Whole grain foods and health - a Scandinavian perspective

Effects of whole grains on glycemic control: a systematic review and dose-response meta-analysis of prospective cohort studies and randomized controlled trials

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.

Association between Whole Grain Intake and Chronic Kidney Disease

BACKGROUND

The relationship between whole grain intake and chronic kidney disease (CKD) remains uncertain.

OBJECTIVE

This study aimed to evaluate the association between whole grain intake and risk of CKD in Chinese adults.

METHODS

The present cross-sectional study used data from the China Health and Nutrition Survey conducted in 2009. Whole grain intake was measured using 3 consecutive 24-h dietary recalls and a household food inventory. A multivariable logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of CKD. In addition, a restricted cubic spline was used to investigate the dose‒response relationship between whole grain and risk of CKD.

RESULTS

A total of 6747 participants were included, 728 of whom had CKD. Compared with those in the lowest whole grain intake group, those in the higher grain intake group had an inverse association with risk of CKD (Q2: adjusted OR 0.70, 95% CI: 0.54, 0.89; Q3: adjusted OR 0.54, 95% CI: 0.42, 0.69; and Q4: adjusted OR 0.29, 95% CI: 0.21, 0.41). The association between whole grain intake and CKD seems to be stronger for individuals who were male (P for interaction = 0.008) or smokers (P for interaction = 0.013). In addition, the restricted cubic spline suggested an obvious L-shaped correlation.

CONCLUSIONS

Increased whole grain intake was associated with a decreased risk of CKD in Chinese adults.

Dietary patterns in relation with nutritional outcomes and associated factors among adolescents: implications for context-specific dietary intervention for the Agrarian Community, Northwest Ethiopia

Introduction

Dietary pattern analysis allows us to characterize the dietary intakes of individuals rather than nutrient intake data and strongly predicts disease risks. The relationship between food intake and adolescents' nutritional health is not well understood yet. Therefore, this study aimed to generate evidence for context-specific dietary intervention for adolescents.

Objective

This study aimed to determine dietary patterns and their relationship with nutritional outcomes and identify the contributing factors among adolescents in the Agrarian Community of Northwest Ethiopia.

Methods

A cross-sectional survey was conducted among 622 randomly selected adolescents. Dietary data were collected over a 1-week recall period using the Food Frequency Questionnaire (FFQ). After testing the basic assumptions, an exploratory factor analysis was conducted to determine the dietary patterns. Anthropometric data on weight and height were collected to determine the nutritional status using WHO Anthroplus 2010 software. A chi-square test was conducted to evaluate the effect of different dietary patterns on nutritional outcomes. A multivariable binary logistic regression model was used to identify factors affecting the dietary patterns of adolescents.

Result

Three types of dietary patterns, namely, traditional, mixed, and animal-source foods with traditional alcoholic beverage consumption were identified. These dietary patterns explain 58.64% of the variance in adolescent diet in the study setting. The burden of stunting was 15.12% vs. 11.21, 19.40% vs. 6.94, and 8.36% vs.17.97% among adolescents with lower traditional, mixed, and higher animal sources with alcoholic dietary pattern consumption habits, respectively (value of p <0.05). Adolescents who resided in low-land agroecology (AOR = 2.44; 95% CL: 1.24, 4.81) and had access to animal-source foods (AOR = 1.64; 95% CI: 1.04, 2.60) were associated with lower consumption of traditional dietary patterns. Similarly, adolescents who resided in low-land (AOR = 1.80; 95% CI: 1.18, 2.74) had formal education (AOR = 2.38; 95% CI: 1.35, 4.19) and had poor nutrition knowledge (AOR = 2.83; 95% CL: 1.55, 5.19) were associated with lower consumption of mixed dietary patterns. Moreover, adolescents residing in the high-land (AOR = 2.50; 95% CI: 1.37, 4.56) and being female (AOR =1.87; 95% CI: 1.27, 2.74) were significant factors associated with lower consumption of animal-sourced foods with traditional alcoholic beverage consumption patterns.

Conclusion

Multidimensional modifiable factors were explored that could be targeted for public health interventions for the identified dietary patterns. Integrated and multifaceted dietary intervention approaches are needed to promote healthy diets and discourage the consumption of unhealthy diets to reduce undernutrition in the study area and similar settings.

Effects of whole-grain cereals on fecal microbiota and short-chain fatty acids in dogs: a comparison of rye, oats and wheat

Dietary fiber in dog food is reported to promote healthy gut microbiota, but few studies have investigated the effects of whole-grain cereals, which contain a variety of fiber types and other bioactive compounds. The aim of the present study was to compare the effects of diets containing whole-grain rye (RYE), oats (OAT) and wheat (WHE) on fecal microbiota and short-chain fatty acid production. Eighteen dogs were fed three experimental diets, each for four weeks, in a cross-over design. Fecal samples were collected at the end of each diet period. Analysis of 16S rRNA gene amplicons showed that family Lachnospiraceae and genus Bacteroides were the gut microbial groups most affected by diet, with lowest relative abundance following consumption of RYE and a trend for a corresponding increase in genus Prevotella_9. Fecal acetate and propionate concentrations were higher after consumption of RYE compared with OAT. In conclusion, rye had the strongest effect on gut microbiota and short-chain fatty acids, although the implications for dog gut health are not yet elucidated.

Evaluation of Subjective Appetite Assessment under Free-Living vs. Controlled Conditions: A Randomized Crossover Trial Comparing Whole-Grain Rye and Refined Wheat Diets (VASA-Home)

BACKGROUND

Accurate assessment of self-reported appetite under free-living conditions is warranted to conduct large-scale intervention studies measuring appetite at a feasible cost. However, the performance of visual analogue scales (VASs) for this purpose has not been widely examined.

METHOD

This randomized crossover trial was conducted to evaluate VASs in free-living vs. clinic-based settings and to assess appetite response following hypocaloric whole-grain rye and refined wheat diets. Twenty-nine healthy adults with overweight or obesity continuously answered VAS questions about their perceived appetite from morning to evening.

RESULTS

No differences in whole-day VAS scores (primary outcome) between clinic-based and free-living settings were observed, whereas measures of total area under the curve (tAUC) showed increased fullness in clinic-based interventions of 7% (p < 0.008) for whole-day responses and 13% (p < 0.03) following a snack. Appetite responses for a whole day did not differ between diets whereas rye-based dinners induced 12% (p < 0.016) higher fullness and reduced hunger by 17% (p < 0.02) irrespective of setting. A reduction in hunger of 15% (p < 0.05) was also observed following rye-based vs. wheat-based lunches.

CONCLUSION

The results suggest that the VAS is valid for evaluation of appetite responses between diets under free-living conditions. No difference in self-reported appetite over the whole day was found after whole-grain rye vs. refined wheat-based diets, but there were some suggested differences at certain postprandial periods, in individuals with overweight or obesity.

Effects of rye inclusion in dog food on fecal microbiota and short-chain fatty acids

BACKGROUND

Rye intake has been associated with beneficial effects on health in human interventions, possibly due to dietary fiber in rye. In dogs, few studies have explored the effects on health of dietary fiber in general, and rye fiber in particular. The aim of this study was to investigate how inclusion of rye, compared with wheat, influenced fecal microbiota composition, short chain fatty acids (SCFA) and apparent total tract digestibility (ATTD) in dogs. Six male Beagle dogs (mean age 4.6 years, SEM 0.95 years; mean body weight 14.6 kg, SEM 0.32 kg) were fed three experimental diets, each for 21 days, including an adaptation period of six days and with 2-2.5 months between diet periods. The diets were similar regarding energy and protein, but had different carbohydrate sources (refined wheat (W), whole grain rye (R), or an equal mixture of both (RW)) comprising 50% of total weight on a dry matter (DM) basis. The diets were baked and titanium dioxide was added for ATTD determination. Fecal samples were collected before and in the end of each experimental period. Fecal microbiota was analyzed by sequencing 16S rRNA gene amplicons and fecal SCFA by high-performance liquid chromatography. Crude protein, crude fat, neutral detergent fiber, and gross energy (GE) in food and feces were analyzed and ATTD of each was determined. Univariate and multivariate statistical methods were applied in data evaluation.

RESULTS

Faecal microbiota composition, differed depending on diet (P = 0.002), with samples collected after consumption of the R diet differing from baseline. This was primarily because of a shift in proportion of Prevotella, which increased significantly after consumption of the R diet (P < 0.001). No significant differences were found for SCFA, but there was a tendency (P < 0.06) for higher molar proportions of acetic acid following consumption of the R diet. The ATTD of crude protein, crude fat, neutral detergent fiber, and GE was lower after consumption of the R diet compared with the other diets (P < 0.05).

CONCLUSIONS

Consumption of the R diet, but not RW or W diets, was associated with specific shifts in microbial community composition and function, but also with lower ATTD.

Effect of Gamma-irradiation on the Physicochemical, Functional, and Antioxidant Properties of Unpigmented Brown Whole Rice Flour

Whole grain brown rice, being a rich source of fiber and other bioactive compounds like polyphenols is effective in reducing the risk of chronic diseases including cardiovascular diseases, hypercholesterolemia and Type II diabetes. The study was aimed to evaluate the effect of gamma irradiation on the physicochemical, functional and antioxidant properties of whole grain brown rice flour. The brown rice flour was conditioned to two different moisture contents of 10% and 12% and treated with gamma irradiation doses of 0 kGy (native or control), 2.5 kGy and 5 kGy. Moisture, protein, fat, ash and carbohydrate content of native flour was found as 10 g/100 g, 6.54 g/100 g, 1.54 g/100 g, 1.0 g/100 g, and 81.48 g/100 g, respectively. The hunter color 'L', 'a', and 'b' values of the native brown rice flour sample were found as 81.95, -0.97 and 17.36, respectively and were non-significantly (p ≥ 0.05) affected by gamma irradiation. Apparent amylose content was observed to decrease significantly (p ≤ 0.05) from 29.97 to 20.30 g/100 g with the increase in gamma irradiation dose and moisture content. The pasting properties such as peak viscosity, trough viscosity and final viscosity of all the flour samples decreased significantly (p ≤ 0.05) with the increase in irradiation dose. The functional properties such as water and oil absorption and emulsion capacities were increased while emulsion stability and foaming stability decreased upon irradiation. Irradiation led to an overall increase in the antioxidant activity of rice flours. In general, FTIR spectra revealed a decrease in the absorption intensities of the functional groups. Therefore, it can be concluded that gamma irradiation can be used as a tool to modify the physicochemical properties of rice flours as well as to improve their antioxidant properties.

Compositional Traits of Grains and Groats of Barley, Oat and Spelt Grown at Organic and Conventional Fields

Barley, oats, or spelt consumed as minimally processed whole grains provide several health benefits, especially when grown under organic field management conditions. Therefore, the effects of organic and conventional farming on the compositional traits (protein, fibre, fat, and ash) of barley, oat, and spelt grains and groats were compared using three winter barley varieties ('Anemone', 'BC Favorit', and 'Sandra'), two spring oat varieties ('Max' and 'Noni'), and three spelt varieties ('Ebners Rotkorn', 'Murska bela', and 'Ostro'). Groats were produced from harvested grains by a combination of threshing, winnowing, and brushing/polishing. Multitrait analysis showed significant differences between species, field management practices, and fractions, with clear compositional differences between organic and conventional spelt. Barley and oat groats had a higher thousand kernel weight (TKW) and β-glucan, but lower crude fibre, fat, and ash contents than the grains. The composition of the grains of the different species differed significantly for more traits (TKW, fibre, fat, ash, and β-glucan) than that of the groats (TKW and fat), while field management only affected the fibre content of the groats and the TKW, ash, and β-glucan contents of the grains. The TKW, protein, and fat contents of the different species differed significantly under both conventional and organic growing conditions, while the TKW and fibre contents of grains and groats differed under both systems. The caloric value of the final products of barley, oats, and spelt groats ranged from 334-358 kcal/100 g. This information will be useful for not only the processing industry, but also for breeders and farmers, and last, but not least, for consumers.

Fecal microbiota composition affects in vitro fermentation of rye, oat, and wheat bread

Fermentation of dietary fiber by gut microbes produces short-chain fatty acids (SCFA), but fermentation outcomes are affected by dietary fiber source and microbiota composition. The aim of this study was to investigate the effect of two different fecal microbial compositions on in vitro fermentation of a standardized amount of oat, rye, and wheat breads. Two human fecal donors with different microbial community composition were recruited. Bread samples were digested enzymatically. An in vitro fermentation model was used to study SCFA production, dietary fiber degradation, pH, and changes in microbiota. Feces from donor I had high relative abundance of Bacteroides and Escherichia/Shigella, whereas feces from donor II were high in Prevotella and Subdoligranulum. Shifts in microbiota composition were observed during fermentation. SCFA levels were low in the samples with fecal microbiota from donor I after 8 h of fermentation, but after 24 h acetate and propionate levels were similar in the samples from the different donors. Butyrate levels were higher in the fermentation samples from donor II, especially with rye substrate, where high abundance of Subdoligranulum was observed. Dietary fiber degradation was also higher in the fermentation samples from donor II. In conclusion, fermentation capacity and substrate utilization differed between the two different microbiota compositions.

Dietary Fiber Intake and Gut Microbiota in Human Health

Dietary fiber is fermented by the human gut microbiota, producing beneficial microbial metabolites, such as short-chain fatty acids. Over the last few centuries, dietary fiber intake has decreased tremendously, leading to detrimental alternations in the gut microbiota. Such changes in dietary fiber consumption have contributed to the global epidemic of obesity, type 2 diabetes, and other metabolic disorders. The responses of the gut microbiota to the dietary changes are specific to the type, amount, and duration of dietary fiber intake. The intricate interplay between dietary fiber and the gut microbiota may provide clues for optimal intervention strategies for patients with type 2 diabetes and other noncommunicable diseases. In this review, we summarize current evidence regarding dietary fiber intake, gut microbiota modulation, and modification in human health, highlighting the type-specific cutoff thresholds of dietary fiber for gut microbiota and metabolic outcomes.

Use of the term whole grain on the label of processed and ultra-processed foods based on cereals and pseudocereals in Brazil

There has been an increasing consumption of processed and ultra-processed foods, accompanied by growing concerns about the relationship between diet quality and health. Whole-grain foods, composed of cereals and pseudocereals, are recommended as part of a healthy diet, and food labeling is an important tool for consumers to identify the presence of whole grains in packaged foods. This study aimed to analyze the use of the term whole grain on the label of processed and ultra-processed foods based on cereals and pseudocereals (amaranth, quinoa, and buckwheat) in Brazil. Data were collected by a census of all food labels in a Brazilian supermarket. Foods were classified into eight groups according to Brazilian legislation and according to the presence or absence of the term whole grain. The prevalence of foods displaying the term whole grain or related expressions on the front label was assessed, and differences between groups were analyzed using Pearson's chi-squared test. Comparisons were also made in relation to the position of whole-grain ingredients in the ingredients list, given that Brazilian food labeling regulations require that ingredients be listed in descending order of weight on packaged foods. The level of significance was defined as p < 0.05. The sample included 1,004 processed and ultra-processed foods based on cereals and pseudocereals, 156 (15.6%) of which displayed the term whole grain and/or similar expressions on the front label. Of these, 98 (9.8%) contained the term whole grain, 25 (2.5%) displayed analogous expressions, and 33 (3.3%) contained the term whole grain concomitantly with analogous terms, identified in foods of the groups Bakery goods, bread, cereals, and related products and Sugars, sugary foods, and snacks. Half of the food products displaying the term whole grain or related expressions on the front label did not have a whole-grain ingredient listed in the first position of the ingredients list. The frequency of whole grains was even lower when analyzing the second and third ingredients. These findings reveal the existence of inaccurate information regarding the term whole grain or analogous expressions on the front label of cereal- and pseudocereal-based packaged foods. It is expected that these results will contribute to stimulating the food industry and regulatory bodies to improve the use of the term whole grain and related expressions on packaged food labels, given that, up to the moment of data collection, there were no regulatory requirements for these statements. Furthermore, the findings might contribute to improving the clarity of information available on food labels, thereby preventing consumer deception at the time of purchase.

Identification and Functional Characterisation of Two Oat UDP-Glucosyltransferases Involved in Deoxynivalenol Detoxification

Oat is susceptible to several Fusarium species that cause contamination with different trichothecene mycotoxins. The molecular mechanisms behind Fusarium resistance in oat have yet to be elucidated. In the present work, we identified and characterised two oat UDP-glucosyltransferases orthologous to barley HvUGT13248. Overexpression of the latter in wheat had been shown previously to increase resistance to deoxynivalenol (DON) and nivalenol (NIV) and to decrease disease the severity of both Fusarium head blight and Fusarium crown rot. Both oat genes are highly inducible by the application of DON and during infection with Fusarium graminearum. Heterologous expression of these genes in a toxin-sensitive strain of Saccharomyces cerevisiae conferred high levels of resistance to DON, NIV and HT-2 toxins, but not C4-acetylated trichothecenes (T-2, diacetoxyscirpenol). Recombinant enzymes AsUGT1 and AsUGT2 expressed in Escherichia coli rapidly lost activity upon purification, but the treatment of whole cells with the toxin clearly demonstrated the ability to convert DON into DON-3-O-glucoside. The two UGTs could therefore play an important role in counteracting the Fusarium virulence factor DON in oat.

The Effect of Rye-Based Foods on Postprandial Plasma Insulin Concentration: The Rye Factor

Consumption of whole grain has been associated with lower incidence of type-2 diabetes, cardiovascular disease and their risk factors including improved glycemic control. In comparison with other whole grain products, rye bread has been shown to induce lower insulin response in the postprandial phase, without affecting the glucose response. This phenomenon has been referred to as the “rye factor” and is being explored in this review where we summarize the findings from meal and extended meal studies including rye-based foods. Overall, results from intervention studies showed that rye-based foods vs. (wheat) control foods had positive effect on both insulin and glucose responses in the postprandial phase, rather than on insulin alone. Mechanistic studies have shown that the rye factor phenomenon might be due to slowing of the glucose uptake in the intestine. However, this has also been shown for wheat-based bread and is likely an effect of structural properties of the investigated foods rather than the rye per se. More carefully controlled studies where standardized structural properties of different cereals are linked to the postprandial response are needed to further elucidate the underlying mechanisms and determinants for the effect of specific cereals and product traits on postprandial glycemic control.

Immunomodulatory and Anticancer Activities of Barley Bran Grown in Jordan: An in vitro and in vivo Study

The Mediterranean diet is regarded as one of the most healthful dietary patterns in the world, owing to a combination of foods high in antioxidants and anticancer constituents. Barley bran is one of the components of the Mediterranean diet. It has nutritional and beneficial effects in different pathological conditions. Many studies were achieved to assess the nutritious values of barley bran, but there is no research indicating immunomodulatory and anticancer activities of barley bran grown in Jordan. The present study aims to examine and assess the potential immunomodulatory and anti-tumor activities of ethanol, n-hexane, aqueous/methanol, and water extracts obtained from barley bran. The Maceration method was utilized to prepare ethanol, n-hexane, aqueous/methanol, and water extracts. Various phytochemical groups were determined by using qualitative phytochemical tests. The antiproliferative activity of extracts was determined against MCF-7, HCT-116, A549, and EMT6/p by the MTT assay. The Folin-Ciocalteu reagent was used to detect the total phenolic content in extracts. Furthermore, immunomodulatory activity was assessed by determining the effect of extracts on splenocytes proliferation in the presence and absence of mitogens. The nitro blue tetrazolium assay and the neutral red method were used to assess the effect of each extract on the phagocytic activity of macrophages and pinocytosis, respectively. For the in vivo part, three different concentrations (10, 20, and 30% w/v) of barley bran were used to test the prophylactic effect in four Balb/C mice groups inoculated with EMT6/p cell-line subcutaneously. Also, serum samples were collected to assess the effect on cytokines (IFN-gamma, IL-2, IL-4, and IL-10). Barley bran extracts inhibited cancer cell proliferation. According to immunoassays, n-hexane and aqueous/methanol extracts could significantly rise lymphocyte proliferation and pinocytosis activity of macrophages. The activity of phagocytosis was increased by n-hexane and ethanol extracts. For the in vivo part, the average tumor size and weight of mice given the 30% barley bran group was significantly reduced (p < 0.05) compared with the control group. During our study, higher levels of TH1 cytokines (IFN- γ, IL-2) and lower levels of TH2 cytokine (IL-4) and T regulatory cytokine (IL-10) were obtained due to consumption of barley bran in food. Barley bran can be used as a prophylactic agent because it has anti-cancer and immunomodulatory activities.

Rye: A wonder crop with industrially important macromolecules and health benefits

Rye (Secale cereale) is a rich source of macromolecules, especially starch, fiber, and proteins which encourages the researchers and industries to use it for various purposes including bakery products, beverages and edible films formulation. However, despite many nutritional and health benefiting properties, rye has not been explored up to its full potential. Interest of consumers in formulating foods with high fiber and phenolic compounds has generated our interest in compiling the detailed information on rye. The present review on rye grains summarizes the existing scientific data on rye macronutrients (starch, arabinoxylan, β-glucan, fructan and proteins) and their corresponding industrial importance. Detailed description in this review unfolds the potential of rye grains for human nutrition. This review provides comprehensive knowledge and fills the remaining gap between the previous and latest scientific findings. Comprehensive information on rye nutrients along with health benefits will help to open a new era for scientific world and industrial sectors.

Rye: Current state and future trends in research and applications

After wheat, rye is the second most important raw material for bread and bakery products, and it is one of the most excellent sources of dietary fibres and bioactive compounds. Besides, rye is utilised in more and more other food products as well, such as breakfast cereals, porridges, pasta, snack products, etc. Interestingly, its production is decreasing worldwide, probably because of the expansion of other cereals (e.g. triticale), but also the effect of climate change can also play a role therein. However, there is no doubt that scientific research aimed at studying the possible health benefits and the potential of rye in the development of novel food products has intensified over the past decade.

The aim of our paper is to make a comprehensive review of the latest results on the compositional and technological properties of rye that fundamentally influence its utilisation for food purposes. Furthermore, this review aims to identify the current development directions and trends of rye products.

A hypocaloric diet rich in high fiber rye foods causes greater reduction in body weight and body fat than a diet rich in refined wheat: A parallel randomized controlled trial in adults with overweight and obesity (the RyeWeight study)

BACKGROUND AND AIM

A high intake of whole grain foods is inversely associated with body mass index (BMI) and body fat in observational studies, but mixed results have been found in interventional studies. Among whole grains, rye is the richest source of dietary fiber and meals containing high-fiber rye foods have shown increased satiety up to 8 h, compared to meals containing refined wheat products. The aim of the study was to determine the effect of consuming high fiber rye products, compared to refined wheat products, on body weight and body fat loss in the context of an energy restricted diet.

METHODS

After a 2-week run-in period, 242 males and females with overweight or obesity (BMI 27-35 kg/m²), aged 30-70 years, were randomized (1:1) to consume high fiber rye products or refined wheat products for 12 weeks, while adhering to a hypocaloric diet. At week 0, week 6 and week 12 body weight and body composition (dual energy x-ray absorptiometry) was measured and fasting blood samples were collected. Subjective appetite was evaluated for 14 h at week 0, 6 and 12.

RESULTS

After 12 weeks the participants in the rye group had lost 1.08 kg body weight and 0.54% body fat more than the wheat group (95% confidence interval (CI): 0.36; 1.80, p < 0.01 and 0.05; 1.03, p = 0.03, respectively). C-reactive protein was 28% lower in the rye vs wheat group after 12 weeks of intervention (CI: 7; 53, p < 0.01). There were no consistent group differences on subjective appetite or on other cardiometabolic risk markers.

CONCLUSION

Consumption of high fiber rye products as part of a hypocaloric diet for 12 weeks caused a greater weight loss and body fat loss, as well as reduction in C-reactive protein, compared to refined wheat. The difference in weight loss could not be linked to differences in appetite response.

CLINICAL TRIAL REGISTRATION

www.clinicaltrials.gov, Identifier: NCT03097237.

Comparative Quality Evaluation of Physicochemical, Technological, and Protein Profiling of Wheat, Rye, and Barley Cereals

Agronomically important cereal crops wheat, barley, and rye of the Triticeace tribe under the genus Triticum were studied with special focus on their physical, proximal, and technological characteristics which are linked to their end product utilization. The physiochemical parameters showed variability among the three cereal grains. Lactic acid-solvent retention capacity (SRC) was found to be higher in wheat (95.86–111.92%) as compared to rye (53.78–67.97%) and barley (50.24–67.12%) cultivars, indicating higher gluten strength. Sucrose-SRC and sodium carbonate-SRC were higher in rye as compared to wheat and barley flours. The essential amino acid proportion in barley and rye cultivars was higher as compared to wheat cultivars. Barley and rye flours exhibited higher biological value (BV) owing to their higher lysine content. SDS-PAGE of wheat cultivars showed a high degree of polymorphism in the low molecular range of 27.03–45.24 kDa as compared to barley and rye cultivars. High molecular weight (HMW) proteins varied from 68.38 to 119.66 kDa (4–5 subunits) in wheat, 82.33 to 117.78 kDa (4 subunits) in rye, and 73.08 to 108.57 kDa (2–4 subunits) in barley. The comparative evaluation of barley and rye with wheat cultivars would help in the development of healthy food products.

Effects of different solid-state fermentation ratios of S. cerevisiae and L. plantarum on physico-chemical properties of wheat bran and the quality of whole wheat bread

BACKGROUND

The addition of wheat bran (WB) could improve the nutritional quality of whole wheat bread (WWB); however, it also caused many negative effects on the quality of bread. To improve the physico-chemical properties of WB and the quality of WWB, WB was solid-state fermented with different ratios of commercially available S. cerevisiae and L. plantarum, and utilized to prepare WWB.

RESULTS

The physico-chemical properties of WB including dietary fiber content and its components, amino acid composition, and antioxidant activities were determined. After solid-state fermentation, the physico-chemical properties of WB were improved. WB_{Sac:Lac = 2:1} showed higher antioxidant activity (only the total antioxidant activity was slightly lower than WB_{Sac:Lac = 1:1} ), and greater concentration of soluble dietary fiber (9.22%) and essential amino acids / total amino acids (42.04) than the other WB samples. Whole wheat bread quality was investigated by measuring specific volume, porosity, texture, aroma, and volatile compounds. The WWB made with WB_{Sac:Lac = 2:1} showed a higher specific volume, more uniform porosity structure, better texture, and more volatile compounds than the other samples.

CONCLUSION

Using a ratio of yeast and lactobacilli of 2:1, the solid-state fermentation maximally improves the processing properties of WB, and prepares WWB with the best quality. © 2021 Society of Chemical Industry.

Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity

COVID-19 pandemic continues to be a global health crisis. The gut microbiome critically affects the immune system, and some respiratory infections are associated with changes in the gut microbiome; here, we evaluated the role of nutritional and lifestyle habits that modulate gut microbiota on COVID-19 outcomes in a longitudinal cohort study that included 200 patients infected with COVID-19. Of these, 122 cases were mild and seventy-eight were moderate, according to WHO classification. After detailed explanation by a consultant in clinical nutrition, participants responded to a written questionnaire on daily sugar, prebiotic intake in food, sleeping hours, exercise duration and antibiotic prescription, during the past 1 year before infection. Daily consumption of prebiotic-containing foods, less sugar, regular exercise, adequate sleep and fewer antibiotic prescriptions led to a milder disease and rapid virus clearance. Additionally, data on these factors were compiled into a single score, the ESSAP score (Exercise, Sugar consumption, Sleeping hours, Antibiotics taken, and Prebiotics consumption; 0–11 points), median ESSAP score was 5 for both mild and moderate cases; however, the range was 4–8 in mild cases, but 1–6 in moderate (P = 0·001, OR: 4·2, 95 % CI 1·9, 9·1); our results showed a negative correlation between regular consumption of yogurt containing probiotics and disease severity (P = 0·007, OR: 1·6, 95 % CI 1·1, 2·1). Mild COVID-19 disease was associated with 10–20 min of daily exercise (P = 0·016), sleeping at least 8 h daily, prescribed antibiotics less than 5 times per year (P = 0·077) and ate plenty of prebiotic-containing food.

Comparative Study on Kernel Quality and Chemical Composition of Ancient and Modern Wheat Species: Einkorn, Emmer, Spelt and Hard Red Spring Wheat

Hulled wheat species are often used as whole grains in processing, and have been attracting attention in the last 20 years in the food industry. Whole wheat flour of hulled wheat can be used in the food industry for value addition. This study was conducted to evaluate the kernel quality and chemical composition of the whole grain flour of hulled wheats as a preliminary approach to use these species for value addition. The experimental design was separate, randomized complete block designs for einkorn, emmer, and spelt, with four field replicates. According to the results, significant differences (p < 0.05) were observed in kernel quality traits, such as test weight, 1000 kernel weight, and kernel hardness, compared to hard red spring wheat. The results of the chemical composition revealed that hulled wheats were characterized by significantly lower (p < 0.05) protein and higher (p < 0.05) crude fat contents compared to whole wheat flour of hard red spring wheat. Among hulled wheats, total dietary fiber content was highest in emmer, followed by einkorn and spelt. In conclusion, the whole wheat flour of einkorn, emmer, and spelt used in this study differ from hard red spring wheat in their kernel quality and chemical composition.

Whole-Grain Intake and Pancreatic Cancer Risk-The Danish, Diet, Cancer and Health Cohort

BACKGROUND

Pancreatic cancer is a highly deadly disease with a poor prognosis. There is limited knowledge about prevention of the disease; thus, identification of risk factors is important to reduce the disease incidence.

OBJECTIVE

The aim of the present study was to prospectively investigate associations between incidence of pancreatic cancer and whole-grain intake measured in 2 ways: as whole-grain product intake (g whole-grain products/d) and as whole-grain intake (grams of whole grains/d). Moreover, the intake of subgroups of these was also investigated: whole-grain products (rye bread, whole-grain bread, and oatmeal/muesli) and cereals (rye, wheat, and oats).

METHODS

In total, 55,995 Danish adults aged 50-64 y, of whom 446 developed pancreatic cancer (17.5 y mean follow-up), were included in the study. Detailed information on daily intake of whole-grain products was available from a validated self-administered FFQ, and intake of whole-grain cereals (wheat, rye, and oats) was estimated using information from a 24-h dietary recall. The association between the whole-grain exposures and incidence of pancreatic cancer was investigated by Cox regression analyses adjusted for potential confounders.

RESULTS

Total whole-grain product intake was associated with a 7% lower incidence of pancreatic cancer per serving (50 g/d) (HR: 0.93; 95% CI: 0.86, 1.00), and in the sex-specific analyses, an inverse association was found only in men. No association was found for total whole-grain intake (per 16-g serving size; HR: 0.96; 95% CI: 0.89, 1.03). When investigating specific whole-grain products and cereals individually, none were alone associated with lower incidence of pancreatic cancer.

CONCLUSION

Our findings indicate that intake of whole grains is associated with lower risk of pancreatic cancer in middle-aged men. Consuming ample amounts of whole grains may prove beneficial in terms of lowering pancreatic cancer risk.

Impact of a Fermented High-Fiber Rye Diet on Helicobacter pylori and Cardio-Metabolic Risk Factors: A Randomized Controlled Trial Among Helicobacter pylori-Positive Chinese Adults

Background: High dietary fiber intake has been associated with reduced risk of Helicobacter pylori infection and co-morbidities such as gastric cancer but also with reduced risk of cardiovascular disease. It has been suggested that fermented rye could affect Helicobacter pylori bacterial load and that high- fiber rye may be superior to wheat for improvement of several cardiometabolic risk factors, but few long-term interventions with high fiber rye foods have been conducted. Objective: To examine the effect of high-fiber wholegrain rye foods with added fermented rye bran vs. refined wheat on Helicobacter pylori infection and cardiometabolic risk markers in a Chinese population with a low habitual consumption of high fiber cereal foods. Design: A parallel dietary intervention was set up and 182 normal- or overweight men and women were randomized to consume wholegrain rye products containing fermented rye bran (FRB) or refined wheat (RW) for 12 weeks. Anthropometric measurements, fasting blood sample collection and ¹³C-urea breath test (¹³C-UBT) were performed at baseline and after 6 and 12 weeks of intervention as well as 12 weeks after the end of the intervention. Results: No difference between diets on Helicobacter pylori bacterial load measured by ¹³C-UBT breath test or in virulence factors of Helicobacter pylori in blood samples were found. Low density lipoprotein cholesterol (LDL-C) and high sensitivity C-reactive protein (hs-CRP) were significantly lower in the FRB group, compared to the RW group after 12 weeks of intervention. The intervention diets did not affect markers of glucose metabolism or insulin sensitivity. Conclusions: While the results of the present study did not support any effect of FRB on Helicobacter pylori bacterial load, beneficial effects on LDL-C and hs-CRP were clearly shown. This suggest that consumption of high fiber rye foods instead of refined wheat could be one strategy for primary prevention of cardiovascular disease. Clinical Trial Registration: The trial was registered at www.clinicaltrials.gov, Identifier: NCT03103386.

The Impact of Whole Grain Intake on Gastrointestinal Tumors: A Focus on Colorectal, Gastric, and Esophageal Cancers

Cereals are one of staple foods in human diet, mainly consumed as refined grains. Nonetheless, epidemiological data indicate that whole grain (WG) intake is inversely related to risk of type 2 diabetes, cardiovascular disease, and several cancer types, as well as to all-cause mortality. Particularly responsive to WG positive action is the gastrointestinal tract, daily exposed to bioactive food components. Herein, we shall provide an up-to-date overview on relationship between WG intake and prevention of gastrointestinal tumors, with a particular focus on colorectal, stomach, and esophagus cancers. Unlike refined counterparts, WG consumption is inversely associated with risk of these gastrointestinal cancers, most consistently with the risk of colorectal tumor. Some WG effects may be mediated by beneficial constituents (such as fiber and polyphenols) that are reduced/lost during milling process. Beside health-promoting action, WGs are still under-consumed in most countries; therefore, World Health Organization and other public/private stakeholders should cooperate to implement WG consumption in the whole population, in order to reach nutritionally effective intakes.

Fonio grains: Physicochemical properties, nutritional potential, and food applications

Fonio grains are a type of small-seeded cereals native to Western Africa and are important cereal crops for food security. The two species are white fonio (Digitaria exilis) (commonly called acha) and black fonio (Digitaria iburua) (commonly called iburu). As a novel food, fonio has attracted attention from other parts of the world due to their attractive nutritional properties (e.g., in whole grain form and being gluten free) and potential food applications. The information regarding the functional properties and applications of fonio is rather scattered. This review summarizes the chemical composition, physicochemical and nutritional properties, and diverse food applications of fonio. The nutritional composition and processing properties of fonio are similar to other cereals. Fonio has potential to be complementary to major cereals for diverse food uses. There are research opportunities to better explore fonio grains for value-added applications.

Cereal grain-based functional beverages: from cereal grain bioactive phytochemicals to beverage processing technologies, health benefits and product features

Increased consumer awareness of health and wellness has promoted a high demand for foods and beverages with functional and therapeutic properties. Cereals, apart from being important staple crops and primary sources of energy and nutrition, are replete with bioactive phytochemicals with health properties. Cereal grains contain a diverse range of bioactive phytochemicals including phenolic compounds, dietary fibers, carotenoids, tocols, phytosterols, γ-oryzanol, and phytic acid and therefore have great potential for processing into functional beverages. Although there are a variety of cereal grain-based beverages produced world-wide, very little scientific and technological attention has been paid to them. In this review, we have discussed cereal grain-based functional beverages based on 3 main categories: cereal grain-based milk alternatives, roasted cereal grain teas, fermented nonalcoholic cereal grain beverages. The processing techniques, health properties and product features of these beverages are elaborated, and the challenges and future perspectives are proposed. As the food market becomes increasingly diverse, cereal grain-based beverages could be a promising new category of health functional beverages in our daily life.

Grain and dietary fiber intake and bladder cancer risk: a pooled analysis of prospective cohort studies

BACKGROUND

Higher intakes of whole grains and dietary fiber have been associated with lower risk of insulin resistance, hyperinsulinemia, and inflammation, which are known predisposing factors for cancer.

OBJECTIVES

Because the evidence of association with bladder cancer (BC) is limited, we aimed to assess associations with BC risk for intakes of whole grains, refined grains, and dietary fiber.

METHODS

We pooled individual data from 574,726 participants in 13 cohort studies, 3214 of whom developed incident BC. HRs, with corresponding 95% CIs, were estimated using Cox regression models stratified on cohort. Dose-response relations were examined using fractional polynomial regression models.

RESULTS

We found that higher intake of total whole grain was associated with lower risk of BC (comparing highest with lowest intake tertile: HR: 0.87; 95% CI: 0.77, 0.98; HR per 1-SD increment: 0.95; 95% CI: 0.91, 0.99; P for trend: 0.023). No association was observed for intake of total refined grain. Intake of total dietary fiber was also inversely associated with BC risk (comparing highest with lowest intake tertile: HR: 0.86; 95% CI: 0.76, 0.98; HR per 1-SD increment: 0.91; 95% CI: 0.82, 0.98; P for trend: 0.021). In addition, dose-response analyses gave estimated HRs of 0.97 (95% CI: 0.95, 0.99) for intake of total whole grain and 0.96 (95% CI: 0.94, 0.98) for intake of total dietary fiber per 5-g daily increment. When considered jointly, highest intake of whole grains with the highest intake of dietary fiber showed 28% reduced risk (95% CI: 0.54, 0.93; P for trend: 0.031) of BC compared with the lowest intakes, suggesting potential synergism.

CONCLUSIONS

Higher intakes of total whole grain and total dietary fiber are associated with reduced risk of BC individually and jointly. Further studies are needed to clarify the underlying mechanisms for these findings.

Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review

Within epidemiological and intervention studies, whole grain consumption has generally shown positive associations with reductions in markers of overweight and obesity. However, studies use varied methods of determining whole grain intake, including different definitions of a whole grain food, which may explain varied results. This systematic review aimed to identify how different methods of reporting and calculating whole grain intake, including whole grain food definitions, affect reported associations between whole grain intake and body weight measures in adults. Systematic searching of PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register for Controlled Trials (CENTRAL), and MEDLINE (all years to 11 June, 2020) identified eligible studies. Cohort and cross-sectional studies assessing whole grain intake and body weight measures in adults were included. Studies that did not specify methods used to calculate whole grain intake were excluded. Twenty-one cross-sectional studies (from 24 articles) and 9 prospective cohort studies (from 7 articles) were included in the review. Many cross-sectional studies showed whole grain intake was, to some degree, significantly associated with body weight measures, whereas associations varied greatly among cohort studies. Studies calculating whole grain intake using total grams of intake, USDA databases, or ≥25% whole grain in combination with listing specific foods, showed consistent beneficial effects of increasing whole grain intake on body weight. Studies with general lists of foods included as "whole grain foods" or lower cut-offs for whole grain content were inconsistent. The majority of studies reported whole grain intake as servings/day or grams whole grain/day. This review suggests that an association between whole grain and body weight measures remains likely, although precise associations are difficult to determine due to heterogeneity in methodologies and an inability to formally compare studies. Moving forward, application of a standardized methodology to calculate whole grain intake is essential.

Consumption of whole grain food and its determinants in a general Italian population: Results from the INHES study

BACKGROUND AND AIMS

Whole grain (WG) food consumption is associated with lower risk of cardiovascular disease, cancer and neurological diseases. The aim of this study was to assess the consumption of WG food and its major demographic, socioeconomic, psychosocial and behavioral determinants in a general Italian population.

METHODS AND RESULTS

Data were from the Italian Nutrition & Health Survey (INHES), a telephone-based survey established in 2010-2013 including 9422 participants aged ≥5 years from all over Italy. WG food intake was assessed by the European Food Propensity Questionnaire and included bread, pasta, breakfast cereals, biscuits and WG soups. WG consumption was categorized as none, occasional (<1 time/week) and regular (≥1 time/week). Overall, 26.9% of the sample reported a regular consumption of WG food (27.2% of adults aged 20-97 y, and 21.9% of children/adolescents aged 5-19 y). In both age-groups, the major food source contributing to total WG intake was WG bread followed by WG pasta. Among adults, greater consumption of WG was associated with healthier lifestyle (e.g. sport activity), and higher educational level. Eating meals outside of the house in adults, and spending >2 h/day watching TV in children/adolescents were inversely associated with WG intake.

CONCLUSIONS

The percentage of WG consumers in Italy in 2010-2013 appears to be quite low and still below that recorded in other countries of Europe where consumption is frequently over 50 percent. WG consumption is likely to be influenced by socioeconomic status and is associated with a number of psychosocial factors, meal patterns and eating-related behaviors.

Dietary intake of fiber, whole grains and risk of colorectal cancer: An updated analysis according to food sources, tumor location and molecular subtypes in two large US cohorts

Epidemiologic evidence relating fiber intake to colorectal cancer (CRC) remains inconclusive and data are limited on different food sources of fiber and heterogeneity by tumor subsite and molecular profile. We prospectively followed for CRC incidence 90,869 women from the Nurses' Health Study (1980-2012) and 47,924 men from the Health Professionals Follow-up Study (1986-2012), who completed a validated food frequency questionnaire every 4 years. Cox proportional hazards regression was used to examine the associations with CRC risk for total, cereal, fruit and vegetable fiber and whole grains. We also assessed the associations according to tumor subsites (proximal colon, distal colon and rectum) and molecular markers (microsatellite instability, BRAF mutation, CpG island methylator phenotype and KRAS mutation). We documented 3,178 CRC cases during 3,685,903 person-years of follow-up in the NHS and HPFS. Intake of total dietary fiber was not associated with CRC risk after multivariable adjustment in either women (hazard ratio [HR] comparing extreme deciles, 1.17; 95% CI, 0.92-1.48, p_trend = 0.55) or men (HR, 0.90; 95% CI, 0.67-1.21, p_trend = 0.47). Higher intake of cereal fiber and whole grains was associated with lower CRC risk in men with an HR of 0.75 (95% CI, 0.57-1.00) and 0.72 (95% CI, 0.54-0.96), respectively. No heterogeneity was detected by tumor subsite or molecular markers (p_{heterogeneity}  > 0.05). Higher intake of total dietary fiber within the range of a typical American diet is unlikely to substantially reduce CRC risk. The potential benefit of cereal fiber and whole grains in men warrants further confirmation.

The Roles of Food Processing in Translation of Dietary Guidance for Whole Grains, Fruits, and Vegetables

The Dietary Guidelines for Americans (DGA) recommend the consumption of whole grains, fruits, and vegetables as part of a healthy diet. However, current consumption patterns suggest that most Americans are not meeting these recommendations. The challenge remains to align the DGA guidance with the food environment and consumers’ expectations for product quality, availability, and affordability. Currently, processed foods play an increasingly important role in American diets. Often characterized as unhealthy, processed foods are contributors to both food and nutritional security. When the alignment of processing strategies with DGA principles exists, achieving DGA goals is more likely, regardless of processing level. In this review, select processing strategies for whole grains, fruits, and vegetables are described to show how DGA principles can guide processing efforts to create healthier products. Although whole grains, supported by industry-wide innovation and guidance, have had some success with consumers, improving intake of fruit and vegetable products remains a challenge. Closing consumption gaps requires new innovations and products aligned with consumer preferences and DGA principles.

Dietary fiber sources and human benefits: The case study of cereal and pseudocereals

Dietary fiber (DF) includes the remnants of the edible part of plants and analogous carbohydrates that are resistant to digestion and absorption in the human small intestine with complete or partial fermentation in the human large intestine. DF can be classified into two main groups according to its solubility, namely insoluble dietary fiber (IDF) that mainly consists on cell wall components, including cellulose, some hemicelluloses, lignin and resistant starch, and soluble dietary fiber (SDF) that consists of non-cellulosic polysaccharides as non-digestible oligosaccharides, arabinoxylans (AX), β-glucans, some hemicelluloses, pectins, gums, mucilages and inulin. The intake of DF is associated with health benefits. IDF can contribute to the normal function of the intestinal tract and it has an important role in the prevention of colonic diverticulosis and constipation. SDF is extensively fermented by gut microbiota and it is associated with carbohydrate and lipid metabolism, with important health benefits due to its hypocholesterolemic properties. Due to these nutritional and health properties, DF is widely used as functional ingredients in food industry, being whole grain cereals, pulses, fruits and vegetables the main sources of DF. Also some synthetic sources are employed, namely polydextrose, hydroxypropyl methylcellulose or cyclodextrins. The DF content of cereals varies depending on cultivars, their botanical components (pericarp, emdosperm and germ) and the processing conditions they have undergone (baking, extrusion, etc.). In cereal grains, AX are the predominant non-cellulose DF polysaccharides followed by cellulose and β-glucans, while in pseudocereals, pectins are quantitatively predominant.

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.

Higher Whole-Grain Intake Is Associated with Lower Risk of Type 2 Diabetes among Middle-Aged Men and Women: The Danish Diet, Cancer, and Health Cohort

BACKGROUND

Type 2 diabetes is a major health concern worldwide. Whole grains and cereal fiber may offer protective effects on type 2 diabetes risk. However, few studies have been conducted in cohorts with detailed information on whole-grain cereal intakes and product types and with wide ranges of intake.

Objective

We investigated the associations between whole-grain intake, including intakes of different cereal types and products, and the risk of type 2 diabetes in a population with wide and diverse whole-grain intake.

Methods

We used data from the Danish Diet, Cancer, and Health cohort including 55,465 participants aged 50-65 y at baseline. Of these, 7417 participants were diagnosed with type 2 diabetes during follow-up (median: 15 y). Detailed information on the intake of whole-grain products was available from a food-frequency questionnaire, and total whole-grain intake and whole-grain cereal types (wheat, rye, oats) were calculated in grams per day. Associations were examined by using Cox proportional hazards models with adjustment for potential confounders.

Results

Whole-grain intake was associated with an 11% and 7% lower risk of type 2 diabetes per whole-grain serving (16 g) per day for men and women, respectively [HR (95% CI)-men: 0.89 (0.87, 0.91); women: 0.93 (0.91, 0.96)]. For men, the intake of all whole-grain cereal types investigated (wheat, rye, oats) was significantly associated with a lower risk of type 2 diabetes, but only wheat and oats intake was significantly associated for women. Among the different whole-grain products, rye bread, whole-grain bread, and oatmeal/muesli were significantly associated with a lower risk of type 2 diabetes for both men and women.

Conclusions

In this cohort study, we found consistent associations between high whole-grain intake and lower risk of type 2 diabetes. Overall, an association was found for all different cereals and whole-grain products tested.

Evaluating Whole Grain Intervention Study Designs and Reporting Practices Using Evidence Mapping Methodology

Consumption of whole grains have been associated with reduced risk of chronic diseases in many observational studies; yet, results of intervention studies are mixed. We aimed to use evidence mapping to capture the methodological and reporting variability in whole grain intervention studies that may contribute to this inconsistency. We conducted a reproducible search in OVID Medline for whole grain human intervention studies (published 1946 to February 2018). After screening based on a priori criteria, we identified 202 publications describing a total of 213 unique trials. Over half (55%) were acute trials, lasting ≤1 day, 30% were moderate duration studies (up to 6 weeks) and 15% were of longer duration (more than 6 weeks). The majority of acute trials (75%) examined measures of glycaemia and/or insulinemia, while most of the longer trials included measures of cardiometabolic health (71%), appetite/satiety (57%) and weight/adiposity (56%). Among the moderate and long duration trials, there was a wide range of how whole grains were described but only 10 publications referenced an established definition. Only 55% of trials reported the actual amount of whole grains (in grams or servings), while 36% reported the amount of food/product and 9% did not report a dose at all. Of the interventions that provided a mixture of whole grains, less than half (46%) reported the distribution of the different grain types. Reporting of subject compliance also varied and only 22% used independent biomarkers of whole grain intake. This evidence map highlights the need to standardize both study protocols and reporting practices to support effective synthesis of study results and provide a stronger foundation to better inform nutrition scientists and public health policy.

Impact of sourdough fermentation on appetite and postprandial metabolic responses - a randomised cross-over trial with whole grain rye crispbread

Sourdough fermentation is considered to have beneficial effects on postprandial satiety and metabolic responses, but studies demonstrating effects at physiological conditions are lacking. The aim of this acute breakfast intervention study was to determine the effect of consumption of sourdough-fermented and unfermented rye crispbread on self-rated appetite, postprandial glucose and insulin response in healthy subjects. In all, twenty-four Swedish adults were included in a single-blinded, randomised cross-over trial. Three crispbreads (sourdough-fermented and unfermented whole grain rye and yeast-fermented refined wheat as control) were consumed as part of a standardised breakfast. Subjective appetite score, assessed using visual analogue scale, and plasma glucose and insulin concentrations were measured at baseline and postprandially until 360 and 240 min, respectively. Structural changes and viscosity during mastication and gastric digestion were investigated using in vitro methods. Hunger and desire to eat were lower (P<0·05) based on AUC measurements after intake of sourdough-fermented rye crispbread compared with after intake of yeast-fermented refined wheat crispbread. On the basis of AUC (0-230 min), insulin response was lowest after intake of unfermented rye crispbread compared with sourdough-fermented rye and yeast-fermented refined wheat crispbread. Degradation of viscous fibres and faster bolus disintegration for the sourdough-fermented bread may partly explain the less favourable metabolic responses compared with unfermented bread. Our results showed that food processing affects the composition and structural characteristics of rye bread, which has implications for appetite and metabolic responses.

Whole Grain Consumption and Risk of Ischemic Stroke: Results From 2 Prospective Cohort Studies

BACKGROUND AND PURPOSE

Higher intake of whole grains may exert cardiometabolic benefits, although findings on stroke risk are inconclusive. The potentially differential effects of individual whole grain foods on ischemic stroke have not been examined.

METHODS

We analyzed whole grain consumption in relation to ischemic stroke among 71 750 women from the Nurses' Health Study and 42 823 men from the Health Professionals Follow-up Study who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline (1984 and 1986, respectively) through 2010 using a Cox proportional hazards model. Validated semiquantitative food frequency questionnaires were used to assess consumption of whole grain intake, including whole grain cold breakfast cereal, dark bread, oatmeal, brown rice, popcorn, bran, and germ. Self-reported incident cases of ischemic stroke were confirmed through medical record review.

RESULTS

During 2 820 128 person-years of follow-up in the 2 cohorts, 2458 cases of ischemic stroke were identified and confirmed. Intake of total whole grains was not associated with risk of ischemic stroke after adjustment for covariates: the pooled hazard ratio (95% confidence interval) comparing extreme intake levels was 1.04 (0.91-1.19). However, intake of whole grain cold breakfast cereal and total bran was inversely associated with ischemic stroke after multivariate adjustment: the pooled hazard ratios (95% confidence intervals) were 0.88 (0.80-0.96; P_trend=0.008) and 0.89 (0.79-1.00; P_trend=0.004), respectively. Other whole grain foods were not associated with a lower risk of ischemic stroke.

CONCLUSIONS

Although overall consumption of whole grains was not associated with lower risk of ischemic stroke, greater consumption of whole grain cold breakfast cereal and bran was significantly associated with a lower risk of ischemic stroke. More studies are needed to replicate these associations between individual whole grain foods and risk of ischemic stroke among other populations.

Whole-Grain Rye and Wheat Affect Some Markers of Gut Health without Altering the Fecal Microbiota in Healthy Overweight Adults: A 6-Week Randomized Trial

Background: Whole grains have shown potential for improving gut health, but evidence comparing different whole-grain types is lacking.Objective: We investigated whether whole-grain wheat (WGW) and whole-grain rye (WGR) improve gut health in different ways compared to refined wheat (RW), with the primary outcomes of microbiota composition and gastrointestinal (GI) symptoms.Methods: In a randomized parallel trial, 70 healthy adults (in means ± SDs; aged 51.0 ± 9.4 y, body mass index [BMI (in kg/m²)] 27.8 ± 1.9, 32:38 men:women) replaced cereal foods from their habitual diet with WGR, WGW, or RW (control). Before and after a 6-wk intervention, a spot stool sample was collected and analyzed for short-chain fatty acids and microbiota composition through the use of 16S ribosomal RNA gene-targeted high-throughput amplicon sequencing. GI symptoms and stool regularity were evaluated by questionnaires at baseline and after weeks 2, 4, and 6.Results: Intakes of whole grains were 145.2 ± 75.9, 124.2 ± 57.3, and 5.4 ± 3.2 g/d in the WGW, WGR, and RW groups, respectively. Gut microbiota composition was not affected by diet. The relative change in fecal butyrate decreased in the RW (-38%) group compared to the WGW (25%, P = 0.014) and WGR groups (-1%, P = 0.037). Other short-chain fatty acids were unaffected. Flatulence was more frequent following intake of WGW (OR: 2.06, 95% CI: 1.03, 4.17) and WGR (OR: 2.62, 95% CI: 1.35, 5.22) compared to RW, whereas bloating was less frequent following WGW (OR: 0.38, 95% CI: 0.18, 0.80) and WGR (OR: 0.34, 95% CI: 0.16, 0.72). Stool frequency increased following WGR but not WGW, compared to RW in weeks 2 (0.4 defecations/d, P = 0.049) and 4 (0.5 defecations/d, P = 0.043), but not in week 6. The WGW and WGR groups did not differ from each other in any of the variables tested.Conclusion: Regular consumption of WGR and WGW affected fecal butyrate concentration and gastrointestinal symptoms in healthy overweight adults, supporting the hypothesis that WGR and WGW can be included in the diet equally to maintain gut health. This trial was registered at clinicaltrials.gov as NCT02358122.

Perspective: A Definition for Whole-Grain Food Products-Recommendations from the Healthgrain Forum

Whole grains are a key component of a healthy diet, and enabling consumers to easily choose foods with a high whole-grain content is an important step for better prevention of chronic disease. Several definitions exist for whole-grain foods, yet these do not account for the diversity of food products that contain cereals. With the goal of creating a relatively simple whole-grain food definition that aligns with whole-grain intake recommendations and can be applied across all product categories, the Healthgrain Forum, a not-for-profit consortium of academics and industry working with cereal foods, established a working group to gather input from academics and industry to develop guidance on labeling the whole-grain content of foods. The Healthgrain Forum recommends that a food may be labeled as "whole grain" if it contains ≥30% whole-grain ingredients in the overall product and contains more whole grain than refined grain ingredients, both on a dry-weight basis. For the purposes of calculation, added bran and germ are not considered refined-grain ingredients. Additional recommendations are also made on labeling whole-grain content in mixed-cereal foods, such as pizza and ready meals, and a need to meet healthy nutrition criteria. This definition allows easy comparison across product categories because it is based on dry weight and strongly encourages a move from generic whole-grain labels to reporting the actual percentage of whole grain in a product. Although this definition is for guidance only, we hope that it will encourage more countries to adopt regulation around the labeling of whole grains and stimulate greater awareness and consumption of whole grains in the general population.

Effects of whole grain rye, with and without resistant starch type 2 supplementation, on glucose tolerance, gut hormones, inflammation and appetite regulation in an 11-14.5 hour perspective; a randomized controlled study in healthy subjects

BACKGROUND

The prevalence of obesity is increasing worldwide and prevention is needed. Whole grain has shown potential to lower the risk of obesity, cardiovascular disease and type 2 diabetes. One possible mechanism behind the benefits of whole grain is the gut fermentation of dietary fiber (DF), e.g. non-starch polysaccharides and resistant starch (RS), in whole grain. The purpose of the study is to investigate the effect of whole grain rye-based products on glucose- and appetite regulation.

METHOD

Twenty-one healthy subjects were provided four rye-based evening test meals in a crossover overnight study design. The test evening meals consisted of either whole grain rye flour bread (RFB) or a 1:1 ratio of whole grain rye flour and rye kernels bread (RFB/RKB), with or without added resistant starch (+RS). White wheat flour bread (WWB) was used as reference evening meal. Blood glucose, insulin, PYY, FFA, IL-6 as well as breath H₂ and subjective rating of appetite were measured the following morning at fasting and repeatedly up to 3.5 h after a standardized breakfast consisting of WWB. Ad libitum energy intake was determined at lunch, 14.5 h after evening test and reference meals, respectively.

RESULTS

The evening meal with RFB/RKB + RS decreased postprandial glucose- and insulin responses (iAUC) (P < 0.05) and increased the gut hormone PYY in plasma the following morning 0-120 min after the standardized breakfast, compared to WWB (P = 0.01). Moreover, RFB increased subjective satiety and decreased desire to eat, and both RFB and RFB/RKB decreased feeling of hunger (AUC 0-210 min). All rye-based evening meals decreased or tended to decrease fasting FFA (P < 0.05, RFB/RKB: P = 0.057) and increased breath hydrogen concentration (0-120 min, P < 0.001). No effects were noted on energy intake at lunch or inflammatory marker IL-6 (0 + 180 min) after the rye-based evening meals, compared to WWB.

CONCLUSION

Whole grain rye bread has the potential to improve cardiometabolic variables in an 11-14.5 h perspective in healthy humans. The combination RFB/RKB + RS positively affected biomarkers of glucose- and appetite regulation in a semi-acute perspective. Meanwhile, RFB and RFB/RKB improved subjective appetite ratings. The effects probably emanate from gut fermentation events.

TRIAL REGISTRATION

The study was registered at: ClinicalTrials.gov, register number NCT02347293 ( www.clinicaltrials.gov/ct2/show/NCT02347293 ). Registered 15 January 2015.

Wholegrain rye, but not wholegrain wheat, lowers body weight and fat mass compared with refined wheat: a 6-week randomized study

BACKGROUND

Observational studies suggest inverse associations between wholegrain intake and body weight gain. Only few controlled intervention studies have supported this association and few compare effects of different grain varieties.

OBJECTIVE

To investigate how wholegrain wheat (WGW) and rye compared with refined wheat (RW) affect body weight and composition and appetite sensation.

DESIGN

Seventy overweight/obese adults participated in this 6-week randomized parallel study, in which they replaced their habitual cereal foods with RW, WGW or wholegrain rye (WGR). Further, a 4 h postprandial test meal challenge was completed with meals corresponding to diet allocation in the beginning and after the intervention. Body weight and composition, fasted blood samples, compliance and 4-day dietary intake were obtained before and after the intervention period. Appetite and breath hydrogen excretion was assessed during the postprandial test meal challenge.

RESULTS

Diet allocation affected body weight significantly (P=0.013) and tended also to affect fat mass (P=0.065). Both body weight and fat mass decreased more in the WGR group (-1.06±1.60 and -0.75±1.29 kg, respectively) compared with the RW group (+0.15±1.28 and -0.04±0.82 kg, respectively; P<0.01 and P<0.05, respectively). Further, the decrease in fat mass in the WGR group tended to exceed that in the WGW group (P=0.07). Overall, no effect of diet on appetite sensation was observed; however, energy intake from study products was ~200 kcal lower in the WGR group when compared with that in the RW group (P<0.05), although total energy intake did not differ between groups.

CONCLUSIONS

Our results support a role for WGR foods in body weight regulation, when provided ad libitum. The effect may be mediated by satiation reflected in a reduction in energy intake, mainly from the wholegrain products without compensation in other parts of the diets, despite no difference in appetite.

Bioactive phytochemicals in barley

Epidemiological studies have consistently shown that regular consumption of whole grain barley reduces the risk of developing chronic diseases. The presence of barley fiber, especially β-glucan in whole grain barley, has been largely credited for these health benefits. However, it is now widely believed that the actions of the fiber component alone do not explain the observed health benefits associated with the consumption of whole grain barley. Whole grain barley also contains phytochemicals including phenolic acids, flavonoids, lignans, tocols, phytosterols, and folate. These phytochemicals exhibit strong anti-oxidant, antiproliferative, and cholesterol lowering abilities, which are potentially useful in lowering the risk of certain diseases. Therefore, the high concentration of phytochemicals in barley may be largely responsible for its health benefits. This paper reviews available information regarding barley phytochemicals and their potential to combat common nutrition-related diseases including cancer, cardiovascular disease, diabetes, and obesity.

Mineral Nutritional Yield and Nutrient Density of Locally Adapted Wheat Genotypes under Organic Production

The aim of the present investigation was to investigate the nutritional yield, nutrient density, stability, and adaptability of organically produced wheat for sustainable and nutritional high value food production. This study evaluated the nutritional yield of four minerals (Fe, Zn, Cu, and Mg) in 19 wheat genotypes, selected as being locally adapted under organic agriculture conditions. The new metric of nutritional yield was calculated for each genotype and they were evaluated for stability using the Additive Main effects and Multiplicative Interaction (AMMI) stability analysis and for genotypic value, stability, and adaptability using the Best Linear Unbiased Prediction (BLUP procedure). The results indicated that there were genotypes suitable for production under organic agriculture conditions with satisfactory yields (>4000 kg·ha⁻¹). Furthermore, these genotypes showed high nutritional yield and nutrient density for the four minerals studied. Additionally, since these genotypes were stable and adaptable over three environmentally different years, they were designated “balanced genotypes” for the four minerals and for the aforementioned characteristics. Selection and breeding of such “balanced genotypes” may offer an alternative to producing nutritious food under low-input agriculture conditions. Furthermore, the type of evaluation presented here may also be of interest for implementation in research conducted in developing countries, following the objectives of producing enough nutrients for a growing population.