Objective: To review evidence relating to the consumption of whole grains and healthy body weight (BW). Design: Systematic review and analysis of observational studies reporting wholegrain consumption and measures of BW and adiposity, including the effect on macronutrient intakes and lifestyle factors. Setting: Medline and other databases were searched for the period 1990 to 2006 to produce a full reference list; observational studies were retained for further analysis if they included an appropriate control group and reported whole-grain intake and body mass index (BMI) or a measure of adiposity. Subjects: Fifteen trials were identified which included data from 119 829 male and female subjects aged 13 years and over. Results: The combined and weighted mean difference in BMI from 15 studies representing 20 treatment groups (n 5 119 829) using a random-effects model was 0Á630 kg/m 2 lower when high versus low whole-grain intake was compared, P , 0Á0001 (95 % confidence interval (CI) 0Á460, 0Á800 kg/m 2 ). In high consumers, adiposity assessed as waist circumference was reduced by 2Á7 (95 % CI 0Á2, 5Á2) cm, P 5 0Á03 (six data sets, n 5 4178) or as waist:hip ratio by 0Á023 (95 % CI 0Á016, 0Á030), P , 0.0001 (four data sets, n 5 20 147). Higher intake of whole grains led to increased dietary fibre intake (9 g, P , 0Á01), while total and saturated fat intakes decreased by 11 g and 3Á9 g, respectively. Conclusion: A higher intake of whole grains (about three servings per day) was associated with lower BMI and central adiposity. In addition, people who consume more whole grains are likely to have a healthier lifestyle as fewer of them smoke, they exercise more frequently and they tend to have lower fat and higher fibre intakes. Keywords Whole grains Healthy weight Body mass index AdiposityThe challenge of obesity to the health of Western society has been clearly identified by the World Health Organization (WHO) (1) , which also recognises that maintenance of a healthy weight is in itself as large a challenge as obesity. In the UK, the Department of Health's publication, Choosing Health: Making Healthy Choices Easier, aimed to improve the understanding of the increasing rise in the overweight and obese population in the UK and from this numerous strategies and networks are being developed to reduce the prevalence of an obese population (2) . Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children was published by the National Institute for Clinical Excellence (NICE) in December 2006. The first two NICE dietary guidelines for healthy weight maintenance recommend (3) :> Base meals on starchy foods such as potatoes, bread, rice and pasta, choosing whole grains wherever possible;> Eat plenty of fibre-rich foods -such as oats, beans, peas, lentils, grains, seeds, fruit and vegetables, as well as whole-grain bread and brown rice and pasta.The recent Dietary Guidelines for Americans (4) state that 3 or more ounce equivalents of whole-grain products should b...
Chronic multifactorial diet related diseases are the major causes of death and illness worldwide. The amount and composition of fat in the diet is an important determinant of the pathobiology of many of these conditions. In the current review the associations between dietary fat and disease risk will be considered. Mean population fat intakes will be compared with dietary recommendations aimed at reducing the population burden of disease and the main sources of fat in the adult and childhood diet will be given. An assessment will be made of the principal vegetable oil sources used in the manufacture of processed foods, in particular fried foods, with particular reference to the rheological and nutritional justification for their use. The impact of the more widespread use of alternative oil sources with improved fatty acid profiles, on the fat composition of fried foods and the overall diet will be presented, demonstrating that such apparently focussed approaches could potentially result in a significant impact on population fat intake and potentially overall chronic disease burden.
By using data from the National Diet and Nutrition Survey (NDNS) rolling programme, the objective was to determine the extent to which consumers meet the nutrition guidelines implicit in the eatwell plate; to profile those eating healthily and gain insight on how they achieved the recommendations and whether in doing so, their eating pattern was also potentially more sustainable.Only 4% of adults simultaneously met five targets related to fat, saturated fatty acids (SFA), 5 A DAY fruit and vegetables, fibre (non-starch polysaccharide; NSP) and protein intake and, with the exception of target protein intake, the majority of people (51%) achieved none of the guidelines. The addition of the oil-rich fish recommendation reduces those meeting all six targets to 1%. Just 12% of the population (n = 94) met the three targets for fat, SFA and fruit and vegetable intake. These were designated achievers, who tended to be older by 5 years and to have a degree (P < 0.05), while non-achievers were more likely to smoke (P < 0.05). Energy intakes were slightly lower in achievers (non-significant), who had significantly lower fat and SFA intakes and higher intakes of protein. Intakes of NSP were significantly higher among achievers, who on average met the dietary reference value for NSP. The main NDNS food groups with a significantly higher intake in achievers were skimmed milks, chicken and turkey dishes, white fish (not fried) and shellfish and wholemeal breads, while non-achievers consumed more coated chicken, meat pies and pastries, cheese, whole milks and white bread. It appears that the achievers have reduced the fat content of their diet by focussing on lower fat/higher fibre alternatives within the same category of foods rather than introducing more plant foods such as legumes, nuts and seeds.There is growing interest in the future sustainability of current dietary patterns in light of expected climate change and an expanding global population. Although only one facet of a very complex picture, plant foods are typically associated with fewer greenhouse gas (GHG) emissions than those of animal origin. On this limited basis, achievers were not necessarily eating more sustainably. It is suggested, by reference to literature values (primarily for potential GHG emissions of food production), that with some rebalancing and through the inclusion in current UK dietary patterns of more plant foods, particularly more plant proteins and starchy foods, the existing eatwell plate could not only provide the basis of a cost-effective healthy diet, but also a potentially more sustainable one too. However, in order to meet these joint objectives, improved consumer understanding and practical advice on how to use the eatwell plate in this way is clearly required.
Reducing elevated LDL-cholesterol is a key public health challenge. There is substantial evidence from randomised controlled trials (RCT) that a number of foods and food components can significantly reduce LDL-cholesterol. Data from RCT have been reviewed to determine whether effects are additive when two or more of these components are consumed together. Typically components, such as plant stanols and sterols, soya protein, b-glucans and tree nuts, when consumed individually at their target rate, reduce LDL-cholesterol by 3 -9 %. Improved dietary fat quality, achieved by replacing SFA with unsaturated fat, reduces LDL-cholesterol and can increase HDL-cholesterol, further improving blood lipid profile. It appears that the effect of combining these interventions is largely additive; however, compliance with multiple changes may reduce over time. Food combinations used in ten 'portfolio diet' studies have been reviewed. In clinical efficacy studies of about 1 month where all foods were provided, LDL-cholesterol is reduced by 22-30 %, whereas in community-based studies of .6 months' duration, where dietary advice is the basis of the intervention, reduction in LDL-cholesterol is about 15 %. Inclusion of MUFA into 'portfolio diets' increases HDL-cholesterol, in addition to LDL-cholesterol effects. Compliance with some of these dietary changes can be achieved more easily compared with others. By careful food component selection, appropriate to the individual, the effect of including only two components in the diet with good compliance could be a sustainable 10 % reduction in LDL-cholesterol; this is sufficient to make a substantial impact on cholesterol management and reduce the need for pharmaceutical intervention.
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