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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

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 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. [ABSTRACT FROM AUTHOR]

AbstractThe 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract 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.

Excessive consumption of refined grains harms human health and ecosystem viability. Whole grains, as a healthy and sustainable alternative to refined grains, can benefit individual health by providing dietary fiber, B vitamins, and bioactive substances. Additionally, they aid in improving the environment due to their higher extraction rate and lower carbon emission during the processing stage. However, few studies have attempted to evaluate the economic and social benefits of increasing the amount of whole grain in grain intake. This paper estimates the potential savings in healthcare costs and reduced food carbon footprints (CFs) that could result from a shift toward whole grain consumption following the Chinese Dietary Guidelines (CDG). We investigate hypothetical scenarios where a certain proportion (5–100%) of Chinese adults could increase their whole grain intakes as proposed by CDG to meet the average shortfall of 30.2 g. In that case, the healthcare costs for associated diseases (e.g., type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and colorectal cancer (CRC)) are expected to reduce by a substantial amount, from USD 2.82 to 56.37 billion; the carbon emission levels are also projected to decrease by 0.24–5.72 million tons. This study provides compelling evidence that advocating for the transition towards greater consumption of whole grain products could benefit individual health, the environment, and society, by reducing both healthcare costs and carbon emissions.

Osteoporosis is a chronic systemic skeletal disease that mainly affects postmenopausal women and older men, and is characterized by the destruction of bone tissue microstructure, reduced bone content, and a tendency to fracture. Nutrients provided by food are necessary for human survival, and at the same time, the various components of food act back on the human body, affecting its health status. Recent studies have shown that whole grain nutrition is beneficial in relieving osteoporosis and improving bone health. This review focuses on the beneficial effects of dietary pattern including whole grains on bone mineral density and the classical mechanisms of whole grain-enriched diet in regulating bone resorption and bone formation. Whole grain nutritional interventions might offer new possibilities for the prevention and treatment of osteoporosis. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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/m2) 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Abstract 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.

The current study was carried out to prepare functional flakes from various cereals and to assess the nutritional value of breakfast cereal flakes and their sensory acceptability. Oat, soft wheat and durum wheat, barley (hull-less and hulled), triticale, millet and sorghum grains have been used. Physicochemical, functional, phytochemical properties and sensory evaluation were determined. The developed cereal flakes have high nutritional value and are high in dietary fiber. Concerning the overall acceptability of flakes, durum wheat, hull-less barley and triticale were more preferred than the other samples. Meanwhile, hulled barley and millet flakes showed the lowest scores compared with other flake samples due to the lowest score of their appearance and color. Triticale, durum wheat and hulled barley turned to be good alternatives for oat to prepare flakes of high-quality characteristics, as they have high protein (13.46, 11.92 and 11.67%, respectively) and ash contents along with low content of fat and low calories. In terms of nutritional quality, the results indicated that oat flakes were higher in Mg and P content, durum wheat flakes showed higher content of Mn, triticale had the highest content of K and Ca, and millet had the highest content of Zn and Fe. Triticale flakes showed significantly higher content of dietary fiber and water absorption index at room and hot temperatures when compared with other flakes. While comparing total phenolic content, the millet and barley flakes showed the highest values. Additionally, most flake samples had significantly higher values of antioxidant activity compared to oat flakes used as control samples.

Abstract 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, HbA1C, 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

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. [ABSTRACT FROM AUTHOR]

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, HbA1C, 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, I2 = 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; I2 = 72.99%, P < 0.01) and had modest effects on HbA1C (MD = -0.662 mmol/mol (-0.06%), 95% CI: -1.335 to 0.010; I2 = 64.55%, P = 0.05) and HOMA-IR (MD = -0.164, 95% CI: -0.342 to 0.013; I2 = 33.38%, P = 0.07). The intake of whole grains and FBG, HbA1C, 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

BackgroundHealth 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.MethodsHealthy 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.ResultsANCOVA showed that average D scores at the end of the study shifted significantly toward a positive implicit association between WG and good taste (p

BackgroundRecent research has emphasized a growing trend of weight gain attempts, particularly among adolescents and boys and young men. Little research has investigated these efforts among adults, as well as the specific diet modifications individuals who are trying to gain weight engage in. Therefore, the aims of this study were to characterize the diet modification efforts used by adults across five countries who reported engaging in weight gain attempts and to determine the associations between weight gain attempts and concerted diet modification efforts.MethodsCross-sectional data from the 2018 and 2019 International Food Policy Study, including participants from Australia, Canada, Mexico, the United Kingdom, and the United States (N = 42,108), were analyzed. In reference to the past 12 months, participants reported on weight gain attempts and diet modification efforts related to increased consumption of calories, protein, fiber, fruits and vegetables, whole grains, dairy products, all meats, red meat only, fats, sugar/added sugar, salt/sodium, and processed foods. Unadjusted (chi-square tests) and adjusted (modified Poisson regressions) analyses were conducted to examine associations between weight gain attempts and diet modification efforts.ResultsWeight gain attempts were significantly associated with higher likelihood of each of the 12 forms of diet modification efforts among male participants, and 10 of the diet modification efforts among female participants. Notably, this included higher likelihood of efforts to consume more calories (males: adjusted prevalence ratio [aPR] 3.25, 95% confidence interval [CI] 2.94-3.59; females: aPR 4.05, 95% CI 3.50-4.70) and fats (males: aPR 2.71, 95% CI 2.42-3.03; females: aPR 3.03, 95% CI 2.58-3.55).ConclusionsOverall, the patterns of association between weight gain attempts and diet modification efforts may be indicative of the phenomenon of muscularity-oriented eating behaviors. Findings further highlight the types of foods and nutrients adults from five countries may try to consume in attempts to gain weight.

INTRODUCTION: Higher intake of fiber has been associated with lower risk of incident symptomatic osteoarthritis (OA). We examined whether levels of alkylresorcinol (AR), a marker of whole grain intake, were associated with OA in subjects in The Multicenter Osteoarthritis (MOST) Study. METHOD: Knee x-rays and knee pain were assessed at baseline and through 60-months. Stored baseline fasting plasma samples were analyzed for AR homologues (C17:0, C19:0, C21:0, C23:0, C25:0) and total AR levels (AR sum). Two nested case-control studies, one for incident radiographic OA and one for incident symptomatic OA were performed with participants re-assessed at 15, 30 and 60 months. Multivariable conditional logistic regression with baseline covariates including age, sex, BMI, physical activity, quadriceps strength, race, smoking, depressive symptoms, diabetes and knee injury tested the association of log transformed AR levels with OA outcomes. RESULTS: Seven hundred seventy-seven subjects were, on average, in their 60s, and most were women. For 60-month cumulative incidence, there was no significant association between quartiles of AR concentration and incident radiographic (e.g., for incident radiographic OA, highest vs lowest quartile of AR sum showed RR = 0.93 (95% CI 0.59, 1.47), and for symptomatic OA RR was 1.22 (95% CI 0.76, 1.94). In secondary analyses examining 30-month incidence, high AR levels were associated with a reduced risk of X-ray OA (RR = 0.31 (95% CI 0.15, 0.64). CONCLUSION: In primary analyses, AR levels were not associated with risk of OA, but secondary analyses left open the possibility that high AR levels may protect against OA.

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.

Existing studies have clearly demonstrated that people eating more whole grains have reduced risks of many chronic metabolic diseases compared to those eating less. In the past 20 years, the whole grain industry has developed so rapidly in major developed countries and regions. In recent years, whole grains have also attracted extensive attention in our country. The research and development efforts of the whole grain standards in China have been strengthened. This paper introduced the progress of the global definition consensus of whole grain and whole grain food, summarized the international development status of whole grain raw materials and whole grain food related standards in many countries and institutions, such as the Working Group of ISO Whole Grain, the United States, Canada, the Netherlands, Codex Alimentarius Commission, and so on. This paper also reviewed the present situation of definition of the whole grain and whole grain food related standards in China. More than 20 relevant raw materials, food related standards and production technical regulations and the publishment situation of other whole grain standards in China, including national standards and industry standards and local standards and group standards, were summarized, and some whole grain related standards under formulation were also introduced. Finally, the paper puts forward the development direction and suggestions for the construction of whole grain standard system in China, including fully combining with the actual production situation of China’s whole grain food industry, integrating with international standards, and combining standard testing and certification. On the whole, the gradual improvement of the standard system of the whole grain food industry will help guide and regulate the high-quality and healthy development of the whole grain industry in China, and promote the creation of a diversified and healthy grain food ecology, and provide a technical basis for the development of the whole grain industry.

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. [ABSTRACT FROM AUTHOR]

Background and Objective: Maize is the major staple in sub‐Saharan Africa. Whole‐grain maize meal (WGMM) is highly susceptible to rancidity development. This work investigated whether rancidity development in micronutrient‐fortified WGMM is retarded by drying the grain of safe moisture content to below this level using a commercial hot‐air grain dryer before milling. Findings: Fat acidity (hydrolytic rancidity measure) of WGMM from maize dried to 11.6% moisture and stored for 47 days at 40°C was only 61% of meal from the undried grain control (13.3% moisture). Peroxide value (oxidative rancidity measure) was only 53%. With the exception of riboflavin, there was no reduction in fortificant micronutrients during meal storage. Descriptive sensory evaluation indicated greater similarity to the control for stored maize meal and its stiff porridge from dried maize than for meal and porridge from undried maize. Conclusions: Drying maize grain to 11.6% moisture substantially retards rancidity development in fortified WGMM development, probably by inactivating the grain's lipase and oxidative enzymes, providing a shelf life of at least 20 weeks at 25°C. Significance and Novelty: This simple process to extend the shelf life of whole‐grain maize meal is implementable by any mill with access to a hot‐air grain dryer. [ABSTRACT FROM AUTHOR]

Background: Micronutrient interventions for Adult Attention-Deficit/Hyperactivity (ADHD) could be helpful. We used a naturally processed whole wheat grains supplement containing higher doses of micronutrients named Nutrition Bio Shield (NBS). We aimed to determine its effects on ADHD symptoms in adults. Methods: Fifty-two medication-free adults with ADHD were randomly assigned to receive 5 g of NBS supplement or placebo daily for eight weeks. Results: Twenty-three participants in the NBS group and 24 participants in the placebo group completed the study. After 8 weeks, compared with the placebo, the ADHD scores significantly decreased (mean difference 95%CI): -4.9 (-8.6 to -1.1); p=0.01; Cohen's d=0.74), and quality of life significantly improved (mean difference 95%CI): 5.6 (0.12 to 11.3); p=0.04; Cohen's d=0.59) in the NBS group. The observed side effects were minimal and did not differ statistically between groups. Conclusion: Quality of life increased during consumption of the NBS supplement, compared to the placebo. However, despite the statistically significant findings, these changes in ADHD symptoms were small and the clinical significance may be low (about 5%). [ABSTRACT FROM AUTHOR]

Background: The relationship between fruit, whole grain, and total energy consumption and the gut microbiome in the Chinese population remains unclear. Objective: We investigated the relationship between intakes of fruits, whole grains, and energy, and the diversity and composition of gut microbiota. Design: This cross-sectional study included 167 subjects aged 40-75 years who underwent colonoscopy at Nankai Hospital in Tianjin, China. Each of the participants completed a personal history questionnaire, a 7-day dietary record, and donated a fecal sample. The V3-V4 hypervariable region of the bacterial 16S rRNAgene was amplified and sequenced using Illumina Novaseq. The relationship between diet and gut microbiota was evaluated in terms of both the overall composition and the abundance of specific taxon. Results: Fruits intake was positively related to the abundance of Bacilli, Porphyromonadaceae, Streptococcaceae, Parabacteroides, Streptococcus, and Bilophila in fecal samples. Higher whole grains intake was associated with higher microbial diversity, as measured by Shannon, Simpson, and Chao1 indices. Specifically, there was a significant increase inthe relative abundance of Lachnospiraceae and a decrease in Actinobacteria with increased whole grains intake. Moreover, higher intake of total energy was associated with a lower abundance of Anaerostipes and a higher abundance of Lactobacillales and Acidaminococcus. Conclusion: Whole grains intake was positively associated with gut microbial diversity. Fruits and total energy intake were related to the abundance of specifictaxon (e.g., Bacilli and Acidaminococcus). These findings highlight the potential importance of dietary interventions for modulating gut microbiota composition and promoting overall health.

In this review, the effects of starch, protein, oil, polyphenols and other components in whole grains on the processing characteristics of dough and the quality of flour products were introduced, and problems and improvement measures of whole grain flour products were analyzed, in order to provide references for the research of whole grain flour products.

Breast cancer survivors often have a reduced digestive capacity to digest whole grains due to cancer treatment. The purpose of this study was to investigate the independent and joint associations of whole grain and refined grain consumption with total mortality among breast cancer survivors. We studied a cohort of 3081 female breast cancer survivors who provided demographic, dietary, and lifestyle data at baseline, year 1 and year 4. Mortality was assessed via semi-annual telephone interviews and confirmed by the National Death Index (NDI) and death certificates. We assessed the associations of whole grain and refined grain with incident of mortalities using Cox proportional hazards models. Increased whole grain consumption was marginally associated with an increased risk of total mortality (p = 0.07) but was not significantly associated with breast cancer-specific mortality (p = 0.55). An increased intake of refined grains was associated with an increased risk of both total (HR = 1.74; 95% CI,1.17 to 2.59) and breast cancer-specific mortality (HR = 1.16; 95% CI, 1.08 to 1.26). Furthermore, we examined the joint associations of whole grain and refined grain with total mortality. Among those with a high consumption of refined grain, those with high consumption of whole grain had a higher risk of total mortality (HR = 1.52, 95% CI, 1.07 to 2.14) than those with a low consumption of whole grain. Increased consumption of whole grains may exacerbate the adverse associations of refined grain with mortality among breast cancer survivors. Our findings indicate the need to revisit current dietary guidelines for breast cancer survivors regarding whole grain intake.

Abstract Background In this prospective cohort study, we aimed to evaluate the association between dietary carbohydrates, whole grains, refined grains, and simple sugar with the risk of metabolic syndrome (MetS) and assess the effect of weight change on these associations. Methods This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS). We included 1915 healthy participants with complete demographic, anthropometric and dietary measurements, among whom 591 developed MetS during 8.9 years of follow-up. Intake of dietary carbohydrates, whole grains, refined grains, and simple sugar was assessed with a validated semi-quantitative food frequency questionnaire. Multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) for MetS events across tertiles of dietary variables. Using joint classification, the effect of weight change on the association between dietary variables and risk of MetS was assessed by Cox regression. Results Carbohydrate intake was not associated with the risk of MetS in multivariable-adjusted models. Whole grains intake was inversely associated with the risk of MetS (HR: 0.78, CI: 0.63–0.98), while this association disappeared after adjustment for weight change. The risk of MetS increased by 11% (1.11, 1.09–1.14) for each 3% energy increment from simple sugar, and by 5% (1.05, 1.03–1.08) for each 1 serving/day increment in refined grains. Consumption of refined grains increased the risk of MetS; an effect modification of this association was found by weight change. Among subjects with weight loss, intake of refined grains

Carbohydrates play a crucial role in the development of chronic diseases, and although research in this area is expanding, the precise definition of carbohydrate quality remains unclear. Currently, commonly utilized indicators encompass dietary fiber content, whole grain intake, free sugars intake and the glycemic index (GI). High-quality carbohydrate foods typically exhibit high dietary fiber content, consist of whole grain components, contain low levels of free sugars, and possess a low GI. The GI, in particular, directly influences the human blood sugar response and serves as a vital measure for describing carbohydrate quality. This article provides a comprehensive overview of the factors that influence the GI, focusing on three aspects: digestion and absorption, processing methods, and starch composition and structure. It further examines the GI values of various food sources. The rate of digestion and absorption, as well as diverse processing methods, can influence the GI. Additionally, the composition and structure of starch directly affect the GI. Amylose and amylopectin exhibit dissimilar structural compositions, with amylopectin containing more amylase binding sites than amylose, leading to a higher digestion rate. Consequently, foods with elevated amylose content tend to have relatively low GI values. Additionally, starch can be categorized into three types (A-type, B-type, and C-type) based on the crystal form of amylopectin present in the starch. Among these types, A-type starch is the most readily digestible, while B-type and C-type starch exhibit low GI characteristics due to their reduced digestibility. By studying the microstructure of starch, researchers can gain valuable insights into the influencing factors of the GI, thereby introducing a fresh perspective to the assessment of food carbohydrate quality.

The high-throughput amplicon sequencing technology was used to study the microbiota of the the traditional fermented whole grain Tianpei from the typical regions of our country. The correlations between the bacteria communities and the properties of Tianpei were also analyzed. The results showed that Firmicutes were most abundant. At genus level, the abundance of Weissella, Lactobacillus and Staphylococcus was the highest ones. Principal coordinate analysis (PCoA) showed that the compositions of bacterial community among three kinds of Tianpei were different. According to Lefse analysis, the related biomarkers were found in each Tianpei, including Lactobacillus and Staphylococcus. By the distance-based redundancy analysis (db-RDA), it is illustrated that the bacterial community of Tianpei was significantly correlated with the properties of Tianpei (lactic acid, flavone, amino acid, protein, starch, free fatty acid and reducing sugar content). The prediction of bacterial functions in Tianpei based on 16S rDNA mainly involved in amino acid transport and metabolism and carbohydrate transport and metabolism etc. This study laid a theoretical foundation for the exploration of microbial resources of traditional whole grain fermented food, the improvement of the quality of Tianpei and the industrial production etc. It also could provide a reference for the research on the microbiota of other fermented foods.

Objectives: The consumption of whole grains is widely recognised as healthy and included in several national dietary guidelines. Despite that, the consumption of whole grain products remains sub-optimal. Methods: We developed a questionnaire investigating perceptions of price, taste, positive and negative health effects, sustainability and versatility of whole grains and the consumption frequency of whole grain food products. This questionnaire was administered to a sample of 1,014 individuals in Northern Italy. Results: We observed an overall positive attitude towards whole grain products, especially in relation to positive health effects, versatility and taste, that resulted in strong drivers for whole grain consumption. Age, gender and educational level were identified as influences on whole grain perceptions, especially for taste and positive health effects. Respondents were clustered according to the attitudes they expressed. Conclusion: The characteristics of these clusters could be used to customise future nutritional education programmes. [ABSTRACT FROM AUTHOR]

According to the Global Burden of Disease Study, 3 million deaths were attributable to high sodium intake and low intake of whole grains. With the rapid evolution of the food industry, we hypothesize that dietary intake of sodium has increased and that dietary intake of whole grains or fibers has decreased because of easier access to highly processed food. Country-level data on dietary factors and country income levels from 1990 to 2018 were collected from 3 public databases. The trend of dietary intake was modeled using the linear mixed model accounting for random effects of individual countries. The country-level differences in dietary factors between males and females were calculated, and the trends were also modeled accounting for the random effects of countries. Both males and females consumed increasing amounts of dietary sodium from 1990 to 2018 in high-income, middle- to high-, middle-, and low-income countries. Dietary fiber intake increased in low-to-middle, middle-, and middle-to-high income countries for both men and women over the past 3 decades. Men tend to consume more sodium and less fiber and whole grains in their diets than women, the trend of which is statistically significant in middle-income countries. Over the past 3 decades, the macrotrend of dietary sodium has increased around the globe. To reduce the sodium intake level, nutrition policy should emphasize sodium reduction, especially in high-income, middle- to high-income, middle-income, and low-income countries. Global landscape for dietary sodium and whole grains from 1990 to 2018. The graphical abstract describes the consumption of dietary sodium and fiber from 1990 to 2018 by country income levels. Low-income countries consume higher levels of dietary fibers, whereas middle-income countries consume higher levels of sodium. [Display omitted] [ABSTRACT FROM AUTHOR]

The use of non-conventional seed flour is of interest in obtaining healthy breakfast cereals. The research aimed to study the physico-functional, bioactive, microstructure, and thermal characteristics of breakfast cereals using scanning electron microscopy, X-ray diffractometry, and differential scanning calorimeter. The increase in feed moisture content (16 %) enhanced the bulk density (5.24 g/mL), water absorption index (7.76 g/g), total phenolic content (9.03 mg GAE/g), and antioxidant activity (30.36 %) having desirable expansion rate (2.84 mm), water solubility index (48 %), and color attributes. The microstructure showed dense inner structures with closed air cells in extruded flours. Extrusion treatment rearranged the crystalline structure from A-type to V-type by disrupting the granular structure of starch, reducing its crystallinity, and promoting the formation of an amylose–lipid complex network. Increasing conditioning moisture enhanced the degree of gelatinization (%), peak gelatinization temperature (Tp), and starch crystallinity (%) and reduced the gelatinization enthalpy (ΔHG) and gelatinization temperature ranges. The results reported in this study will help industries to develop innovative and novel food products containing functional ingredients.

Abstract The objective of this work was to determine the genetic correlations and the direct and indirect associations of agronomic traits and grain quality attributes with the percentage of whole grains in flood irrigated rice. The experiment was carried out in two environments, in a randomized complete block design with three replicates, using 23 irrigated rice genotypes. The evaluated traits were: percentage of whole grains, caryopsis length, caryopsis width, panicle length, panicle weight, 1,000 grain weight, days to flowering, percentage of chalky grains with white belly, total chalky area, total whiteness, vitreous whiteness, and defects in coloring. The percentage of grains with white belly and total chalky area were positively correlated, whereas the percentage of grains with white belly and vitreous whiteness were negatively correlated. The traits caryopsis width, percentage of chalky grains with white belly, panicle weight, and 1,000 grain weight showed indirect effects on whole-grain yield response according to total chalky area and total whiteness. Total chalky area and total whiteness are the factors that most negatively influence the percentage of whole grains according to the genotypic correlations and direct effects.

ABSTRACT OBJECTIVE This study aims to evaluate the use of “whole grains” claims in food products marketed in Brazil and evaluate the nutrient profile of these products. METHODS Data from 775 grain-based packaged foods collected in Brazil from April to July 2017 were analyzed. Based on the INFORMAS protocol for food labeling, the prevalence of packaged foods with “whole grains” claims was estimated. Information on the list of ingredients was analyzed to evaluate the presence and amount of whole or refined grains in six food groups. The nutrient profiles of the products with and without “whole grains” claims were compared using the Pan American Health Organization (PAHO) nutrient profile model. RESULTS The packages of about 19% of the evaluated products showed “whole grains” claims in their front panel. Of these, 35% lacked any whole grains among their top three ingredients. Breakfast cereals, granola bars, bread, cakes and other bakery products, cookies, and pasta had higher amounts of refined flour than whole grain ingredients in their compositions.We found 66% of products with “whole grains” claims were high in nutrients of concern according to PAHO’s criteria. CONCLUSION Our results showed that over a third of the products in Brazil with “whole grains” claims lacked whole grains as one of their main ingredients. Most had a high content of nutrients associated with noncommunicable chronic disease risk factors, indicating the overestimation of their health benefits.

Background: In this prospective cohort study, we aimed to evaluate the association between dietary carbohydrates, whole grains, refined grains, and simple sugar with the risk of metabolic syndrome (MetS) and assess the effect of weight change on these associations. Methods: This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS). We included 1915 healthy participants with complete demographic, anthropometric and dietary measurements, among whom 591 developed MetS during 8.9 years of follow-up. Intake of dietary carbohydrates, whole grains, refined grains, and simple sugar was assessed with a validated semi-quantitative food frequency questionnaire. Multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) for MetS events across tertiles of dietary variables. Using joint classification, the effect of weight change on the association between dietary variables and risk of MetS was assessed by Cox regression. Results: Carbohydrate intake was not associated with the risk of MetS in multivariable-adjusted models. Whole grains intake was inversely associated with the risk of MetS (HR: 0.78, CI: 0.63–0.98), while this association disappeared after adjustment for weight change. The risk of MetS increased by 11% (1.11, 1.09–1.14) for each 3% energy increment from simple sugar, and by 5% (1.05, 1.03–1.08) for each 1 serving/day increment in refined grains. Consumption of refined grains increased the risk of MetS; an effect modification of this association was found by weight change. Among subjects with weight loss, intake of refined grains < median intake decreased the risk of MetS (0.59, 0.41–0.87). However, consumption of refined grains ≥ median intake increased the risk of MetS in individuals with weight gain (1.47, 1.08–2.01). Simple sugar was positively associated with an increased risk of MetS, after adjustment for weight change (3.00, 2.37–3.82). In joint classification, intake of simple sugar greater than median intake increased the risk of MetS, independent of weight change. Conclusion: Our findings suggest an effect modification by weight change on the association between carbohydrates, and refined grains intake and the risk of MetS. Weight loss along with lower consumption of carbohydrates, and refined grains reduced the risk of MetS. However, simple sugar intake, regardless of weight change, was associated with an increased risk of MetS. [ABSTRACT FROM AUTHOR]

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Evidence indicates that whole-grain food consumption reduces the risk of cardiovascular disease, type-2 diabetes, and some cancers. Increasing whole-grain consumption in developing countries is likely to significantly benefit the health of the population. However, there is very limited information on consumer whole-grain knowledge, attitudes, and behaviors in developing countries. An online cross-sectional survey was conducted among 1000 South African consumers with sufficient income to make food purchase choices and who were generally representative in terms of gender, age, and ethnicity. Most respondents (64%) were confident of their whole-grain knowledge. However, 60% of all participants selected incorrect definitions of whole grains. Whilst most correctly identified common cereals as whole grains, at most 50% of participants correctly identified common whole-grain foods. Also, whilst most (67%) thought that they were consuming enough whole grains, the majority (62%) underestimated the recommended level of consumption. Furthermore, respondent knowledge regarding whole-grain food attributes and the health benefits of whole-grain consumption was generally poor. Clearly, consumer-focused strategies are needed in developing countries to increase whole-grain food consumption to help the broader population achieve a healthy and sustainable diet. Actions proposed include: simple-to-understand information on whole-grain content relative to recommendations on food product labels, the provision of whole-grain foods in school nutrition schemes, and coordinated social and behavior change communication initiatives. [ABSTRACT FROM AUTHOR]

Whole grains (WGs) may have various health benefits, including lowering blood glucose and improving insulin sensitivity. To conduct a meta-analysis of the effects of WGs compared with non-WGs on changes in fasting glucose, fasting insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR). A systematic literature search was performed for all published randomized controlled trials on the effects of WG intake on fasting glucose, fasting insulin, HbA1c and HOMA-IR response up to February 2021. Weighted mean differences (WMD) were calculated. Pre-specified subgroup and univariate meta-regression analyses were explored to identify the sources of heterogeneity. Sensitivity analysis and bias analysis were conducted to appraise study quality. Among 12,435 articles screened for eligibility, data were extracted from 48 articles. Meta-analysis of 4,118 participants showed that WG consumption resulted in a significant reduction in fasting glucose by −0.15 mmol/L, fasting insulin by −2.71 pmol/L, HbA1c by −0.44%, and HOMA-IR by −0.28, respectively. Compared with mixed grains, brown rice, and wheat, oats were significantly lower on marker of glycemic. Besides, multiple interventions per day consolidated effectiveness of WGs. WG consumption decreased the levels of fasting glucose, fasting insulin, HbA1c, and HOMA-IR compared with non-WG consumption. Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2001429. [ABSTRACT FROM AUTHOR]

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Background and Objectives: “Adai” is a traditional South Indian breakfast prepared using the wet ground batter of white rice and pulses. Convenience foods are gaining popularity and owing to the increasing prevalence of noncommunicable diseases such as diabetes, there is a need for food products with lower glycemic index (GI). The current study aimed to develop an instant adai mix using brown rice, millets, pulses, and spices. Materials and Methods: The instant adai mix was prepared by blending pulverized brown rice, sorghum, and pulses (green gram, horse gram, decorticated and split red gram, black gram, and chickpea) along with roasted cumin, red chilies, and salt. The nutritional composition of the instant adai mix was analyzed, and GI of “adai” was evaluated in healthy human volunteers using International organization for standardization protocol. Results: The instant adai mix was rich in whole grains (48%) and pulses (45%). Nutritional profiling of the instant adai mix revealed that it is rich in protein and dietary fiber. One hundred grams of instant adai mix fulfill 27.8% of protein and 29.6% of dietary fiber requirements of recommended dietary allowance of adult male. Likewise, 100g of instant adai mix fulfill 34.9% of protein requirements of the estimated average requirement of an adult male. The “adai” prepared from the instant mix exhibited medium GI (65.1). Conclusion: The instant “adai” mix was found to be nutritionally superior, and the adai prepared from the mix showed a medium GI. It can be a healthy option compared with instant mixes containing refined grains such as white rice. More formulation trials are needed to prepare an adai mix to achieve a low GI. Reformulation of traditional foods with nutritious ingredients and achieving a lower GI can expand the healthier food choices for this vulnerable population who are at risk for type 2 diabetes. [ABSTRACT FROM AUTHOR]

ObjectiveThis study determined the extent to which schools adhered to select nutrition and wellness provisions of the 2010 Healthy, Hunger-Free Kids Act and examined differences by US region and school poverty level.DesignComparison of cross-sectional observational data from the Healthy Communities Study (2013-2015) by region and school poverty level.ParticipantsA total of 401 US elementary and middle schools.Main outcome measuresAdherence with federal nutrition standards for meals and competitive foods; extent of implementation of select aspects of school wellness policies.AnalysisDescriptive statistics and multivariate regression were used. Differences were examined by school poverty level and region, adjusting for other school- and community-level covariates.ResultsMost schools reported meeting reimbursable school meal nutrition standards (74%); more schools in the West met nutrition standards (82%) than in the Midwest (64%). Most grains offered at lunch were whole grain-rich (82%), and most competitive foods complied with standards (78%) before they were required. Most schools had a wellness coordinator (80%). Lowest levels of adherence were reported for guidelines for classroom or school event foods. No differences were observed by school poverty level.Conclusions and implicationsFindings suggest that Healthy Hunger-Free Kids Act provisions were feasible across a wide variety of schools, and schools successfully implemented reimbursable school meal nutrition standards regardless of school poverty level.

IntroductionLarge prospective cohort studies show a lower risk of developing type 2 diabetes among adults with higher whole grain consumption. Less is known about the relationship between whole grain consumption and precursors for diabetes risk in adolescents. We examined whether intake of whole grains was associated with impaired fasting glucose (IFG) in adolescents.MethodsWe analyzed data on dietary intake from an average of two 24-hour diet recalls from fasting, nondiabetic adolescents aged 12-18 years (N = 2,286) across 5 cycles of the National Health and Nutrition Examination Survey (NHANES 2005-2014). We used logistic regression to calculate the odds of having IFG (100-125 mg/dL) with respect to servings of whole and refined grains, as well as percentage of whole grains, adjusting for sex, age, race/ethnicity, annual household income, obesity, total energy, and diet quality.ResultsIFG was present in 17% of participants. After adjusting for covariates, number of servings per day of whole grains was significantly associated with lower odds of IFG, but there was no relationship between IFG and servings of refined grains or percentage of whole grains. Consuming at least 1 ounce-equivalent serving (16 g) of whole grains daily, compared with consuming no whole grains, was associated with a 40% reduction in the adjusted odds of having IFG (adjusted odds ratio = 0.60; 95% CI, 0.38-0.93).ConclusionAnalysis of 10 years of national cross-sectional data suggests that US adolescents whose daily diets consist of a minimum threshold amount of whole grains may be less likely to have IFG, a finding that has implications for diabetes prevention in adolescents.