Behavioural, attitudinal and dietary responses to the consumption of wholegrain foods

Methods to evaluate the scavenging activity of antioxidants toward reactive oxygen and nitrogen species (IUPAC Technical Report)

This project was aimed to identify the quenching chemistry of biologically important reactive oxygen and nitrogen species (ROS/RNS, including radicals), to show antioxidant action against reactive species through H‐atom and electron transfer reactions, and to evaluate the ROS/RNS scavenging activity of antioxidants with existing analytical methods while emphasizing the underlying chemical principles and advantages/disadvantages of these methods. In this report, we focused on the applications and impact of existing assays on potentiating future research and innovations to evolve better methods enabling a more comprehensive study of different aspects of antioxidants and to provide a vocabulary of terms related to antioxidants and scavengers for ROS/RNS. The main methods comprise the scavenging activity measurement of the hydroxyl radical (•OH), dioxide(•1–) (O2 •–: commonly known as the superoxide radical), dihydrogen dioxide (H2O2: commonly known as hydrogen peroxide), hydroxidochlorine (HOCl: commonly known as hypochlorous acid), dioxidooxidonitrate(1–) (ONOO−: commonly known as the peroxynitrite anion), and the peroxyl radical (ROO•). In spite of the diversity of methods, there is currently a great need to evaluate the scavenging activity of antioxidant compounds in vivo and in vitro. In addition, there are unsatisfactory methods frequently used, such as non-selective UV measurement of H2O2 scavenging, producing negative errors due to incomplete reaction of peroxide with flavonoids in the absence of transition metal ion catalysts. We also discussed the basic mechanisms of spectroscopic and electrochemical nanosensors for measuring ROS/RNS scavenging activity of antioxidants, together with leading trends and challenges and a wide range of applications. This project aids in the identification of reactive species and quantification of scavenging extents of antioxidants through various assays, makes the results comparable and more understandable, and brings a more rational basis to the evaluation of these assays and provides a critical evaluation of existing ROS/RNS scavenging assays to analytical, food chemical, and biomedical/clinical communities by emphasizing the need for developing more refined, rapid, simple, and low‐cost assays and thus opening the market for a wide range of analytical instruments, including reagent kits and sensors.

Consumer Choices in the Bread Market: The Importance of Fiber in Consumer Decisions

The aim of the current study was two-fold: (1) to identify consumer segments based on bread selection motives and (2) to examine differences between the identified segments in terms of perception of bread and bread with added fiber, and information on the food label. The data were collected using a CAPI (computer-assisted personal interview) survey on a sample of 1013 consumers. The k-means clustering method was used to identify four clusters of consumers, namely, Enthusiastic, Involved, Ultra-Involved, and Neutral. The Enthusiastic was the group that expressed the most positive opinions about the bread and about the addition of fiber to white bread. Moreover, they appreciated the most the information placed on the bread label. On the other hand, the Ultra-Involved and the Involved presented moderate opinions on these issues. In contrast, the consumers from the Neutral segment agreed the least with the opinion that white bread fortified with fiber is healthier and more expensive compared to white bread without added fiber. Consumers belonging to the Enthusiastic segment declared, to a greater extent than others, that cereal products with added fiber facilitate a healthy lifestyle and can reduce the adverse effects of an inadequate diet. The obtained results indicated that relatively positive opinions on the addition of fiber to white bread, including its benefits for health, are an opportunity to further develop the market of cereal products with added fiber. However, the information about bread on the label and its readability should meet the expectations of consumers who differ significantly in terms of their motives for choice. Both now and in the future, this aspect will be a challenge for food entrepreneurs and organizations that are engaged in the education and development of information aimed at consumers.

Liking and Acceptability of Whole Grains Increases with a 6-Week Exposure but Preferences for Foods Varying in Taste and Fat Content Are Not Altered: A Randomized Controlled Trial

BACKGROUND

Since 2005, the Dietary Guidelines for Americans have recommended consuming at least half of total grains as whole grains (WGs) for optimal health benefits; however, consumption of WGs falls far short of recommended amounts.

OBJECTIVE

This study aimed to evaluate the effect of mere exposure to WGs on liking, acceptability, and consumption of WG foods and to determine if exposure to WG would influence liking and wanting for other foods varying in fat content and sweet taste.

METHODS

Healthy, self-identified low WG consumers (n = 45) were randomly assigned to either a 6-wk WG intervention or a refined grain (RG) control condition during which they received a weekly market basket of grain products to incorporate into daily meals and snacks. Consumption of grain products was measured by weekly logs and weigh-backs. A sensory evaluation protocol was conducted at baseline and week 6 to evaluate changes in perception of grain products. Computer tasks designed to measure liking and wanting for other foods varying in high/low-fat content and sweet/savory taste were also completed at baseline and week 6.

RESULTS

Participants in the WG group significantly increased WG consumption. Exposure to WG products resulted in improved ratings of liking, flavor, texture, and willingness to include WG in the regular diet. No significant changes in liking or wanting for foods representing high-fat sweet (HFSW), low-fat sweet (LFSW), high-fat savory (HFSA), or low-fat savory (LFSA) categories were found in the WG group. In contrast, exposure to RG foods resulted in an increased explicit wanting for HFSW and LFSW and a decreased wanting for HFSA foods.

CONCLUSIONS

Mere exposure to WG foods represents a feasible and easily applied behavioral strategy for increasing consumption of WGs. Encouraging consumers to focus on enjoyment of the taste may be more effective than emphasizing the health benefits of WG consumption. This trial was registered at clinicaltrials.gov as NCT01403857.

The Choice of Bread: The Association between Consumers' Awareness of Dietary Fiber and Declared Intentions to Eat

The objective of the study was to find whether consumers declare an intention to eat bread enriched with fiber in the situation of availability of a plain bread and plain bread with grains, and how these intentions are related to their awareness of fiber in bread. The data were collected in a cross-sectional survey among 1014 Polish adults. Based on three pictures of rolls: plain wheat roll (CR), roll enriched with 12% fiber (RF), and roll topped with sunflower seeds (RSS), the participants' perception regarding fiber content and its impact on intentions to eat were assessed. The respondents were not informed about the differences in composition of the rolls. Although RSS contained only slightly more fiber (0.98 g) than CR (0.81 g), and much less than RF (3.08 g), most of the respondents indicated RSS as containing the most fiber (50.8%) and declared their intention to eat it (39.0%). Respondents who pointed out the importance of fiber, and grains or wholemeal flour addition when making purchase decision, were more likely to declare an intention to eat RSS compared with CR. The low interest in fiber content in a diet increased the chances of declaring an intention to eat CR and RF. People less educated and with low incomes were more likely to declare an intention to eat CR rather than RSS. While people from rural areas were more likely to choose RSS compared with CR and RF. In conclusion, there is interest in bread enriched with fiber, but consumers experience difficulties in recognizing it. Declared intentions to eat each rolls were determined to the greatest extent by the perception of the roll as source of fiber. Thus, educational activities should be focused on consumers' perception of fiber-rich products and their skills related to the selection of high-fiber foods.

Whole Grains and Phenolic Acids: A Review on Bioactivity, Functionality, Health Benefits and Bioavailability

Cereal grains represent one of the major sources of human food and nowadays, their production has increased to fulfill the needs of the world's population. Among whole grains, wheat is the most popular and contributes significantly to the human diet. Whole grains possess great nutritional and bioactive properties due to their fractions, bran and germ, that comprise unique health-promoting bioactive components. The evidence of health benefits in human intervention studies, as well as a World Health Organization report for 2012⁻2016, supports the dietary consumption of whole grains and whole-grain foods. The inverse correlation between whole grain consumption and the reduced risk of chronic diseases and metabolic syndromes was underlined by several epidemiological studies. This article focuses on the bioactive components of whole grains and their fractions, namely phenolic acids, starting from their chemical structure, bioactivity and bioavailability. According to the conclusive evaluation of the human intervention studies conducted using cereal bran and whole grains intake, the assumption that the bioactive compounds determine health outcomes is illustrated. In the last part of the work, the functional potential and the health claims related to whole grains and bran intake are discussed, as well as new technologies and strategies to enhance their health potential by an increased bioavailability.

Healthcare Expenditure and Productivity Cost Savings from Reductions in Cardiovascular Disease and Type 2 Diabetes Associated with Increased Intake of Cereal Fibre among Australian Adults: A Cost of Illness Analysis

An ageing population and growing prevalence of chronic diseases including cardiovascular disease (CVD) and type 2 diabetes (T2D) are putting increased pressure on healthcare expenditure in Australia. A cost of illness analysis was conducted to assess the potential savings in healthcare expenditure and productivity costs associated with lower prevalence of CVD and T2D resulting from increased intake of cereal fibre. Modelling was undertaken for three levels of increased dietary fibre intake using cereal fibre: a 10% increase in total dietary fibre; an increase to the Adequate Intake; and an increase to the Suggested Dietary Target. Total healthcare expenditure and productivity cost savings associated with reduced CVD and T2D were calculated by gender, socioeconomic status, baseline dietary fibre intake, and population uptake. Total combined annual healthcare expenditure and productivity cost savings of AUD$17.8 million-$1.6 billion for CVD and AUD$18.2 million-$1.7 billion for T2D were calculated. Total savings were generally larger among adults of lower socioeconomic status and those with lower dietary fibre intakes. Given the substantial healthcare expenditure and productivity cost savings that could be realised through increases in cereal fibre, there is cause for the development of interventions and policies that encourage an increase in cereal fibre intake in Australia.

Whole Grain Nutrition Education Program Improves Whole Grain Knowledge and Behaviors Among Community-Residing Older Adults

U.S. older adults are not meeting the recommendation for whole grain (WG) intake. This pilot study determined the influence that a WG nutrition education program for community-residing adults aged 60 + years has on WG knowledge and behaviors. The program included WG education and discussion, participation in hands-on activities and taste testing. Participants were mostly white, females. Total grain and WG dietary intake frequencies (WG frequency; p ≤ 0.001), and "knowledge score" increased from PRE to POST (p ≤ 0.001). Participants in PowerPoint-based classes had a higher "knowledge scores" at POST (p = 0.002). Nearly all (n = 139, 88.5%) intended to eat more WG foods, with almost two-thirds (n = 93, 59.3%) reporting a "strong" intention to do so. There was a positive association between strength of intention to eat WG foods and "WG frequency" at POST (r = 0.435, p ≤ 0.001). Results suggest that this WG program is an effective strategy for improving WG knowledge and behaviors among older adults.

Does Perception of Dietary Fiber Mediate the Impact of Nutrition Knowledge on Eating Fiber-Rich Bread?

The average daily intake of fiber is still too low in relation to nutritional recommendations, as was found in several studies. Therefore, it is necessary to recommend ways to increase fiber intake in the diet. Increasing the consumption of bread rich in fiber as a substitute of white bread is one of the ways to increase fiber intake. The aim of this study was to find out whether nutrition knowledge and perception of dietary fiber affected the frequency of eating wholemeal bread and white bread fortified with fiber. The data were collected in 2014 through a cross-sectional quantitative survey that was performed under the Bioproduct project among a group of 1013 Polish adults. The associations between variables were investigated using multiple regression analysis. The respondents’ general knowledge on nutrition influenced their knowledge on fiber intake (correlation coefficient r = 0.30). Respondents with a greater knowledge perceived higher benefits of consuming cereal products that were fortified with fiber (r = 0.78), and attached greater importance to the information on the label (r = 0.39) as well. The nutrition knowledge determined the familiarity with fiber-enriched bread and the consumption of this product (r = 0.40) to a greater degree than the frequency of wholemeal bread consumption (r = −0.10). The respondents’ perception of dietary fiber was observed to play a partial mediation role between the knowledge on nutrition and the consumption of both kinds of breads, suggesting that it can be an important predictor of bread consumption. To increase the consumption of bread that is rich in fiber, emphasis should be laid on specific information on fiber, referring to food products as well as on individual’s perception of those products. The said information should be reinforced along with overall communication regarding nutrition to influence the bread-related decisions.

Factors influencing adolescent whole grain intake: A theory-based qualitative study

Whole grain consumption is associated with reduced risk of chronic disease. One-fifth of UK adults and children do not consume any whole grains, and adolescents have low consumption rates. Factors affecting whole grain intake among adolescents are not well understood. This study examined the socio-economic, environmental, lifestyle and psychological factors likely to influence consumption and explored whether outcomes aligned with behavioural predictors proposed in the Reasoned Action Approach. Five focus groups explored young people's attitudes towards, knowledge and consumption of wholegrain foods, as well as barriers to, and facilitators of, consumption. Participants were male and female adolescents (n = 50) aged 11-16 years from mixed socioeconomic backgrounds and ethnicities, recruited through schools in the city of Leeds, UK. Focus groups were analysed using thematic analysis. Most participants had tried wholegrain food products, with cereal products being the most popular. Many recognised whole grain health benefits related to digestive health but not those related to heart disease or cancers. Several barriers to eating whole grains were identified including: difficulties in identifying wholegrain products and their health benefits; taste and visual appeal; and poor availability outside the home. Suggested facilitators of consumption were advertisements and educational campaigns, followed by improved sensory appeal, increased availability and choice, and tailoring products for young people. All constructs of the Theory of Reasoned Action were identifiable in the data, suggesting that the factors influencing whole grain intake in adolescents are well captured by this model. Study outcomes may inform research and health promotion to increase whole grain intake in this age group.

The Cholesterol-Lowering Potential of Whole Grains

Diet is a contributing factor in the risk, development, and progression of cardiovascular disease. Emphasizing whole grain intake in a heart healthy diet is sometimes overlooked. Whole grains confer cardioprotective benefits and those whole grains higher in soluble, or viscous, fiber aid in the reduction of serum total cholesterol and low-density lipoprotein cholesterol concentrations. Whole grains contain all 3 parts of the grain kernel, and the unique combination of nutrients and phytochemicals inherent in all 3 parts of the kernel account for the many health benefits of whole grains. Health care providers have the opportunity to influence whole grain intake. By highlighting the health benefits associated with whole grain consumption and offering practical tips to help identify and add more whole grains to the diet, patients will be better equipped and more apt to increase their whole grain intake.

Federal food package revisions: effects on purchases of whole-grain products

BACKGROUND

In 2009, the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented revisions to the composition and quantities of WIC-provided foods. New whole-grain products such as whole-wheat bread and allowable substitutes were added to encourage increased intake of whole grains and fiber among WIC participants.

PURPOSE

This paper assesses how the WIC revisions affected purchases of bread and rice among WIC-participating households in Connecticut and Massachusetts.

METHODS

Scanner data from a regional supermarket chain were used to examine bread and rice purchases of 2137 WIC households. Purchased volume of bread and rice was compared before and after implementation of the WIC revisions (2009-2010) using generalized estimating equation models. Data were analyzed in 2013.

RESULTS

Before the WIC revisions, when no bread or rice was provided through WIC, white bread dominated bread purchases among WIC households (78% of volume), and almost all rice purchased was white (94%). As a result of the WIC revisions, the share of 100% whole-grain bread in total bread purchases tripled (from 8% to 24%), replacing purchases of white bread; the share of brown rice rose to 30% of rice purchases. WIC households used WIC benefits to change some of their bread purchases, rather than to buy more bread overall, whereas total rice purchases increased.

CONCLUSIONS

The 2009 WIC revisions significantly increased purchases of whole-grain bread and rice among WIC-participating families. The likely increase in whole-grain and fiber intake among low-income communities could have important public health implications.

The impact of a 16-week dietary intervention with prescribed amounts of whole-grain foods on subsequent, elective whole grain consumption

Previous (mainly population-based) studies have suggested the health benefits of the elective, lifelong inclusion of whole-grain foods in the diet, forming the basis for public health recommendations to increase whole grain consumption. Currently, there is limited evidence to assess how public health recommendations can best result in longer-term improvements in dietary intake. The present study aimed to assess the impact of a previous 16-week whole-grain intervention on subsequent, elective whole grain consumption in free-living individuals. Participants completed a postal FFQ 1, 6 and 12 months after the end of the whole-grain intervention study period. This FFQ included inputs for whole-grain foods commonly consumed in the UK. Whole grain consumption was significantly higher (approximately doubled) in participants who had received whole-grain foods during the intervention (P< 0.001) compared with the control group who did not receive whole-grain foods during the intervention. This increased whole grain consumption was lower than whole grain intake levels required by participants during the intervention period between 60 and 120 g whole grains/d. Aside from a significant increase (P< 0.001) in NSP consumption compared with control participants (mean increase 2-3 g/d), there were no obvious improvements to the pattern of foods of the intervention group. The results of the present study suggest that a period of direct exposure to whole-grain foods in non-habitual whole-grain food consumers may benefit subsequent, elective dietary patterns of whole grain consumption. These findings may therefore aid the development of future strategies to increase whole grain consumption for public health and/or food industry professionals.

Meeting recommended dietary intakes in meal plans with ≥4 servings of grain-based foods daily

Objective

To develop meal plans using grain-based foods demonstrating how to incorporate wholegrain foods into a balanced diet for weight maintenance for different cuisines. The present study examines the ability of meal plans with ≥4 grain-based servings daily to meet nutrient recommendations using lacto-ovo vegetarian and rice-based cuisines.

Design

Eighteen plans from each cuisine for three age brackets for both genders were developed. Plans aimed for ≥4 servings of grain-based foods daily, with separate plans for all wholegrain, all refined-grain and half wholegrain–half refined-grain foods. Meal plans followed an isoenergetic approach and were designed to meet specific Australian nutrient reference values and serving sizes.

Results

All plans met the Recommended Dietary Intake or Adequate Intake for targeted nutrients except for Fe in the rice-based meal plan for females aged ≥19 years (17 mg). In the plans for 14–18 year and ≥19 year age groups, four servings of grain-based foods could be accommodated. In the plans for 9–13 years, increasing the number of grain-based food servings to four reduced micronutrients levels delivered by the total diet. Specific food choices were made to ensure nutrient targets were met across each category for wholegrain and refined-grain plans. The major difference in nutrients between wholegrain and refined-grain foods was found in the vegetarian cuisine, where the meal plans containing whole grains produced on average 30 % higher fibre (38–53 g) levels than those with refined grains (27–40 g).

Conclusions

With careful food selection, meal plans with ≥4 servings of grain-based foods daily can meet nutrient reference values for lacto-ovo vegetarian and rice-based cuisines.

Whole-grain consumption is associated with diet quality and nutrient intake in adults: the National Health and Nutrition Examination Survey, 1999-2004

BACKGROUND

The consumption of whole grains and its association with nutrient intake has not been assessed in a recent nationally representative population.

OBJECTIVE

To examine the association of consumption of whole grains, using the new whole-grain definition, with diet quality and nutrient intake in a recent, nationally representative sample of adults.

DESIGN

Secondary analysis of cross-sectional data from 1999-2004 National Health and Nutrition Examination Survey.

PARTICIPANTS AND METHODS

Adults aged 19 to 50 years (n=7,039) and aged 51 years and older (n=6,237).

MAIN OUTCOME MEASURES

Participants were divided into four whole-grain consumption groups: ≤0 to <0.6, ≥0.6 to <1.5, ≥1.5 to <3.0, and ≥3.0 servings (ounce equivalents)/day. Macro- and micronutrient intakes and diet quality, using the Healthy Eating Index, were determined for each group.

STATISTICAL ANALYSES

Sample weights were applied. The percentages of adults in whole-grain consumption groups were calculated. The covariates used were energy, ethnicity, sex, and age. Least-square means were calculated. P for linear trend analysis was determined using whole-grain intake as a linear covariate. A P value of ≤0.05 was considered significant.

RESULTS

Adults aged 19 to 50 and 51+ years consumed a mean of 0.63 and 0.77 servings of whole grains per day, respectively. For both age groups, diet quality and intake of energy, fiber, and polyunsaturated fatty acids were significantly higher in those consuming the most servings of whole grains. Intake of total sugars (19 to 50 year age group only), added sugars, saturated fatty acids, monounsaturated fatty acids, and cholesterol was significantly lower in those consuming the most servings of whole grains. Intake of all micronutrients, except vitamin B-12 and sodium, was higher among individuals who consumed the most servings of whole grains.

CONCLUSIONS

Overall consumption of whole grains in the US population was low using the recently updated whole-grain definition. Adults who consumed the most servings of whole grains had better diet quality and nutrient intakes.

Relationship between whole grain and fiber consumption and body weight measures among 6- to 18-year-olds

OBJECTIVES

To examine the relationship between whole grain and fiber consumption and body weight measures in children 6 to 12 (n=3868) and adolescents 13 to 18 (n=4931) years old.

STUDY DESIGN

Combined 1999 to 2004 National Health and Nutrition Examination Survey data were analyzed. Mean body mass index (BMI), BMI percentile, BMI z-score, waist circumference, and prevalence of overweight/obesity were compared across categories of whole grain consumption (0 to <0.6, >or=0.6 to <1.5, >or=1.5 to <3, and >or=3 servings) with (1) a sex, ethnicity, and total energy intake-adjusted model and (2) a cereal fiber plus model 1 covariates profile.

RESULTS

Mean whole grain intake was 0.59 and 0.63 servings/d among children 6 to 12 years and adolescents 13 to 18 years, respectively. In children, consumption of >or=3 servings of whole grain was not associated with body weight measures; however, consumption of 1.5 to <3 servings was positively associated with all weight measures. In adolescents, BMI z-score was significantly lower in the highest whole grain consumption group compared with the lowest 2 groups; BMI percentile and waist circumference (model 1 only) were also significantly lower in the highest whole grain consumption group.

CONCLUSIONS

Overall consumption of whole grain was below current recommendations of at least 3 servings per day. Only in adolescents was this level of whole grain intake associated with lower BMI z-scores.

New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre?

Epidemiological studies have clearly shown that whole-grain cereals can protect against obesity, diabetes, CVD and cancers. The specific effects of food structure (increased satiety, reduced transit time and glycaemic response), fibre (improved faecal bulking and satiety, viscosity and SCFA production, and/or reduced glycaemic response) and Mg (better glycaemic homeostasis through increased insulin secretion), together with the antioxidant and anti-carcinogenic properties of numerous bioactive compounds, especially those in the bran and germ (minerals, trace elements, vitamins, carotenoids, polyphenols and alkylresorcinols), are today well-recognised mechanisms in this protection. Recent findings, the exhaustive listing of bioactive compounds found in whole-grain wheat, their content in whole-grain, bran and germ fractions and their estimated bioavailability, have led to new hypotheses. The involvement of polyphenols in cell signalling and gene regulation, and of sulfur compounds, lignin and phytic acid should be considered in antioxidant protection. Whole-grain wheat is also a rich source of methyl donors and lipotropes (methionine, betaine, choline, inositol and folates) that may be involved in cardiovascular and/or hepatic protection, lipid metabolism and DNA methylation. Potential protective effects of bound phenolic acids within the colon, of the B-complex vitamins on the nervous system and mental health, of oligosaccharides as prebiotics, of compounds associated with skeleton health, and of other compounds such as alpha-linolenic acid, policosanol, melatonin, phytosterols and para-aminobenzoic acid also deserve to be studied in more depth. Finally, benefits of nutrigenomics to study complex physiological effects of the 'whole-grain package', and the most promising ways for improving the nutritional quality of cereal products are discussed.

Neuroprotective effects of Triticum aestivum L. against beta-amyloid-induced cell death and memory impairments

beta-Amyloid (A beta) is a key component of senile plaques, neuropathological hallmarks of Alzheimer's disease (AD) and has been reported to induce cell death via oxidative stress. This study investigated the protective effects of Triticum aestivum L. (TAL) on A beta-induced apoptosis in SH-SY5Y cells and cognitive dysfunctions in Sprague-Dawley (SD) rats. Cells treated with A beta exhibited decreased viability and apoptotic features, such as DNA fragmentation, alterations in mitochondria and an increased Bax/Bcl-2 ratio, which were attenuated by TAL extract (TALE) pretreatment. To elucidate the neuroprotective mechanisms of TALE, the study examined A beta-induced oxidative stress and cellular defense. TALE pretreatment suppressed A beta-increased intracellular accumulation of reactive oxygen species (ROS) via up-regulation of glutathione, an essential endogenous antioxidant. To further verify the effect of TALE on memory impairments, A beta or scopolamine was injected in SD rats and a water maze task conducted as a spatial memory test. A beta or scopolamine treatment increased the time taken to find the platform during training trials, which was decreased by TALE pretreatment. Furthermore, one of the active components of TALE, total dietary fiber also effectively inhibited A beta-induced cytotoxicity and scopolamine-caused memory deficits. These results suggest that TALE may have preventive and/or therapeutic potential in the management of AD.

Whole grain consumption and body mass index in adult women: an analysis of NHANES 1999-2000 and the USDA pyramid servings database

OBJECTIVE

To examine the relationship between whole grain consumption and body mass index (BMI) in a sample of American adult women.

METHODS

Dietary intake data from the National Health and Nutrition Examination Survey 1999-2000 were linked to the USDA Pyramid Servings Database. Women 19 years of age and older (n = 2,092) were classified into groups based on their average whole grain (WG) intake: 0 servings, more than 0 but less than 1 serving, and > or =1 servings per day. Within these classifications, mean BMI, mean waist circumference and percent overweight/obese (BMI > or = 25) were identified as primary dependent variables. Regression and logistic regression analyses were used to assess associations between BMI, waist circumference and percent of the population overweight/obese (BMI > or =25) and WG consumption.

RESULTS

Women consuming at least one serving of WG had a significantly lower mean BMI and waist circumference than women with no WG consumption (p < 0.05). Multiple regression analysis showed a significant inverse relationship between BMI and whole grain intake after adjustment for age, energy intake, dietary fiber and alcohol intake (p = 0.004). This effect was mildly attenuated but remained significant after further adjustment for level of physical activity, smoking status, ethnicity and education (p = 0.018). The odds ratio for having a BMI > or = 25 was 1.47 (95% CI 1.12-1.94; p for trend 0.013) for women consuming no WG compared to those consuming at least one serving, after adjustment for all covariates.

CONCLUSIONS

These data support other research suggesting increased WG intake may contribute to a healthy body weight in adult women.

The development of psychosocial measures for whole-grain intake among children and their parents

The effectiveness of behavioral intervention programs can be assessed by measuring changes in behavior using reliable and valid instruments. To our knowledge, a reliable instrument designed to measure changes in psychosocial determinants of whole-grain intake by children due to an intervention does not exist in the literature. This article describes the development and testing of two questionnaires designed to measure psychosocial determinants of whole-grain intake among children and their parents. The questionnaires were pilot-tested with 39 parent/child pairs from one school and subsequently used in an intervention program with 150 parent/child pairs from two schools. Internal consistencies for the child and parent scales were modest (alpha=.41 to .63), with the exception of intention to choose whole-grain foods for children, which was low (alpha=.19). Test-retest reliability of the child and parent scales was acceptable (r=0.58 to 0.90). Principal components analysis confirmed three parenting subscales: enabling behaviors, whole grain health benefits, and role modeling. Identification of whole-grain foods remains a substantial barrier to the development of a questionnaire that accurately measures psychosocial determinants related to whole-grain intake. Future work should focus on instrument development and testing on a broader scale.

The NHF-NRG In Balance-project: the application of Intervention Mapping in the development, implementation and evaluation of weight gain prevention at the worksite

Very few examples of theory-driven and systematically developed weight gain prevention interventions for adults have been described in the literature. The present paper systematically describes the development, implementation and evaluation framework of a weight gain prevention programme directed at young adults at the worksite, namely the NHF-NRG In Balance-project. It not only can be used as a guide to systematically develop weight gain prevention interventions, but also gives an overview of the current theoretical and empirical knowledge-base in the field of obesity prevention. The outline of the paper follows the Intervention Mapping protocol, which includes a systematic inventory of important health issues, their risk behaviours and determinants of these risk behaviours, and specification of the proximal objectives of the programme directed at both energy intake and energy expenditure. The objectives are translated into behaviour change methods and strategies, which are combined in a stepwise intervention programme, and used for a detailed evaluation plan (process and effect evaluation). The NHF-NRG In Balance-project combines mass media and individually tailored communications with worksite environmental changes to raise awareness, to motivate and to enable energy balance behaviour changes. A quasi-experimental pre-test-multiple post-test control group design was applied in 12 worksites (>500 employees).

Whole grains and CVD risk

There is an increasing body of evidence, including that from prospective population studies and epidemiological observational studies, suggesting a strong inverse relationship between increased consumption of wholegrain foods and reduced risk of CVD. This evidence has translated into specific dietary recommendations in the USA to consume at least three servings of whole grain per d, and has informed the development of specific health claims for wholegrain foods both in the USA and in Europe. Wholegrain foods are rich sources of many nutrients and phytochemicals, including complex carbohydrates, dietary fibre, minerals, vitamins, antioxidants and phyto-oestrogens such as lignans. Many of these components are lost from the grain during processing and although some may be replaced (such as in the mandatory fortification of white flour), this practice ignores the possible synergistic effects of the ‘natural’ constituents. The notion that wholegrain foods are simply a source of dietary fibre has been dispelled, although the additional components that contribute to the health benefits have not been clearly identified. In addition, the mechanisms by which wholegrain foods may have their effect are poorly understood. At present there are few strictly-controlled intervention studies that have confirmed a beneficial effect of increased consumption of wholegrain foods, demonstrated the level of consumption required to elicit a beneficial effect or provided evidence of modes of action. Although wholegrain foods are considered amongst the healthiest food choices available, their consumption falls well below current recommendations, which have been based mainly on epidemiological evidence. Well-controlled intervention studies are needed to provide more detailed mechanistic evidence to support the health claims and findings which can be used to develop effective public health strategies to promote whole-grain consumption.

Study protocol of a cluster randomised controlled trial investigating the effectiveness of a tailored energy balance programme for recent retirees

BACKGROUND

People in transitional life stages, such as occupational retirement, are likely to gain weight and accumulate abdominal fat mass caused by changes in physical activity and diet. Hence, retirees are an important target group for weight gain prevention programmes, as described in the present paper.

METHODS/DESIGN

A systematic and stepwise approach (Intervention Mapping) is used to develop a low-intensity energy balance intervention programme for recent retirees. This one-year, low-intensity multifaceted programme aims to prevent accumulation of abdominal fat mass and general weight gain by increasing awareness of energy balance and influencing related behaviours of participants' preference. These behaviours are physical activity, fibre intake, portion size and fat consumption. The effectiveness of the intervention programme is tested in a cluster randomised controlled trial. Measurements of anthropometry, physical activity, energy intake, and related psychosocial determinants are performed at baseline and repeated at 6 months for intermediate effect, at 12 months to evaluate short-term intervention effects and at 24 months to test the sustainability of the effects.

DISCUSSION

This intervention programme is unique in its focus on retirees and energy balance. It aims at increasing awareness and takes into account personal preferences of the users by offering several options for behaviour change. Moreover, the intervention programme is evaluated at short-term and long-term and includes consecutive outcome measures (determinants, behaviour and body composition).

Beliefs about Whole-Grain Foods by Food and Nutrition Professionals, Health Club Members, and Special Supplemental Nutrition Program for Women, Infants, and Children Participants/State Fair Attendees

Whole-grain foods are important components of healthful diets that may help prevent chronic diseases. Consumer beliefs that influence consumption of whole grains are poorly understood. This analysis surveyed three groups regarding their beliefs about whole-grain foods. The groups were food and nutrition professionals (n=103), health club members (n=103), and individuals representing various consumer segments of the general population, including participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and state fair attendees (n=68). Most respondents were aware of the term whole-grain foods, but less often reported that they use the term. Bread and cereal were most often named as examples of whole-grain foods. Lack of processing and use of the entire grain were the major reasons a food was perceived as being a whole-grain food. The major benefit of eating whole grains was reported to be fiber intake. Food and nutrition professionals provided more differentiated responses, whereas WIC/state fair participants had fewer and less elaborate responses. Assessing beliefs about whole grains offers insights to nutrition professionals for encouraging healthful food consumption.

Intake of alkylresorcinols from wheat and rye in the United Kingdom and Sweden

Alkylresorcinols, phenolic lipids present in high amounts in whole-grain wheat and rye but not present in appreciable amounts in other foods, are candidates as biomarkers of whole-grain intake from these cereals. We estimated the intake of alkylresorcinols in Sweden and the UK using two different methods: food supply data (FSD); food consumption data (FCD; based on individual and household survey data). The average per capita intake of alkylresorcinols in Sweden was 17.5 mg/d (FSD) and 22.9 (sd 16.6) mg/d (FCD), while in the UK it was 11.9 mg/d (FSD) and 11.8 (sd 18.62) mg/d (FCD). Ninety-six per cent of all Swedes consumed some alkylresorcinols, compared with 50 % of British people surveyed. Both women and men over the age of 40 years had a higher alkylresorcinol intake than younger people. The average results from the two methods were similar, but the FCD data provided more detail about the range of alkylresorcinol intake, and indicate that because the intake of alkylresorcinols varies so widely, they may be good markers of diets rich or poor in whole-grain wheat/rye products.

Dietary fiber as a versatile food component: An industrial perspective

The continued emphasis on the importance of dietary fibers to the Western diet and the need for products with a lower calorific content is pressuring food companies to allocate more resources to the development of fiber-enriched products. The challenge to the industry is to accomplish this goal without sacrificing the organoleptic appeal of some of their core offerings. As future research details specific nutritional benefits of individual components of dietary fiber, food companies will need flexible alternatives in order to validate new 'functional' food claims and to respond rapidly to emerging trends in fiber-enriched products. These objectives will be achieved by understanding the physicochemical basis for the biotechnical functionality of fibers and by developing, and making available fibers which provide a broad spectrum of bioactive and texture modulating properties.

Whole-grain rye bread consumption by women correlates with plasma alkylresorcinols and increases their concentration compared with low-fiber wheat bread

Whole-grain rye and wheat products are rich in lignans, the precursors of enterolactone (ENL) and alkylresorcinols (ARs), which are phenolic lipids. In this crossover trial, we examined the effect of whole-grain rye bread compared with low-fiber wheat bread on plasma AR levels. Women (n = 39) aged 59 +/- 0.94 y (mean +/- SEM) were advised to consume rye (214 +/- 7.1 g/d) or wheat (178 +/- 6.5 g/d) bread (20% of total daily energy intake) in random order for 8 wk. The test periods were separated by an 8-wk washout period. ARs with different homologues and ENL were measured in plasma collected at the beginning (habitual diet) and end of the test bread periods. AR concentrations were higher (P < 0.001) after the rye bread (352 +/- 24.7 nmol/L) and habitual diet (97.7 +/- 12.1 and 88.3 +/- 8.7 nmol/L) periods than after the wheat bread period (36.6 +/- 4.2 nmol/L). Plasma AR concentrations were correlated with intake of rye bread (r = 0.34, P = 0.037), and with insoluble fiber from the whole diet during the rye (r = 0.39, P = 0.013) and wheat (r = 0.32, P = 0.047) bread periods. The plasma AR 17:0/21:0 ratio differed after the rye (0.84 +/- 0.04) and wheat (0.53 +/- 0.08) bread diet periods (P < 0.001). These data strongly suggest that plasma ARs could be used as specific biomarkers for whole-grain rye intake, and their homologue pattern could be used as an indicator of the bread type consumed.