Defining whole-grain foods – does it change estimations of intakes and associations with CVD risk factors: an Australian and Swedish perspective

Abstract

Historically, there are inconsistencies in the calculation of whole-grain intake, particularly through use of highly variable whole-grain food definitions. The current study aimed to determine the impact of using a whole-grain food definition on whole-grain intake estimation in Australian and Swedish national cohorts; and investigate impacts on apparent associations with CVD risk factors. This utilised the Australian National Nutrition and Physical Activity Survey 2011-12, the Swedish Riksmaten adults 2010-11, and relevant food composition databases. Whole-grain intakes and associations with CVD risk factors were determined based on consumption of foods complying with the Healthgrain definition (≥30% whole grain (dry weight), more whole than refined grain and meeting accepted standards for ‘healthy foods’ based on local regulations), and compared to absolute whole-grain intake. Compliance of whole-grain containing foods with the Healthgrain definition were low in both Sweden (29 of 155 foods) and Australia (214 of 609 foods). Significant mean differences of up to 24.6g/10MJ/day of whole-grain intake were highlighted using Swedish data. Despite these large differences, application of a whole-grain food definition altered very few associations with CVD risk factors. Specifically, changes with body weight and blood glucose associations in Australian adults where a whole-grain food definition was applied, and some anthropometric measures in Swedish data where a high percentage of whole-grain content was included. Use of whole-grain food definitions appear to have limited impact on measuring whole-grain health benefits but may have greater relevance in public health messaging.

A New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report

“…Whole grain content is calculated per dry weight, following prior studies [ 20 , 21 ]. Most RTE cereals score a whole grain point for having ≥25% whole grains, as do about half of breads, cooked cereals, crackers, and savory snacks ( Table 3 ).…”

“…Similar median splits are used in metrics of adherence to Mediterranean diets, allowing for maximum discriminating power [ 20 ]. The whole grain cutoff of ≥25% whole grain dry weight is based on past studies that awarded a passing score to foods containing ≥25% whole grain on a dry-weight basis [ 21 , 22 ]. Current US regulations state that foods containing at least 25% whole grain on a dry-weight basis may make a front-of-pack claim.…”

The relation of whole grain surrogate estimates and food definition to total whole grain intake in the Finnish adult population

“…With a 25% cut-off, the underestimation was up to 10%. Moreover, when the Healthgrain Forum whole grain food definition was applied in the Australian (n = 12 153, aged ≥ 2 years) and Swedish (n = 1797, aged 18-80 years) populations, significantly smaller whole grain intakes were detected compared to total whole grain intake [21,34].…”

Multiple Metrics of Carbohydrate Quality Place Starchy Vegetables Alongside Non-starchy Vegetables, Legumes, and Whole Fruit

“…Whole grain content of foods was obtained from the FPEDs database and converted to g/100 g ( 15 , 16 ). Following past work, whole grain CF were identified as those foods that contained > 25% whole grain by dry weight ( 15 , 16 ). Current US regulations state that foods containing at least 25% whole grain by dry weight may make a front of pack claim.…”

“…Non-starchy vegetables, legumes and fruits were identified using WWEIA classification codes. Whole grain content of foods was obtained from the FPEDs database and converted to g/100 g ( 15 , 16 ). Following past work, whole grain CF were identified as those foods that contained > 25% whole grain by dry weight ( 15 , 16 ).…”