The need for a standard definition for whole-grain foods is evidenced by the fact that: whole-grain foods are not consistently defined,. The roundtable experts agreed to assess 4 criteria for the establishment of a whole-grain food definition: scientific basis rationale , food formulation feasibility , consumer acceptance, and ease of label education application.
Standardizing a definition for whole-grain foods would encourage manufacturers and governmental and regulatory authorities to develop and label foods with meaningful amounts of whole grain, provide researchers with a consistent approach to quantify whole-grain intake, and help advance science related to the effects of whole grain on health outcomes.
The current lack of a clear definition for whole-grain foods may be contributing to the widespread failure of consumers to meet current whole-grain dietary recommendations. A call to action to develop a definition for whole-grain foods that could be universally accepted and applied to dietary recommendations and planning was issued by the U.
Clear definitions would also help consumers identify foods that can help them meet the Dietary Guidelines recommendation 2. The purpose of the meeting was to discuss and agree upon a definition for a whole-grain food that could be used both in the United States and internationally.
The roundtable, jointly sponsored by the General Mills Bell Institute of Health and Nutrition United States and Cereal Partners Worldwide Switzerland , hosted experts from the United States and Europe in multiple disciplines, including epidemiology, public health nutrition, dietetics, clinical medicine, consumer education, policy and law, food science, and technology, including grain food processing.
The panel of experts recognized that establishing a whole-grain food definition is critical to move the field forward, not only to improve dietary guidance but to provide a standard for the food industry to translate dietary recommendations for consumers. The primary objectives of the Whole Grain Roundtable were to: 1 present and discuss relevant scientific evidence to confirm that the benefits of whole grain are attributable to many of its components; and 2 review relevant evidence and develop a standard definition for whole-grain foods.
Although this is not a comprehensive review of the whole-grain science literature, the expert panel at the roundtable engaged in a review of the evidence relevant to the objectives. The evidence linking whole-grain intake to reduced risk of cardiovascular disease CVD , diabetes, and excess weight is briefly summarized in Table 1. Consumption of whole grains also has been associated with greater nutrient intakes and enhanced diet quality 3 — 6.
Summary of the potential whole-grain health benefits evidence 1 , 2. Conclusions are drawn from a series of meta-analyses and critical systematic reviews of whole grains in relation to health outcomes.
Findings from large, population-based, prospective, observational studies have consistently observed a dose-response relation between whole-grain intake and disease risk, with health benefits proportional to the amount of whole grain consumed 7 — Generally, the current evidence shows that consuming between 3 and 5 servings of whole grains per day reduce not only the risk of ischemic heart disease and CVD events but also risk factors associated with CVD 15 , 18 — Potential mechanisms for whole grain health benefits include aiding in the maintenance of glucose and insulin homeostasis, lowering of serum cholesterol and LDL-cholesterol concentrations, and reducing inflammation and oxidative stress 7.
These observational data have been supported to some extent by small-scale intervention studies of at-risk populations, i.
In addition, there may be as-yet—unidentified genetic and other lifestyle influences that interact with the inclusion of whole grains in the diet as well as inherent metabolic differences among populations and between men and women that affect study outcomes.
Another factor contributing to inconsistent findings is that the diets of free-living populations typically contain a variety of grains, with different phytonutrients e. Interactions among these whole grain co-passengers may contribute to the observed differences in health benefits, but because they exist together as part of the whole-grain package, delineating which compound s is are responsible for observed health benefits or whether specific synergies exist remains a challenge not yet addressed 28 — Although the understanding of the mechanisms behind whole-grain health benefits is limited, relying on randomized controlled trials that focus on intermediate outcomes alone may not be the best approach for setting dietary recommendations.
In evaluating studies for the Dietary Guidelines, the DGTAC gave more weight to experimental studies than to observational studies, more weight to meta-analysis of randomized controlled trials than to individual randomized controlled trials, and more weight to cohort studies than to case-control studies 6. Global dietary whole-grain guidelines 1. Worldwide, dietary recommendations for consuming whole grains range from the generic, e.
Table 2 provides a summary of some existing global dietary whole-grain guidelines. However, the specific quantities of whole grains recommended to be consumed per day vary considerably. The first specific advice in the United States to include whole-grain servings was a part of the DGA This change from a more general grain recommendation to a specific whole-grain recommendation was developed from and supported by a body of epidemiological 52 and mechanistic experimental 53 studies linking whole-grain intake to an array of beneficial outcomes.
Whole-grain recommendations in some countries have recently become more specific. In Mexico, e. Many recommendations stress the importance of the co-passengers in whole grain, including fiber and phytochemicals, but without specifying quantities or defining what constitutes a whole-grain food. Historically, increasing whole-grain intake was recommended primarily because it increased fiber intake, as whole-grain foods make an important contribution to dietary fiber intake.
Choosing whole grains that are higher in fiber has additional health benefits; however, high fiber does not always equate with whole grain, just as whole grain does not always equate with high fiber 2 , 54 Table 3. Dietary recommendations in some countries have slowly shifted over time from being nutrient based to being food based 55 — Importantly, although countries may vary in their food vs.
Fiber content of a variety of grains 1. Data from reference The AACCI established this working group as a source of accurate scientific information on whole grains and charged the group with discussing and establishing criteria to define a whole grain.
This definition was adopted and issued by the U. The principle anatomical components—the endosperm, germ and bran—are to be present in the same relative proportions as they exist in the intact kernel. Small losses of components, i. It has been suggested that the effects of further processing baking, malting, and fermentation should be determined before a whole-grain food definition is developed However, available research suggests that the frequency of consumption and amount of whole grain eaten, rather than the type of processing, are the most important considerations when selecting a healthful diet As new scientific evidence emerges, dietary recommendations and guidelines should be reexamined and further consideration of defining whole-grain foods may be warranted.
Although definitions exist for whole grains and relevant whole-grain ingredients, a consistent definition for what constitutes a whole-grain food has not been developed and adopted for use by the FDA, the USDA, or the European Commission. Researchers have defined criteria for quantifying whole-grain foods based on the available information and marketplace of whole-grain products, but in the absence of an accepted definition of a whole-grain food, an array of packaged food products provides diverse amounts of whole grain per serving.
Given the different regulatory standards and requirements across the globe, for the purpose of this roundtable meeting and discussions, the United States was considered as the starting point for defining whole-grain foods. Though no universally accepted definition has existed for whole-grain foods, several government agencies in the United States and elsewhere have established whole-grain food definitions for a wide range of purposes 31 , 35 , 41 , 47 , 48 , 62 , 63 , 65 , 68 — 72 , which has added to the confusion Table 4.
Some have argued for quantifying whole-grain content of foods based on fiber content, e. However, fiber content of whole grains varies widely Table 3 , considerably limiting its reliability as a whole-grain indicator for all whole-grain foods.
Furthermore, the content and type of fiber in a whole-grain food depends not only on the grain but also on the density of the product, moisture content, amount of bran, and other ingredients. An internationally accepted definition for whole-grain foods could help in the development of clear regulatory standards and food package labeling, differentiate between whole grains and fiber, promote easier identification of whole-grain foods by consumers, and contribute to improved quantification of whole-grain intake.
Multiple whole-grain dietary guidance, policies, and regulations in the United States and internationally 1. This is not a comprehensive list of all relevant guidance, regulations, or policies.
Whole-grain research, both observational and intervention trials, largely relies upon the completeness and accuracy of nutrient databases to capture whole-grain intakes of study participants. A substantial increase in the availability of whole-grain products during the past decade has made accurate assessment of whole-grain intake increasingly challenging. Dietary intakes in most observational studies reflect intakes before the introduction of a wider variety of whole-grain foods, with whole-grain intakes being represented mainly by whole-grain breads and whole-grain ready-to-eat breakfast cereals.
Existing whole-grain food composition data are limited, as are the number of whole-grain food items listed on some FFQs. Up-to-date nutrient databases are needed to better assess whole-grain intake and capture the changing whole-grain food supply.
Products made with whole grains that fail to meet a study's unique criteria for what constitutes a whole-grain food may still contribute to an individual's whole-grain intake. Failure to account for these foods may lead to substantial misclassification of whole-grain intake and have an impact on study outcomes. However, such a ranking strategy cannot completely quantify the content of whole grains within foods, making the comparison of findings across studies difficult, particularly among diverse populations.
Comparisons of study findings are also hampered by the diversity and characteristics within whole grains oats vs. They also differ substantially in the amounts and spectrum of the bioactive components such as dietary fiber, micronutrients, and phytochemicals each serving provides due to differences in composition of the 2 cereal grains.
The lack of a standard measurement for a whole-grain food could also affect the observed association between biomarkers and health outcomes. Unless a whole-grain food definition is developed that allows researchers to capture the whole-grain contribution of lower fiber whole grains as well as products with different whole-grain content, determining health effects will continue to be challenging, particularly if whole grains are consumed in combination with refined grains.
There is a clear need for large, controlled, dietary intervention studies in diverse ethnic populations that examine the potential health effects of specific and well-characterized whole grains alone and in combination, as a prerequisite to demonstrating sustained health effects over time. Overall, observational research suggests that health benefits are dose dependent, i. However, intervention studies are needed to better identify the amount of whole grains likely to confer the most health benefits.
In tandem, standardized methods for identifying and classifying whole grains and their biomarkers are needed to help distinguish whole-grain intake from fiber intake and intact grains from processed flours, and to accurately identify and precisely quantify whole-grain foods.
Gaining consensus on a definition of what constitutes a whole-grain food can help overcome current challenges in determining whole-grain intakes in populations and ultimately in evaluating the strength of the evidence for issuing population-specific dietary guidance internationally.
A clear definition for whole-grain foods would help health professionals and consumers to accurately identify foods that provide a meaningful amount of whole grains. In the UK, the average daily whole grain intake is 14—16 g, with one-third of the adult population never eating whole grains The average whole-grain consumption in France is only 7.
Motivators and barriers to increasing consumption of whole-grain foods are sometimes similar, depending on consumer perceptions of taste; familiarity with whole-grain foods, especially for children; cost; identification skills; and knowledge of the associated health benefits 85 , The following are strategies found to be effective in increasing whole-grain consumption 87 , 88 : Direct substitution i. Replacement of refined-grain foods with whole-grain foods, where the 2 foods differ i.
Adding new whole-grain foods in the diet i. Structural changes in meal patterns i. Stealth approach i. Inconsistencies in labeling and wide variations in the amounts of whole grain found in foods labeled as whole grain make it difficult for educators to provide advice to consumers on what to look for in a whole-grain food product. Because whole grain is an ingredient, and not a nutrient, it does not appear on the Nutrition Facts Panel, the very place where consumers are instructed to look for important nutrition information.
Consumers often equate fiber, which is available on the Nutrition Facts Panels of food products, with whole grain 89 , mistakenly believing that a food must be high in fiber to provide whole grains. Barriers to increasing the consumption of whole grains should be addressed in part by focusing on identification skills 86 , 90 , Unlike fruits and vegetables, which are available in distinct, recognizable units, making it easy for consumers to know if they are meeting recommendations, whole grains are often consumed as an ingredient in a packaged food and are not easily identified.
A standard whole-grain food definition would identify whole-grain foods for consumers. Multicomponent educational strategies in schools, including classroom curricula, family newsletters, and supermarket and bakery tours coupled with daily exposure in school cafeterias, have increased the knowledge and whole-grain product identification skills of children, parents, and school food service personnel and increased intake among children 85 , Guidance for choosing whole-grain foods should be in the context of the overall healthful diet and include specific information on how to identify and limit whole-grain foods that are high in calories, sugar, sodium, saturated fats, or trans fats.
In the United States, this would be in accordance with the FDA's definitions for acceptable levels of negative nutrients The ongoing obesity and diabetes epidemics call for the grain community to provide leadership by making more nutrient-dense, lower energy, whole-grain options available. Additionally, to ensure nutrient adequacy, especially for folate, individuals, especially women of child-bearing age, who consume all of their grains as whole grains should include some enriched grains that have been fortified with folic acid 2.
There must also be whole-grain educational efforts within the food industry itself. Currently, little effort focuses on industry-wide recommendations for food product formulation that would increase availability of more healthful whole-grain foods in the marketplace An environment in which supermarkets, restaurants, homes, and other venues support current dietary guidance on whole grains will require small and gradual modifications to grain food staples, combined with aggressive consumer education and awareness building.
A universally accepted definition for whole-grain foods outlining a meaningful minimum amount of whole grains would ease the transition for the food industry as its members develop new whole-grain food products and for consumers as they learn to more easily identify and incorporate whole-grain foods into their daily dietary intake.
To increase consumption in populations, whole-grain foods must be formulated to be practical, affordable, and desirable for consumers. Consumer taste preferences often present the greatest challenge in the development of whole-grain food products.
The variety of the grain, the cultivar, and the processing technique employed all affect flavor, appearance, texture, shelf life, and the final cost of a product. A variety of other factors affect the formulation and processing of whole-grain foods, including serving size; stability of the food matrix; moisture content; presence of other ingredients such as yeast, spices, sugar, fats, and oils; and total grain content.
For example, a food with a larger portion size can accommodate more whole grains in its formulation without introducing considerable changes in taste, appearance, or texture, i. This would encourage manufacturers to promote whole-grain foods with smaller serving sizes and potentially increase whole-grain intake while gaining wider consumer acceptance.
Although new processing opportunities exist for the future, the industry is faced with processing challenges now. Most manufacturing facilities are designed to accommodate large volumes of refined grains, not whole grains. New cost-effective manufacturing lines and processes that can work with large volumes of whole grains would be able to accommodate any resulting increase in demand for whole-grain foods.
A coordinated effort to implement comprehensive change across the entire food industry is needed, yet food companies may be hesitant to initiate such widespread formulation and processing changes without clear consumer demand and preferences for whole-grain foods. A consistent definition for whole-grains foods would not only enable clearer identification of whole-grain foods but can also increase their availability and consumer acceptance of whole-grain foods.
In the United States, grains and grain-based foods constitute a considerable portion of the packaged foods consumed New products can serve as the primary vehicles to carry beneficial whole grains while reducing fat, sugar, sodium, calories, and portion size, in keeping with dietary guidance. Packaged foods represent a unique opportunity to increase whole-grain consumption.
Objective: Eating whole grains WG is recommended for health, but multiple conflicting definitions exist for identifying whole grain WG products, limiting the ability of consumers and organizations to select such products. We investigated how five recommended WG criteria relate to healthfulness and price of grain products. Error Include a valid email address.
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Products and services. Whole grains: Hearty options for a healthy diet Find out why whole grains are better than refined grains and how to add more to your diet. By Mayo Clinic Staff. While gluten can cause side effects in certain individuals, such as those with celiac disease, most people can and have eaten gluten most of their lives—without any adverse reaction.
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Skip to content The Nutrition Source. Harvard T. The Nutrition Source Menu. Search for:. Choose whole grains instead of refined grains. These components have various effects on our bodies: Bran and fiber slow the breakdown of starch into glucose—thus maintaining a steady blood sugar rather than causing sharp spikes.
Fiber helps lower cholesterol as well as move waste through the digestive tract. Fiber may also help prevent the formation of small blood clots that can trigger heart attacks or strokes. Phytochemicals and essential minerals such as magnesium, selenium and copper found in whole grains may protect against some cancers. The Whole Grain Stamp is a widely used marker on food products. The stamp, while designed to steer consumers towards healthy whole grains, identified products with more fiber and less sodium and trans fat but that were higher in sugar and calories than whole grain foods without the stamp.
The other three USDA criteria had mixed results in identifying healthier whole grain products, but criterion 4 the carbohydrate-to-fiber ratio of less than proved to be the most effective measure of healthfulness.
Foods that met this criterion were higher in fiber and less likely to contain trans fats, sodium, and sugar.
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