The impact of Folic Acid Fortification in Australia
Just over a year after the introduction of mandatory folic acid fortification in wheat flour for bread making, Australian researchers have set out to determine the impact it has had on the blood folate levels of Australians.
Research suggests an adequate intake of folate pre conception can reduce the incidence of neural tube defects in newborn infants. This has lead to the introduction of government sponsored health promotion campaigns encouraging women of child-bearing age to supplement with folic acid. In 1995, voluntary fortification was introduced and successfully increased the populations’ blood folate levels, and resulted in a reduction in neural tube defects between 1996 and 2006. In September 2009, fortification of 2-3mg of folic acid per kg of wheat flour for bread making was mandated under Standard 2.1.1 of the Food Standards Code, resulting in 0.135mg of folic acid per 100g of bread (approx 2-3 slices), or around half the recommended dietary intake (RDI) of folate. Note: the RDI is higher for woman of childbearing age.
Over 20,000 blood samples were used for the study between April 2009 and April 2010, as well as April 2007 and April 2008 (used as baseline). These samples tested for serum and red blood cell (RBC) folate levels in diagnostic pathology labs.
Between April 2009 and April 2010 the prevalence of low serum folate levels decreased by 77% (from 9.3% to 2.1%) and the prevalence of low RBC folate levels decreased by 85% (from 3.4% to 0.5%). The even better news is that while concerns were originally raised that women of child-bearing age may not be huge consumers of bread, the prevalence of low RBC folate levels amongst women of child-bearing age (15-50) was reduced to only one sample from 609 samples tested (0.16%). There was also a 31% increase in mean serum folate and a 22% increase in mean RBC folate levels for the samples tested.
It’s important to note the samples are not necessarily representative of the whole Australian population as they were obtained unexpectedly from those for whom a blood folate test was requested for the investigation of a possible folate deficiency, and are therefore likely to be biased towards low folate levels. Another limitation is that different patients were studied pre and during the mandatory fortification period and both samples would have included blood samples from those patients with coeliac disease or others on wheat free diets. Lastly, the authors stated they do not know the number of patients that might have already been taking a folate supplement.
Although no evaluation has been made to date on the impact of mandatory folic acid fortification of wheat flour for bread making on the incidence of neural tube defects, the results of this study are somewhat impressive in relation to the reduction of folate deficiency in the Australian population.
Already one of the leading sources of fibre in the diets of Australians, low in fat, a source of protein, thiamin, niacin and folic acid, there are plenty of reasons to enjoy the goodness of bread!
Reference:
Brown et al. The impact of mandatory fortification of flour with folic acid on the blood folate levels of an Australian Population. MJA (2011) 194: 65-67
Tuesday, February 1, 2011
Food or Physical Activity?
Picking sides in the energy balance equation
As the holidays draw to a close and children start heading back to school its is vital to get yourself and the kids back into the school routine, organising after school sport, switching computer game time with homework time, limiting TV time, and producing quick, easy and healthy family dinners at the table.
With unpleasant stats on childhood obesity and the fact many families are becoming increasingly squeezed for time it’s worth entering the debate on what is more effective - food intake or physical activity?
We know the stats are unpleasant with one in four children overweight or obese in Australia. But with our busy lifestyles and often not enough hours in the day, Dietitian’s are often asked, what is the easiest way to help kids maintain a healthy weight? One of the main causes of obesity is energy imbalance, with epidemiological studies indicating that children’s habitual energy expenditure has declined and their energy intake has increased. However, the underlying cause cannot be related to just one factor. A combination of everything that makes tasty, tempting, energy dense, nutrient-lacking food items easily available, convenient, cheap and marketable is one major contributor, along with every technological advance that results in us doing less physical work; washing machines, dryers, mix masters, cars and the endless list continues all which makes us more prone to excessive energy intake and inadequate physical activity than any previous generation.
The science suggests that there is little evidence dietary composition or macronutrient distribution has a meaningful influence on weight management independent of energy intake. However, it has been established that diet can affect satiety and is likely to influence weight indirectly by affecting the quantity of kilojoules eaten.
A recent review of the research completed in the US set out to understand the relative importance of overconsumption and physical inactivity to excess weight gain. The researchers found that there is wide variation in data quality and in the accuracy of measures of energy intake, and based on the available evidence there was no consensus on whether overconsumption or physical inactivity was the main driver for weight gain among US children and teens.
Despite this conclusion, intervention studies usually report that dietary modifications can be effective at weight loss on their own, whereas exercise based interventions do not, although a combination of the two works better than either on its own. From a practical perspective it is important to think about the most efficient ways to lose weight, and whilst we always, and will continue to recommend physical activity which has powerful influences on weight and health, we have to accept the challenge of getting an increasingly sedentary generation to participate in physical activity, all which could be undone by an unhealthy food or drink choice.
If you think about the 1000kJ a child might burn during 1 hour of bike riding per day and then consider the 2500kJ++ in a Happy Meal that takes less than 5 mins to eat, it’s easy to understand how hard it is becoming to maintain a healthy weight. This example emphasises the challenge we will continue to face unless we improve the quantity and quality of children’s diets. A study just published has found that that detailed representation of fast food and soft drink brands (developed via experience and advertising) has higher scores on an ‘added flavour’ sugar/fat/salt liking palate, fundamentally changing children's taste palates to increase their liking of highly processed and less nutritious foods. The researchers concluded early food-related behaviours are important and if we want to intervene we need to start when children are young.
Back to school lunch box tips
Katz DL. Unfattening our children: Forks over feet. International Journal of Obesity (2011) 35, 33-37.
Bleich SN et al. Relative contribution of energy intake and energy expenditure to childhood obesity: a review of the literature and directions for future research. International Journal of Obesity (2011) 35, 1-15.
Cornwell TB et al. Alternative thinking about starting points of obesity. Development of child taste preferences. Appetite (2011) Published online ahead of print.
As the holidays draw to a close and children start heading back to school its is vital to get yourself and the kids back into the school routine, organising after school sport, switching computer game time with homework time, limiting TV time, and producing quick, easy and healthy family dinners at the table.
With unpleasant stats on childhood obesity and the fact many families are becoming increasingly squeezed for time it’s worth entering the debate on what is more effective - food intake or physical activity?
We know the stats are unpleasant with one in four children overweight or obese in Australia. But with our busy lifestyles and often not enough hours in the day, Dietitian’s are often asked, what is the easiest way to help kids maintain a healthy weight? One of the main causes of obesity is energy imbalance, with epidemiological studies indicating that children’s habitual energy expenditure has declined and their energy intake has increased. However, the underlying cause cannot be related to just one factor. A combination of everything that makes tasty, tempting, energy dense, nutrient-lacking food items easily available, convenient, cheap and marketable is one major contributor, along with every technological advance that results in us doing less physical work; washing machines, dryers, mix masters, cars and the endless list continues all which makes us more prone to excessive energy intake and inadequate physical activity than any previous generation.
The science suggests that there is little evidence dietary composition or macronutrient distribution has a meaningful influence on weight management independent of energy intake. However, it has been established that diet can affect satiety and is likely to influence weight indirectly by affecting the quantity of kilojoules eaten.
A recent review of the research completed in the US set out to understand the relative importance of overconsumption and physical inactivity to excess weight gain. The researchers found that there is wide variation in data quality and in the accuracy of measures of energy intake, and based on the available evidence there was no consensus on whether overconsumption or physical inactivity was the main driver for weight gain among US children and teens.
Despite this conclusion, intervention studies usually report that dietary modifications can be effective at weight loss on their own, whereas exercise based interventions do not, although a combination of the two works better than either on its own. From a practical perspective it is important to think about the most efficient ways to lose weight, and whilst we always, and will continue to recommend physical activity which has powerful influences on weight and health, we have to accept the challenge of getting an increasingly sedentary generation to participate in physical activity, all which could be undone by an unhealthy food or drink choice.
If you think about the 1000kJ a child might burn during 1 hour of bike riding per day and then consider the 2500kJ++ in a Happy Meal that takes less than 5 mins to eat, it’s easy to understand how hard it is becoming to maintain a healthy weight. This example emphasises the challenge we will continue to face unless we improve the quantity and quality of children’s diets. A study just published has found that that detailed representation of fast food and soft drink brands (developed via experience and advertising) has higher scores on an ‘added flavour’ sugar/fat/salt liking palate, fundamentally changing children's taste palates to increase their liking of highly processed and less nutritious foods. The researchers concluded early food-related behaviours are important and if we want to intervene we need to start when children are young.
Back to school lunch box tips
- Pat wet ingredients dry with a paper towel and layer lettuce between wet ingredients and bread to prevent moisture from spreading. Prepare sandwiches as close to lunchtime as possible to ensure freshness.
- Older students might go for something a little more gourmet. Tempt teen tastebuds with roast vegies on Turkish bread or a wholemeal wrap.
- If the kids keep throwing out their crusts, beat them to it. Try using breads with no crust, such as wraps or Turkish bread. Alternatively, cut the crust of regular bread and use the left over crusts to make croutons or breadcrumbs.
- Wholegrain dinner rolls with healthy fillings can be used instead of larger bread rolls for younger kids. Cutting sliced bread into different shapes or creating a face by adding a grape cut in half for the eyes, a piece of carrot for the nose and a capsicum mouth can make lunches fun.
- Get kids involved with a best filling competition or a naming competition for sandwiches. Encourage the school canteen to have a reduced price or a meal deal with a free apple or yoghurt.
- Introduce wholegrain breads into the kids’ diet with ‘zebra’ sandwiches by using one slice of wholegrain and one white slice. Wholegrain crispbreads and rice cakes are a good alternative for kids who don’t like bread.
Katz DL. Unfattening our children: Forks over feet. International Journal of Obesity (2011) 35, 33-37.
Bleich SN et al. Relative contribution of energy intake and energy expenditure to childhood obesity: a review of the literature and directions for future research. International Journal of Obesity (2011) 35, 1-15.
Cornwell TB et al. Alternative thinking about starting points of obesity. Development of child taste preferences. Appetite (2011) Published online ahead of print.
Wednesday, December 1, 2010
Carbohydrates may be linked to hearing loss
Age related hearing loss effected by quality of carbohydrate nutrition.
A new Australian study suggests that age-related hearing loss could potentially be reduced by decreasing the amount of lower quality carbohydrate in the diet and increasing the intake of cereal fibre
Age-related hearing loss is the most prevalent form of hearing loss worldwide. Research suggests that nutrition is a modifiable risk factor that could play a role in the development of age-related hearing loss. The Blue Mountains Hearing Study investigated whether a cross-sectional or longitudinal relationship exists between carbohydrate nutrition, starch, cereal and total fibre, and age-related hearing loss in a large group of adults aged 50 years and older. Of the total 2448 participants 32.1% had hearing loss and more than two thirds (67.9%), had no hearing loss over the 5 year follow up period. Those with hearing loss had a significant change between baseline and the follow up period.
In this group of older adults the higher Glycaemic Index (GI) of foods eaten are associated with an increased risk of hearing loss. However, this association is reduced when there is an increase in dietary intake of cereal fibre. This suggests that the effect of cereal fibre may override the effects of other components of carbohydrate and may have a protective effect on the hearing function, possibly by improving insulin sensitivity or by reducing blood glucose levels after eating.
The incidence of hearing loss in this 5 year period was predicted by a high Glycaemic Load* (GL). A high GL diet at baseline is found to increase the risk of developing age-related hearing loss by 76% among older adults. This is regardless of other potential variables such as education, smoking, previous history of diagnosed stroke and diabetes, family history of hearing loss and exposure to noise at work.
The association with GL and hearing loss suggests that both the quantity and quality of carbohydrate may play a role in the development of age-related hearing loss. The underlying causes for these findings are unknown, however long term higher dietary Glycaemic Load (GL) brings on abnormally high blood sugar levels and excess levels of insulin circulating in the blood. This can lead to diabetes, hypertension, and/or dislipidemia in individuals who are at risk. Other studies show a relationship between hearing and diabetes mellitus, stroke, and vascular risk factors such as high blood pressure and serum lipids. Therefore, dietary GL could potentially influence hearing function through its adverse effects on vascular health. The current study speculates oxidative damage as the underlying mechanism between carbohydrate and hearing loss.
The authors however, conclude that in order to confirm this theory and replicate findings, large high quality randomised controlled trials of long duration are needed to investigate any potential links between carbohydrate nutrition and hearing.
Key:
Glycaemic Load* - the product of a food’s glycaemic index and total available carbohydrate content, and represents both the quantity and quality of carbohydrates.
Source:
Gopinath B et al. Dietary Glycemic Load is a Predictor of Age-Related Hearing Loss in Older Adults. J. Nutr. 140: 2207-2212, 2010.
A new Australian study suggests that age-related hearing loss could potentially be reduced by decreasing the amount of lower quality carbohydrate in the diet and increasing the intake of cereal fibre
Age-related hearing loss is the most prevalent form of hearing loss worldwide. Research suggests that nutrition is a modifiable risk factor that could play a role in the development of age-related hearing loss. The Blue Mountains Hearing Study investigated whether a cross-sectional or longitudinal relationship exists between carbohydrate nutrition, starch, cereal and total fibre, and age-related hearing loss in a large group of adults aged 50 years and older. Of the total 2448 participants 32.1% had hearing loss and more than two thirds (67.9%), had no hearing loss over the 5 year follow up period. Those with hearing loss had a significant change between baseline and the follow up period.
In this group of older adults the higher Glycaemic Index (GI) of foods eaten are associated with an increased risk of hearing loss. However, this association is reduced when there is an increase in dietary intake of cereal fibre. This suggests that the effect of cereal fibre may override the effects of other components of carbohydrate and may have a protective effect on the hearing function, possibly by improving insulin sensitivity or by reducing blood glucose levels after eating.
The incidence of hearing loss in this 5 year period was predicted by a high Glycaemic Load* (GL). A high GL diet at baseline is found to increase the risk of developing age-related hearing loss by 76% among older adults. This is regardless of other potential variables such as education, smoking, previous history of diagnosed stroke and diabetes, family history of hearing loss and exposure to noise at work.
The association with GL and hearing loss suggests that both the quantity and quality of carbohydrate may play a role in the development of age-related hearing loss. The underlying causes for these findings are unknown, however long term higher dietary Glycaemic Load (GL) brings on abnormally high blood sugar levels and excess levels of insulin circulating in the blood. This can lead to diabetes, hypertension, and/or dislipidemia in individuals who are at risk. Other studies show a relationship between hearing and diabetes mellitus, stroke, and vascular risk factors such as high blood pressure and serum lipids. Therefore, dietary GL could potentially influence hearing function through its adverse effects on vascular health. The current study speculates oxidative damage as the underlying mechanism between carbohydrate and hearing loss.
The authors however, conclude that in order to confirm this theory and replicate findings, large high quality randomised controlled trials of long duration are needed to investigate any potential links between carbohydrate nutrition and hearing.
Key:
Glycaemic Load* - the product of a food’s glycaemic index and total available carbohydrate content, and represents both the quantity and quality of carbohydrates.
Source:
Gopinath B et al. Dietary Glycemic Load is a Predictor of Age-Related Hearing Loss in Older Adults. J. Nutr. 140: 2207-2212, 2010.
Friday, November 26, 2010
New year, new diet?
Wholegrains, legumes and refined grains in weight loss...
If you are gearing up for a healthy summer eating plan and are not sure what to include, consider the results of some new research that has just been published. Over one hundred people participated in an 18 month weight loss trial with advice to either follow a control diet based on the National Heart Foundation of New Zealand guidelines, or a diet that emphasised wholegrains and legumes.
The first 6 months involved 2-weekly counselling sessions, cooking classes, supermarket tours, and recipe ideas, in the following 12 months participants had monthly contact with the investigators. Participants in the (very healthy) control group were instructed to follow the guidelines published by the National Heart Foundation of New Zealand which included recommendations to eat at least 3 servings of vegetables and 2 serving of fruit, at least 6 servings of breads and cereals (where 1 serve is equivalent to 1 slice of bread),at least 2 servings of reduced fat milk and milk products, 1-2 small servings of protein-rich foods (meat, poultry, fish, seafood and legumes) and 1-2 tablespoons of monounsaturated or polyunsaturated fats and oil products and a small amount of nuts and seeds. The intervention group was given similar advice, except they were specifically instructed to consume 2 servings of legumes as a substitute for 2 serving of breads and cereals, and all other breads and cereals were to be wholegrain.
Key foods were provided to the participants for the first 6 months of the study to encourage consumption of the ‘suitable foods’ for their group. For example, participants assigned to the control group received cornflakes, cans of fruits and veggies white bread and cereals with a medium to high glycaemic index. The intervention group received rolled oats and rye, canned legumes, wholegrain and rye bread. Providing key foods seems to have played a role in the participant’s weight loss, as after 6 months when less support was provided many people re-gained some of the weight they had lost.
Data from weighed food records showed that most people in the intervention group complied reasonably well with the substitution of legumes into their diet, with the median legume intake over the first 6 months almost reaching the advised 2 serves/day. This declined to just under 1 serve/day in the last 6 months of the study. Wholegrain intake remained stable in the intervention group over the 18 months at around 1.5 serves/day. Wholegrain intake was slightly higher in the intervention vs the control group at 2 and 6 months, but no different at 12 months, therefore, it is likely that poor compliance after 6 months could have diminished the difference between diets.
The great thing about this study for the participants is that both groups lost a significant amount of weight – approximately 7kg at 6months, and 5kg at 18 months, compared to their weight when they started the weight loss program. Due to the overall similar decrease in energy intake and similar weight loss in both groups it is more difficult to see differences between the two interventions. Overall, there was a small difference in wholegrain intakes between both groups and significantly noticeable differences between legume intakes. Both groups decreased blood pressure, triglycerides and glycaemic load resulting in significant weight loss in both intervention groups, but there was no significant difference between the groups. Despite a small difference in the glycaemic index (GI) between the two diets, there was no relationship of GI to weight loss, consistent with other trials. The group that ate more wholegrains and legumes had a significantly lower waist circumference by 2.8cm after 18 months of the weight loss program. This group also had a lower Total cholesterol and a lower LDL cholesterol at the end of the study.
From a practical perspective, 81% of people stuck out the complete 18 months of the weight loss program, giving a good indication that people were willing to incorporate wholegrains and legumes in their diet over this period. Overall, all participants found the diets easy to follow and did not report any decrease in dietary satisfaction. The researchers concluded that their data provides strong evidence in support of national guidelines for healthy eating that recommend the inclusion of wholegrains and legumes in the diet. This research also shows that although wholegrain foods are a better choice, core refined grain foods such as white bread, white pasta, and white rice can be included as part of a successful weight loss program.
Venn BJ et al, 2010. The effect of increasing consumption of pulses and wholegrains in obese people – a randomised controlled trial. JACN
If you are gearing up for a healthy summer eating plan and are not sure what to include, consider the results of some new research that has just been published. Over one hundred people participated in an 18 month weight loss trial with advice to either follow a control diet based on the National Heart Foundation of New Zealand guidelines, or a diet that emphasised wholegrains and legumes.
The first 6 months involved 2-weekly counselling sessions, cooking classes, supermarket tours, and recipe ideas, in the following 12 months participants had monthly contact with the investigators. Participants in the (very healthy) control group were instructed to follow the guidelines published by the National Heart Foundation of New Zealand which included recommendations to eat at least 3 servings of vegetables and 2 serving of fruit, at least 6 servings of breads and cereals (where 1 serve is equivalent to 1 slice of bread),at least 2 servings of reduced fat milk and milk products, 1-2 small servings of protein-rich foods (meat, poultry, fish, seafood and legumes) and 1-2 tablespoons of monounsaturated or polyunsaturated fats and oil products and a small amount of nuts and seeds. The intervention group was given similar advice, except they were specifically instructed to consume 2 servings of legumes as a substitute for 2 serving of breads and cereals, and all other breads and cereals were to be wholegrain.
Key foods were provided to the participants for the first 6 months of the study to encourage consumption of the ‘suitable foods’ for their group. For example, participants assigned to the control group received cornflakes, cans of fruits and veggies white bread and cereals with a medium to high glycaemic index. The intervention group received rolled oats and rye, canned legumes, wholegrain and rye bread. Providing key foods seems to have played a role in the participant’s weight loss, as after 6 months when less support was provided many people re-gained some of the weight they had lost.
Data from weighed food records showed that most people in the intervention group complied reasonably well with the substitution of legumes into their diet, with the median legume intake over the first 6 months almost reaching the advised 2 serves/day. This declined to just under 1 serve/day in the last 6 months of the study. Wholegrain intake remained stable in the intervention group over the 18 months at around 1.5 serves/day. Wholegrain intake was slightly higher in the intervention vs the control group at 2 and 6 months, but no different at 12 months, therefore, it is likely that poor compliance after 6 months could have diminished the difference between diets.
The great thing about this study for the participants is that both groups lost a significant amount of weight – approximately 7kg at 6months, and 5kg at 18 months, compared to their weight when they started the weight loss program. Due to the overall similar decrease in energy intake and similar weight loss in both groups it is more difficult to see differences between the two interventions. Overall, there was a small difference in wholegrain intakes between both groups and significantly noticeable differences between legume intakes. Both groups decreased blood pressure, triglycerides and glycaemic load resulting in significant weight loss in both intervention groups, but there was no significant difference between the groups. Despite a small difference in the glycaemic index (GI) between the two diets, there was no relationship of GI to weight loss, consistent with other trials. The group that ate more wholegrains and legumes had a significantly lower waist circumference by 2.8cm after 18 months of the weight loss program. This group also had a lower Total cholesterol and a lower LDL cholesterol at the end of the study.
From a practical perspective, 81% of people stuck out the complete 18 months of the weight loss program, giving a good indication that people were willing to incorporate wholegrains and legumes in their diet over this period. Overall, all participants found the diets easy to follow and did not report any decrease in dietary satisfaction. The researchers concluded that their data provides strong evidence in support of national guidelines for healthy eating that recommend the inclusion of wholegrains and legumes in the diet. This research also shows that although wholegrain foods are a better choice, core refined grain foods such as white bread, white pasta, and white rice can be included as part of a successful weight loss program.
Venn BJ et al, 2010. The effect of increasing consumption of pulses and wholegrains in obese people – a randomised controlled trial. JACN
Wednesday, October 13, 2010
Wholegrain goodness
Study finds those who eat more wholegrains have a better diet overall
We know that something in wholegrains is good for us. Whether it’s the fibre, phytochemicals or more likely a combination of multiple components working together in the wholegrain. Whatever the mechanism, there is something good in wholegrains that makes them really special.
Despite strong growth in wholegrain products, there is limited information about wholegrain intakes in the Australian population. A recent study just published has assessed the consumption of wholegrains and association with nutrient intake in a nationally representative US population.
The data was collected from a secondary analysis of cross-sectional data from the US National Health and Nutrition Examination Survey in 1999-2004. In the absence of Australian consumption data for wholegrains at a nationally representative level, this study may give some indication about the level of wholegrain intake in developed countries such as Australia. The US study investigated over 7000 adults, aged 19 to 50 year olds and over 6000 adults, 51 years and over. Participants were divided into four wholegrain consumption groups 0-0.6, 0.6-1.5, 1.5-3.0, and >3.0 serves a day. Serve sizes are calculated based on ounce equivalents of grains (one serve). One ounce equivalent is equal to the amount of food considered equivalent to ½ cup cooked rice, pasta or cooked cereal, 1 slice of bread or 1 cup of breakfast cereal. Note that Australian and US serve sizes are different. Australian serve sizes are larger, for example, one serve is equal to 2 slices of bread.
The study found that Adults aged 19 to 50 and 51+ years consumed a mean of 0.63 and 0.77 servings of wholegrains per day respectively. Seventy two percent of 19 to 50 year olds, and 70% of 51+ year olds consumed less than 0.6 servings of wholegrains or less daily, with only 4.8% and 6.6% of individuals in these age groups, respectively, eating the recommended 3 serves of wholegrains daily.
For both age groups, diet quality and intake of energy, fibre and polyunsaturated fatty acids were significantly higher in those consuming the most servings of wholegrains. Intake of negative nutrients such as total sugars, added sugars, saturated fatty acids, and cholesterol was significantly lower in those consuming the most servings of wholegrains, as was monounsaturated fatty acids. Apart from Vitamin B12 and sodium, the intake of all micronutrients was higher among those individuals who consumed the most servings of wholegrains.
Although these are positive results, unfortunately the majority of the Adult US population was not consuming enough wholegrains, which is likely to be the similar story in Australia. What we do know is US adults who consumed the most servings of wholegrains had better diet quality and nutrient intakes.
The researchers in this study used a stricter definition for wholegrain than many previous studies. Known as the My Pyramid Equivalents Database (MPED), this definition excludes added bran and pearled barley, which are not technically wholegrain; most published studies have not used this newer definition. The intake of wholegrains was slightly lower in this study compared to other US studies, however this is likely due to the change in the definition of wholegrains used.
Some of the well documented barriers to wholegrain consumption include lack of familiarity and preparation, lack of understanding of the health benefits, the higher price associated with some wholegrain foods, an inability to identify wholegrains and a reported preference for refined grain foods. The authors conclude how important it is for health professionals, industry, government and public health campaigns to promote the consumption of wholegrains more vigorously. They state that dietitian’s need to know more about wholegrains and ways to promote them; health claims could be another way to help increase wholegrain consumption and they also stress the importance of a national wholegrain campaign such as the 2&5 fruit and vegetable campaign.
Go Grains Health & Nutrition is actively involved in many similar strategies aimed to ultimately increase wholegrain consumption and the results of this study help to support the work of Go Grains in Australia.
Source:
O’Neil C, Nicklas T, Zanovec M and Cho S. Whole-grain Consumption is Associated with Diet Quality and Nutrient Intake in Adults: The National Health and Nutrition Examination Survey, 1999-2004. Journal of the American Dietetic Association. Oct 2010, Vol 110, (10) 1461-1468.
We know that something in wholegrains is good for us. Whether it’s the fibre, phytochemicals or more likely a combination of multiple components working together in the wholegrain. Whatever the mechanism, there is something good in wholegrains that makes them really special.
Despite strong growth in wholegrain products, there is limited information about wholegrain intakes in the Australian population. A recent study just published has assessed the consumption of wholegrains and association with nutrient intake in a nationally representative US population.
The data was collected from a secondary analysis of cross-sectional data from the US National Health and Nutrition Examination Survey in 1999-2004. In the absence of Australian consumption data for wholegrains at a nationally representative level, this study may give some indication about the level of wholegrain intake in developed countries such as Australia. The US study investigated over 7000 adults, aged 19 to 50 year olds and over 6000 adults, 51 years and over. Participants were divided into four wholegrain consumption groups 0-0.6, 0.6-1.5, 1.5-3.0, and >3.0 serves a day. Serve sizes are calculated based on ounce equivalents of grains (one serve). One ounce equivalent is equal to the amount of food considered equivalent to ½ cup cooked rice, pasta or cooked cereal, 1 slice of bread or 1 cup of breakfast cereal. Note that Australian and US serve sizes are different. Australian serve sizes are larger, for example, one serve is equal to 2 slices of bread.
The study found that Adults aged 19 to 50 and 51+ years consumed a mean of 0.63 and 0.77 servings of wholegrains per day respectively. Seventy two percent of 19 to 50 year olds, and 70% of 51+ year olds consumed less than 0.6 servings of wholegrains or less daily, with only 4.8% and 6.6% of individuals in these age groups, respectively, eating the recommended 3 serves of wholegrains daily.
For both age groups, diet quality and intake of energy, fibre and polyunsaturated fatty acids were significantly higher in those consuming the most servings of wholegrains. Intake of negative nutrients such as total sugars, added sugars, saturated fatty acids, and cholesterol was significantly lower in those consuming the most servings of wholegrains, as was monounsaturated fatty acids. Apart from Vitamin B12 and sodium, the intake of all micronutrients was higher among those individuals who consumed the most servings of wholegrains.
Although these are positive results, unfortunately the majority of the Adult US population was not consuming enough wholegrains, which is likely to be the similar story in Australia. What we do know is US adults who consumed the most servings of wholegrains had better diet quality and nutrient intakes.
The researchers in this study used a stricter definition for wholegrain than many previous studies. Known as the My Pyramid Equivalents Database (MPED), this definition excludes added bran and pearled barley, which are not technically wholegrain; most published studies have not used this newer definition. The intake of wholegrains was slightly lower in this study compared to other US studies, however this is likely due to the change in the definition of wholegrains used.
Some of the well documented barriers to wholegrain consumption include lack of familiarity and preparation, lack of understanding of the health benefits, the higher price associated with some wholegrain foods, an inability to identify wholegrains and a reported preference for refined grain foods. The authors conclude how important it is for health professionals, industry, government and public health campaigns to promote the consumption of wholegrains more vigorously. They state that dietitian’s need to know more about wholegrains and ways to promote them; health claims could be another way to help increase wholegrain consumption and they also stress the importance of a national wholegrain campaign such as the 2&5 fruit and vegetable campaign.
Go Grains Health & Nutrition is actively involved in many similar strategies aimed to ultimately increase wholegrain consumption and the results of this study help to support the work of Go Grains in Australia.
Source:
O’Neil C, Nicklas T, Zanovec M and Cho S. Whole-grain Consumption is Associated with Diet Quality and Nutrient Intake in Adults: The National Health and Nutrition Examination Survey, 1999-2004. Journal of the American Dietetic Association. Oct 2010, Vol 110, (10) 1461-1468.
Risk of skipping breakfast
Skipping breakfast is linked to risk factors for heart disease, diabetes and obesity
A recent Australian study has found people who regularly eat breakfast are less likely to develop heart disease, diabetes or become obese, than people who start the day on an empty stomach.
A twenty year follow up national study of Australian school children, found that that those who skip breakfast in both childhood and adulthood have a significantly larger waist circumference, BMI (indicator of healthy weight), higher fasting insulin, total cholesterol, and LDL cholesterol compared to those who eat breakfast.
The study suggests that skipping breakfast over a long period may alter metabolism which may result in a greater storage of fat. The higher waist circumference in adults who miss breakfast in childhood and adulthood, may be as a result of higher energy intakes over the course of the day during the 20 year follow up, a factor that has been highlighted by other researchers.
Researchers believe that not eating breakfast seems to be more common, possibly because of efforts to lose weight or due to lack of time. Children and adults who skip breakfast are less likely to meet dietary recommendations for breads and cereals, fruit and dairy, and are more likely to eat takeaway food more than once per week.
Regardless of age, race, socioeconomic status and other lifestyle factors research shows that not only is eating breakfast important but the type of breakfast eaten may play a role in BMI. Eating cereal (cooked or ready to eat cereal) or certain breads for breakfast, is associated with a significantly lower BMI in adults compared to those who skip breakfast or eat other types of breakfast.
Those who eat breakfast that consists of grains (cereals and breads) may have similar energy intakes to other food types, however have lower BMIs, than those who do not eat breakfast or eat meat and eggs for breakfast. Cereals and bread not only provide energy, protein, vitamins and minerals, but some contain insoluble fibre which contributes to a longer lasting feeling of fullness, making them a suitable option for breakfast.
Source:
Smith KJ et al. Am J Clin Nutr 2010. Doi: 10.3945/ajcn.2010.30101. Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study.
Farshchi HR et al. Am J Clin Nutr 2005;81:388-96. Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women.
Sungsoo C et al. JACN 2003;22(4):296-302. The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index: Results from the Third National Health Examination Survey (NHANES III).
A recent Australian study has found people who regularly eat breakfast are less likely to develop heart disease, diabetes or become obese, than people who start the day on an empty stomach.
A twenty year follow up national study of Australian school children, found that that those who skip breakfast in both childhood and adulthood have a significantly larger waist circumference, BMI (indicator of healthy weight), higher fasting insulin, total cholesterol, and LDL cholesterol compared to those who eat breakfast.
The study suggests that skipping breakfast over a long period may alter metabolism which may result in a greater storage of fat. The higher waist circumference in adults who miss breakfast in childhood and adulthood, may be as a result of higher energy intakes over the course of the day during the 20 year follow up, a factor that has been highlighted by other researchers.
Researchers believe that not eating breakfast seems to be more common, possibly because of efforts to lose weight or due to lack of time. Children and adults who skip breakfast are less likely to meet dietary recommendations for breads and cereals, fruit and dairy, and are more likely to eat takeaway food more than once per week.
Regardless of age, race, socioeconomic status and other lifestyle factors research shows that not only is eating breakfast important but the type of breakfast eaten may play a role in BMI. Eating cereal (cooked or ready to eat cereal) or certain breads for breakfast, is associated with a significantly lower BMI in adults compared to those who skip breakfast or eat other types of breakfast.
Those who eat breakfast that consists of grains (cereals and breads) may have similar energy intakes to other food types, however have lower BMIs, than those who do not eat breakfast or eat meat and eggs for breakfast. Cereals and bread not only provide energy, protein, vitamins and minerals, but some contain insoluble fibre which contributes to a longer lasting feeling of fullness, making them a suitable option for breakfast.
Source:
Smith KJ et al. Am J Clin Nutr 2010. Doi: 10.3945/ajcn.2010.30101. Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study.
Farshchi HR et al. Am J Clin Nutr 2005;81:388-96. Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women.
Sungsoo C et al. JACN 2003;22(4):296-302. The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index: Results from the Third National Health Examination Survey (NHANES III).
Wednesday, September 15, 2010
Eating habits and psychological disorders
Mediterranean diet linked to lower depression and anxiety
Healthy diets are commonly linked to a reduced risk of chronic disease such as heart disease, diabetes and cancer. Now research has linked dietary intake to psychological disorders such as depression and anxiety.
An Australian study of 1046 women, aged 20-93 years old, found that those who habitually eat vegetables, fruit, beef, lamb, fish and wholegrain foods (a traditional diet) are less likely to have depression and anxiety disorders compared to those who consume a western diet. A western diet consisted of processed or fried foods, refined grains, sugary products and beer. Women who ate a traditional diet were 35% less likely to have major depression or dysthymia and 32% less likely to have anxiety disorders, whereas the western diet was linked to depressive disorders.
The ATTICA study of 853 men and women from Greece, found that more anxious men and women had different eating habits compared to those less anxious. Women who eat sweets as well as meat and meat products were more likely to be anxious while men who ate legumes and cereals were less likely to be anxious.
Depressive illness is influenced by genetic, hormonal, immunological, biochemical, and neurodegenerative factors. Diet affects each of these factors and possibly the development of depression. Inflammation is thought to play a role in the onset and maintenance of depressive disorders as well as chronic disease such as cardiovascular disease, diabetes and cancer. Adhering to a Mediterranean diet, high in vegetables, fruits, legumes, wholegrains, fish, olive oil and low fat dairy products, ensures an adequate intake of folate, B vitamins, antioxidants and healthy fats. A Mediterranean diet is linked to less inflammation compared to a western diet and may therefore protect against depression and anxiety.
Sources:
Jacka FN et al. 2010. Association of Western and Traditional Diets with Depression and Anxiety in Women. Am J Psychiatry; AiA:1-7.
Sanchez-Villegas A et al. 2009. Association of the Mediterranean Dietary Pattern with the Incidence of Depression. Arch Gen Psychiatry;66(10):1090-1098.
Yannakoulia M et al. 2008. Eating habits in relation to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA study. Appetite; 51:519-525.
Healthy diets are commonly linked to a reduced risk of chronic disease such as heart disease, diabetes and cancer. Now research has linked dietary intake to psychological disorders such as depression and anxiety.
An Australian study of 1046 women, aged 20-93 years old, found that those who habitually eat vegetables, fruit, beef, lamb, fish and wholegrain foods (a traditional diet) are less likely to have depression and anxiety disorders compared to those who consume a western diet. A western diet consisted of processed or fried foods, refined grains, sugary products and beer. Women who ate a traditional diet were 35% less likely to have major depression or dysthymia and 32% less likely to have anxiety disorders, whereas the western diet was linked to depressive disorders.
The ATTICA study of 853 men and women from Greece, found that more anxious men and women had different eating habits compared to those less anxious. Women who eat sweets as well as meat and meat products were more likely to be anxious while men who ate legumes and cereals were less likely to be anxious.
Depressive illness is influenced by genetic, hormonal, immunological, biochemical, and neurodegenerative factors. Diet affects each of these factors and possibly the development of depression. Inflammation is thought to play a role in the onset and maintenance of depressive disorders as well as chronic disease such as cardiovascular disease, diabetes and cancer. Adhering to a Mediterranean diet, high in vegetables, fruits, legumes, wholegrains, fish, olive oil and low fat dairy products, ensures an adequate intake of folate, B vitamins, antioxidants and healthy fats. A Mediterranean diet is linked to less inflammation compared to a western diet and may therefore protect against depression and anxiety.
Sources:
Jacka FN et al. 2010. Association of Western and Traditional Diets with Depression and Anxiety in Women. Am J Psychiatry; AiA:1-7.
Sanchez-Villegas A et al. 2009. Association of the Mediterranean Dietary Pattern with the Incidence of Depression. Arch Gen Psychiatry;66(10):1090-1098.
Yannakoulia M et al. 2008. Eating habits in relation to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA study. Appetite; 51:519-525.
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