Objectives Challenges in estimating total whole grain intake have led to the use of surrogate estimates, of which accuracy has not been assessed. We examined the suitability of five potential surrogates (dietary fiber; bread; rye bread; rye, oat and barley combined; rye) and a whole grain food definition to measure total whole grain intake in the Finnish adult population. Methods Our data comprised 5094 Finnish adults participating in the national FinHealth 2017 Study. Dietary intake was assessed by a validated FFQ. Food and nutrient intakes, including total whole grain, were calculated utilizing the Finnish Food Composition Database. The Healthgrain Forum whole grain food definition was applied to examine definition-based whole grain intake. Spearman correlations and quintile cross-classifications were calculated. Results Definition-based whole grain intake and consumption of rye, oat and barley combined had consistently the strongest correspondence with total whole grain intake. Rye and rye bread consumption also corresponded well with total whole grain intake. The correspondences of dietary fiber and bread with total whole grain were lower and more affected by the exclusion of energy under-reporters. Furthermore, their correlations with total whole grain intake varied the most between population subgroups. Conclusions Rye-based estimates, especially rye, oat and barley combined, and definition-based whole grain intake appeared suitable surrogate estimates of total whole grain intake for epidemiological research of Finnish adults. The variation between surrogate estimates in their correspondence with total whole grain intake demonstrated the need for further evaluation of their accuracy in different populations and regarding specific health outcomes.

Background The role of carbohydrate quantity and quality in weight gain remains unsolved, and research on carbohydrate subcategories is scarce. We examined total carbohydrates, dietary fiber, total sugar, and sucrose intake in relation to the risk of weight gain in Finnish adults. Methods Our data comprised 8327 adults aged 25−70 years in three population-based prospective cohorts. Diet was assessed by a validated food frequency questionnaire and nutrient intakes were calculated utilizing the Finnish Food Composition Database. Anthropometric measurements were collected according to standard protocols. Two-staged pooling was applied to derive relative risks across cohorts for weight gain of at least 5% by exposure variable intake quintiles in a 7-year follow-up. Linear trends were examined based on a Wald test. Results No association was observed between intakes of total carbohydrate, dietary fiber, total sugar or sucrose and the risk of weight gain of at least 5%. Yet, total sugar intake had a borderline protective association with the risk of weight gain in participants with obesity (RR 0.63; 95% CI 0.40−1.00 for highest vs. lowest quintile) and sucrose intake in participants with ≥10% decrease in carbohydrate intake during the follow-up (RR 0.78; 95% CI 0.61−1.00) after adjustments for sex, age, baseline weight, education, smoking, physical activity, and energy intake. Further adjustment for fruit consumption strengthened the associations. Conclusions Our findings do not support an association between carbohydrate intake and weight gain. However, the results suggested that concurrent changes in carbohydrate intake might be an important determinant of weight change and should be further examined in future studies.

Added sugar intake has been associated with several health issues, but few studies have examined its association with overall diet quality. We aimed at examining the association between added sugar intake and overall diet quality in Finnish adults. Associations between added sugar intake and sociodemographic factors, lifestyle factors, and BMI were also explored. Our data comprised 5094 adults residing in Finland who participated in the National FinHealth 2017 Study. Dietary intake was assessed by a validated food frequency questionnaire. Food consumption and nutrient intakes were calculated using the Finnish national food composition database. Added sugar intake was estimated based on food categorization and identifying naturally occurring sugar sources. Overall diet quality was assessed by the modified Baltic Sea Diet Score. The average added sugar intake was 7.6E% in women and 8.3E% in men in this study population. Added sugar intake was inversely associated with education (P=0.03 women; P=0.001 men), physical activity (P<0.0001), and BMI in men (P=0.003), and directly with smoking (P=0.002 women; P<0.0001 men). Added sugar intake was inversely associated with overall diet quality in both sexes (P<0.0001). No interactions were found except for men’s physical activity subgroups, the inverse association being stronger among active men than moderately active or inactive men (P for interaction=0.005). Our findings suggest that high added sugar intake is associated with several unhealthy dietary and lifestyle habits, including poor-quality diets, smoking, and leisure-time inactivity in Finnish adults. Efforts to improve diet quality should consider added sugar intake equally in the whole population.

Background and objectives Whole grains have been deemed a core component in diets promoting human health and environmental sustainability. Yet, research is scarce on whole grain intake in relation to overall diet quality and diet sustainability. We aimed to examine the association of whole grain intake with overall diet quality and key components of sustainable diets (fruits, vegetables, legumes, red and processed meat, plant-based and animal-based proteins) in Finnish adults. Methods Our data comprised 3127 adults (58% women, energy underreporters excluded) aged 18 − 74 years participating in the population-based FinHealth 2017 Study. Dietary intake was assessed by a validated 134-item food frequency questionnaire. Food, nutrient, energy and whole grain intakes were calculated utilizing the Finnish Food Composition Database. Overall diet quality was examined by the modified Baltic Sea Diet Score (excluding cereals). Associations were assessed by linear regression analysis adjusted for relevant confounders. Results Whole grain intake was positively associated with overall diet quality and fruit consumption (p &lt; 0.001) in women and men. A positive association also occurred with plant-based protein intake (p &lt; 0.001, women and men). Yet, whole grain intake was inversely associated with legume consumption in women (p = 0.001), while no association was found in men (p &gt; 0.05). The association between whole grain intake and the intake of animal-based proteins and red and processed meat was inverse (p &lt; 0.001) in both sexes. No association was found between whole grain and vegetable intakes (p &gt; 0.05). Conclusions Our results suggest that whole grain intake is associated with healthier diets and more sustainable protein intake in Finnish adults. However, challenges in furthering healthy and sustainable diets in the population may occur regarding legume consumption. Legumes are especially important in plant-based diets as they complement cereals as a source of essential amino acids. Key messages • Higher whole grain intake may indicate higher overall diet quality and more sustainable protein intake in Finnish adults. • Legume consumption requires further attention among Finnish adults with high whole grain intake despite their generally higher overall diet quality and more sustainable protein intake.