defend their role in the diet and write this series of reviews. Where data exist, cereal grains and wheat as a source of CHOs and other important nutrients will be the focus. CHO-rich staple foods, including those from a wide array of whole and refined grains, are inexpensive sources of energy, protein, and other nutrients. Grain-based staple ingredients have been incorporated into an enormous variety of foods, becoming cultural icons and national dishes that are accepted by populations around the world and adapted to specific agricultural necessities and cultural preferences. Dietary guidance by health promotion bodies around the world recommends that 45–65% of total calories be from CHOs and reinforces the mess...

Optimized nutrition during the first 1000 days (from conception through the 2nd birthday) is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs. Food and nutrition experts can provide women of childbearing age with adequate dietary advice to optimize nutrition, as well as guidance on selecting appropriate dietary supplements. Considering the approaching 2020–2025 Dietary Guidelines for Americans (DGA) will be making specific recommendations for children, it is important to provide accurate scientific information to support health influencers in the field of nutrition. The purpose of this review is to summarize the nutrition and supplementation literature for the first 1000 days; to highlight nutritional and knowledge gaps; and to educate nutrition influencers to provide thoughtful guidance to mothers and families. Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. Nutrition influencers, such as dietitians, obstetricians/gynecologists, and other relevant health professionals, should continue guiding supplement and food intake and work closely with expectant families and nutrition gatekeepers.

Public and private partnerships (PPPs) are a joint venture between the government, industry, and other public and private sectors. PPPs are typically formed to leverage expertise from different sectors to identify problems and work collaboratively to come to a common solution. This article discusses why PPPs are needed to solve the complex problem of getting healthier grain-based foods into the food supply. We introduce and describe three different research initiatives that require a PPP. Successful implementation of these initiatives is desperately needed to address the lack of healthier grain-based foods in our environment and current food supply.

This study compared satiety after high protein pasta (16 g protein, 6 g fiber), high fiber pasta (11 g protein, 8 g fiber) or control pasta (11 g protein, 6 g fiber) in a randomized, placebo-controlled, double-blind crossover trial. Participants were 36 healthy and men and women from the University of Minnesota campus. Fasted men and women ate calorie controlled, but macronutrient different pastas at 12:00 pm along with 500 mL of water. The primary outcome was satiety assessed by Visual Analogue Scales at 0, 15, 30, 45, 60, 90, 120, and 180 min daily after consuming the pastas. Secondary outcomes were calories consumed at an ad libitum snack at 3:00 pm, calories from food intake, gastrointestinal tolerance, and palatability. No differences were found among the pasta treatments for satiety, snacking, or gastrointestinal tolerance. Men ate significantly more calories for the rest of the (P = 0.007) after the high protein pasta versus the high fiber pasta (1701 ± 154 compared with 1083 ± 154) with control pasta being intermediate to the other treatments. No significant differences were found for gastrointestinal tolerance, but the palatability ratings showed the high protein pasta was less tasty (P = 0.03) and less pleasant (P = 0.01) than the other 2 pastas. Satisfaction was positively associated with pleasantness and negatively associated with aftertaste. Our results do not support the idea that high protein or high fiber pasta produces a greater satiety response compared to pasta with lower amounts of either nutrient. It is likely that since pasta is already a very satiating food, the subjects were unable to differentiate between the 3 conditions.

The purpose of this review is to provide an updated discussion on the scientific evidence regarding dietary fiber and body weight or body mass index (BMI). A PubMed search with medical subject head...