Busting Myths about Grain Foods & Weight Loss

Want fast weight loss? Or has a new celebrity diet caught your eye?

Don’t fall for diet fads, or weight loss fast-fixes, is the health warning from the Grains & Legumes Nutrition Council (GLNC).

GLNC’s Michelle Broom, Accredited Practising Dietitian and Nutrition Program Manager says: “People are often spurred on to lose weight by the impending need to fit into a dress, look good for a special occasion or be bikini ready for a beach holiday. It’s this urgency that finds them grasping at straws, looking for a quick fix.

“The truth is individual testimonials often make dramatic claims and don’t end up delivering promised weight loss for others.

“Weight loss can be achieved without the fads, or succumbing to movements which encourage cutting whole food groups from your diet. It’s true that sustainable weight loss won’t happen overnight, but by taking a sensible approach, you won’t just lose the weight but keep it off too,” she said.

GLNC debunks five common myths about fad diets, misconceptions about eating grains and going gluten-free. 

MYTH ONE: Eliminating whole food groups is the key to weight loss.

FACT: The best thing for a healthy body is a balance of foods from all food groups. For weight loss, limiting foods that are high in calories but lack essential nutrients is important, and portion control is also key to sustainable weight loss.

MYTH TWO: A low-FODMAP diet is a healthy diet for all.

FACT: A low-FODMAP diet is not for the long term. It is designed as a short term (2-6 weeks), therapeutic elimination diet, often used to control Irritable Bowel Syndrome and other gut-related issues.  It requires the supervision and support of an experienced Accredited Practising Dietitian and is not for the general population.

MYTH THREE: Carbohydrates make you fat.

FACT: Quality grain foods such as whole grain bread and high fibre breakfast cereals can help with weight management. These foods are linked with a smaller waistline and greater chance of being a healthy weight. In addition, if you’re hitting the gym to boost your weight loss, you need carbs in your diet. In fact, keeping grain foods in your weight loss diet will provide the nutrients to help your metabolism.

MYTH FOUR: A low carb, high fat (LCHF) diet is the secret to slimming.

FACT: LCHF diets are not a more effective way of keeping weight off long term.  LCHF diets are yet to be proven to provide adequate nutrition, be sustainable and prevent disease across the lifespan. In fact, LCHF diets represent a radically different eating pattern to the foods shown by an analysis of the whole scientific evidence base. Diets such as LCHF that restrict fibre and nutrient rich carbohydrate foods have been linked with a 30% increased risk of early death.

MYTH FIVE: A gluten free diet will make you thin.

FACT: Many gluten free foods contain more calories than gluten containing foods as they often contain higher amounts of fat and sugar to make them taste better. Gluten free products are often made with ingredients such as potato starch or tapioca flour, resulting in products lower in fibre and whole grain which are important for digestion and metabolism. Unless medically diagnosed with coeliac disease or gluten intolerance, a gluten free diet provides no nutritional or health benefit to individuals.

Highlights from the Nutrition Society of Australia Annual Scientific Meeting

GLNC was one of the over 250 participants gathered in Hobart in the last week of November to hear the latest research on the link between food and health at the Nutrition Society of Australia Annual Scientific Meeting. GLNC has picked just some of the highlights to share with you.

‘Is Dissemination the Weakest Link in the 2013 Australian Dietary Guidelines?’
Dr Anita Lawrence from Dairy Australia presented the findings of a survey of Australian General Practitioners (GPs). The survey of 300 GPs was conducted in 2014 and compared to a survey of a sample from the Australian population. GP respondents indicated 31% of consultations involved the provision of nutrition advice. However, only 13% of the GPs were familiar with the 2013 Australian Dietary Guidelines, with female GPs more aware then male GPs. This was similar to the sample of the general population with 12% reporting awareness of the Australian Dietary Guidelines. While GPs rated their own confidence in their nutrition knowledge as 7 out of 10, only 8% were able to correctly identify dairy requirements for teens.

Nutrient Intakes of People on a Palaeolithic Diet
A small study of 39 healthy women compared the nutrient intakes of those on a Palaeolithic diet compared to those on a diet recommended by the Australian Dietary Guidelines. Participants followed the diets for four weeks and food intake was not restricted. The Palaeolithic group had a reduced intake of calcium and the B vitamins thiamin and riboflavin, with increased intakes of Vitamin C, E and beta-carotene.

Latest Insights on the Mediterranean Diet
Associate Professor Catherine Itsiopoulos, Head Dietetics and Human Nutrition at La Trobe University, gave an overview of the latest research on the Mediterranean diet. She described how the understanding of heart disease has shifted and it is now understood that low grade inflammation and oxidative stress are the key indicators of heart disease rather than lipid accumulation.  In light of this she suggested that perhaps it is not what we are eating that we should be focussing on, but what we’re not eating.

Dr Itsiopoulos suggested it is perhaps through the effect of polyphenols on chronic inflammation and oxidative stress that the Mediterranean diet is working to reduce risk of cardiovascular disease. She used the recent PREDIMED study to demonstrate this. The PREDIMED study, a large randomized clinical trial of 7,000 people investigating the effect of a Mediterranean Diet on cardiovascular disease (CVD) risk over 5 years, found 30% reduction in CVD mortality.  However, a recent reanalysis of the data to examine the relationship between polyphenol intake and health found a 37% reduction in CVD mortality with higher polyphenol intakes. The polyphenols with the greatest impact included isoflavones, the main source of which was legumes.  This is not surprising given the diet in the intervention included three 150g serves of legumes each week.

Dr Itsiopoulos also highlighted several additional studies currently underway in Australia investigating the effects Mediterranean diet on health including the MEDINA trial of people with non-alcoholic fatty liver disease, the AusMED intervention to reduce secondary acute myocardial infarction, as well as the HELFIMED study looking at the effect on mental illness.

At the end of the presentation an audience member suggested that while research indicates the health benefits of a Mediterranean diet it is perhaps not advisable to insist everyone follow the diet regardless of their cultural diet and that many diets from around the world have been shown to be linked to longevity and better health. Dr Itsiopoulos agreed but suggested that if we are looking for foods to include in a healthier diet for longevity there are common food elements to these diets including leafy green vegetables and legumes.

Fun Facts from the Scientific Meeting

• Australia’s Bogong moth has a similar nutritional profile as a handful of pumpkin seeds.
• Calcium bioavailability varies over life stages. For lactating mothers the availability is 80% compared to 30% for other adults.
• One hectare of land could produce 150 tonnes of insect protein per year (PROteINSECT study).

For more information about the Annual Scientific Meeting, visit www.nsa.asn.au.

Looking Beyond Nutrients to the Whole Package

The appetite for nutrient focused healthy eating messages in the media is insatiable. In 2014 this has been highlighted by the abundance of messages such as ‘quit sugar’ and ‘cut carbohydrate’ in the media. But is demonizing single nutrients really the path to a healthy diet?

Traditionally nutrition research has focused on the effects of individual nutrients and health. While this approach has shed ample light on our understanding of the mechanisms by which nutrients and other bio-active food components act within the body, the messages generated from such research have often unintentionally complicated the concept of healthy eating.

As we eat foods not nutrients, healthy eating messages which focus solely on the presence or absence of an individual nutrient are of limited use. Such messages do not comprehend that nutrients never act on the body in isolation, but rather are packaged with many other nutrients within foods which act together to influence health. For example, whole grains contain more than 26 health promoting nutrients and bio-active components and increasingly studies are showing that single these components do not simply act alone to protect health, but rather in concert. This explains why the observed benefit of the whole food package of whole grains often exceeds that explained by the action of each nutrient.^{(1, 2)}

In addition, a focus on a single nutrient in isolation also overlooks the impact of the food matrix (the structure of foods when consumed) and the overall the composition of the meal within a long term eating pattern. Each of which plays an important role on the impact of food on health.

Clearly nutrition is a very complex system and so focusing on a single nutrient in attempt to establish a healthy eating pattern is like trying to build a house with one tool. Constructing a healthy diet to reduce risk of disease across the lifespan requires a holistic, whole of diet approach as opposed to a reductionist nutrient focused solution. With advances in our understanding of the complexity of nutrition, health authorities and evidenced based practitioners have shifted the emphasis of dietary recommendations away from nutrients towards foods.

A focus on food was a key objective in the development of the 2013 Australians Dietary Guidelines. The Guidelines are designed not only to provide the nutrients essential for wellbeing but also to provide adequate amounts of the foods known to reduce the risk of chronic disease. Underpinned by a comprehensive review of over 55,000 studies, the Guidelines encourage Australians to consume a variety of nutritious, available, affordable and culturally appropriate foods from each of the five food groups: grains, mostly whole grain or high fibre; vegetables and legumes; fruits; lean meats, poultry, fish, eggs, nuts; and dairy.

In addition, with Australians waistlines increasing⁽³⁾, the Guidelines also focus on promoting a healthy weight; for the average size person doing light physical activity, adhering to an eating pattern which reflects the Guidelines will result in a daily reduction in energy intake and should result in weight loss.

Despite the recent re-focus of public health nutrition to foods not nutrients, single nutrient messages are taking centre stage in the media. Many may argue that the intent of messages such as ‘quit sugar’ or ‘low carb’ is to serve public health and encourage Australians to limit energy dense, nutrient poor food choices (i.e. soft drinks, pastries, biscuits, cakes and processed take away foods). However, the blunt nature of a nutrient focused recommendation inevitably results in vocal advocates of such messages also taking aim at foods and food groups such as fruits, whole grains and legumes, calling for the exclusion of these foods from the diet. This is despite the fact these foods are backed by the scientific evidence of being linked with better health.

As a result, these nutrient focused messages fail to reflect the evidence of the relationship between food and health. For those not convinced, such recommendations also contradict evidence from Blue Zones, the populations around the world with the best health and longest lives, who enjoy mostly plant based diets which include whole fruits, whole grains and legumes – each of which appear on the banned list of the latest quit sugar and low carb fads.

Just as past reductionist advice to reduce fat failed to achieve its intended outcome of encouraging people to eat more naturally low fat plant foods available at the time, current and future nutrient focused messages will fail to address the complex relationship between diet and diet related disease risk. Nutrition science continues to increase our understanding of the relationship between the food we eat and health and more often than not studies are demonstrating that it is more about all the elements of foods acting together rather than a single nutrient.

References

1. Fardet A. New Approaches to Studying the Potential Health Benefits of Cereals: From Reductionism to Holism. Cereal Foods World. 2014;59(5):224-9.
2. Parker TL, Miller SA, Myers LE, Miguez FE, Engeseth NJ. Evaluation of synergistic antioxidant potential of complex mixtures using oxygen radical absorbance capacity (ORAC) and electron paramagnetic resonance (EPR). Journal of agricultural and food chemistry. 2010;58(1):209-17.
3. AIHW. Australia's health 2014 Australia's health no. 14. Cat. no. AUS 181. Canberra: AIHW.2014. Available from: http://www.aihw.gov.au/australias-health/2014/

MEDIA RELEASE: Black Rice is the New Black

With a chewy texture and rich nutty flavour, black rice is the newest and trendiest health food on the market. Due to its exquisite burgundy-purple colour and nutrional appeal, expect to see this exotic grain served up in trendy restaurants and cafes across Australia.

According to the Grains & Legumes Nutrition CouncilTM (GLNC), the independent authority on the nutrition and health benefits of grains and legumes, black rice is a healthy alternative for people wanting to eat rice. It’s naturally gluten free, high in fibre and 100 per cent whole grain, making it a simple and delicious way to reach GLNC’s 48g whole grain Daily Target Intake (DTI).

Chris Cashman, GLNC Nutrition Project Officer, said rice is an important carbohydrate which helps to fuel the brain, support working muscles and vital organs.

“As well as being a great source of carbohydrate, it’s the high level of anthocyanin antioxidants in black rice that sets it apart from more well-known varieties like brown and white rice. In fact, black rice contains the same amount of health promoting antioxidants found in blueberries, but with less sugar and more fibre,” he said.

Renowned for centuries for both its attractive looks and perceived health benefits, black rice was once a rare delicacy. Even today the Chinese refer to the ancient grain as ‘forbidden rice’; cultivated for years in very small amounts only for the emperor’s consumption. It was believed black rice helped ensure good health and long life so was only reserved for the nobles. Although black rice was considered rare amongst the general public, today it’s a grain for everyone.

When to use it?
Often served as a dessert, like black rice pudding, most people are unaware of how else to use the ancient grain. Its vibrant colour makes black rice the ideal accompaniment to salads, sushi recipes or a nutritious addition to any grain based dish.  

How to cook it?
Black rice can be cooked in the same way as brown rice. Simply add 1 cup of rice to 2 cups of water or stock over a medium heat. Bring the water or stock to the boil and simmer for 25-30 minutes.

Where to buy it?
This ancient delicacy is becoming more readily available as manufactures, like SunRice, realise the grain’s nutritional and culinary potential amongst health conscious foodies. Black rice can now be found in supermarkets and specialty stores.

For more information and access to a selection of black rice recipes, visit the SunRice website https://www.sunrice.com.au/consumer/products/gourmet-rice/black-rice/. For more information on the nutrition and health benefits of black rice and other grain foods visit the Grains & Legumes Nutrition CouncilTM website www.glnc.org.au.

NEW SCIENTIFIC REVIEW: The Benefits of Breakfast Cereal Consumption

By Professor Peter Williams, Honorary Professorial Fellow at University of Wollongong and Adjunct Professor of Nutrition and Dietetics at the University of Canberra

Breakfast cereal eaters are more likely to have a healthier diet and to weigh less, and are less likely to suffer from certain diseases. That is the key finding of a systematic literature review of more than 230 papers over 30 years, which I undertook on behalf of the Australian Breakfast Cereal Manufacturers Forum and was recently published in the international peer-reviewed journal, Advances in Nutrition.

The findings of the review are significant – not only for the strength of the evidence – but because of the important role breakfast cereals play in delivering the health benefits of grain foods to Australian diets. According to the recent Australian Health Survey, around 43 per cent of Australians ate breakfast cereal, including ready-to-eat cereal (RTEC) and hot porridge, on the day of the survey.

It was clear from the research that regular breakfast cereal eaters have more nutritious diets, which are higher in vitamins and minerals and have a greater likelihood of meeting recommended nutrient intakes. Adults and children who eat breakfast cereal regularly also have higher wholegrain consumption each day.

The benefit of eating breakfast cereal for weight management was one of the strongest findings in the review. Regularly eating breakfast cereal is associated with a lower body mass index and a 12 per cent lower risk of being overweight or obese in both adults and children.

The review also found that high-fibre and wholegrain breakfast cereals help to improve bowel function, prevent constipation, and may lower the risk of diabetes and cardiovascular disease.  Key findings in this area include:

• Breakfast cereals high in soluble fibre (such as oat, barley or psyllium) help lower total and low-density lipoprotein (LDL) cholesterol. 
• Regularly eating wholegrain and high-fibre breakfast cereal is associated with reduced risk of type 2 diabetes (by 24 per cent) and cardiovascular disease (by 20-28 per cent). 
• Breakfast cereal plays an important role in bowel health, with evidence that high-fibre, wheat-based breakfast cereals help prevent constipation and improve bowel function.

Importantly, the review clarified questions about the contribution breakfast cereals make to sodium and total sugars intakes in the overall diet.

According to the research base, breakfast cereal eaters do not have higher sodium intakes than non-breakfast cereal eaters and there is no difference in their overall daily energy intake, total sugars intake or risk of overweight or obesity, whether children consume pre-sweetened breakfast cereals or other breakfast cereals.

The review is the first time the evidence relating to breakfast cereal and its impact on healthy diets, body weight, obesity, diabetes, cardiovascular disease and bowel health has been systematically assessed using the stringent National Health and Medical Research Council (NHMRC) criteria.

As a result of the systematic review, 21 graded summary evidence statements were established and in several instances, the evidence statements are as strong as or even stronger than that for fruit and vegetable consumption.

For more information, including a full summary report and link to the open access journal paper, visit http://www.cereal4brekkie.com.au/new-science/

GLNC notes the findings of this review align with the findings in the recently released Draft SCAN Carbohydrates and Health Report from the UK. This comprehensive review of the scientific evidence on the health effects of carbohydrate foods included a review of the effects of breakfast cereals containing at least 25% bran or 25% whole grain. The review concluded there is an 11% reduced risks of coronary events and 13% reduced risk of Type 2 Diabetes for every half serving of cereal. 

An Insight into Low FODMAP Diets

By Dr Jane Muir PhD (Head of Unit) and Dr Jane Varney PhD (Senior Research Dietitian) from the unit of Translational Nutrition Science, Department of Gastroenterology, Monash University.

The Department of Gastroenterology at Monash University conducts a major research program into the use of diet to treat irritable bowel syndrome (IBS).  IBS is characterised by chronic and relapsing symptoms, including lower abdominal pain and discomfort, bloating, wind, distension and altered bowel habits (ranging from diarrhoea to constipation), but with no abnormal pathology. The Monash team has discovered that IBS symptoms are relieved in 75% of sufferers, when a group of poorly absorbed short chain carbohydrates (FODMAPs, which stands for Fermentable Oligo-saccharides, Disaccharides, Mono-saccharides and Polyols), is restricted from the diet. FODMAPs are found in a whole range of foods including garlic, onion, wheat, rye, legumes, lentils and certain fruits and vegetables.

Owing to the restrictive nature of this diet, the Monash team emphasises that it is not appropriate for healthy individuals with no gastrointestinal disorders to follow a strict low FODMAP diet.  Rather, a low FODMAP diet should be trialled under the guidance of an experienced dietitian, for a period of 2–6 weeks. After this time and under the guidance of the dietitian, FODMAP containing food should be gradually re-introduced into the diet.

The team at Monash is focussed on translational research and has developed a number of tools which enable them to communicate their research findings to people suffering IBS. These include the Monash University Low FODMAP Diet Booklet and the Monash University Low FODMAP Diet App suitable for iPhone and Android devices. These tools draw on data from Monash research that has quantified the FODMAP content of different foods. The App and booklet provide accurate information about foods that may aggravate IBS symptoms, enabling sufferers to better manage their IBS symptoms. The App has been overwhelmingly successful having been downloaded in over 60 different countries and having reached number one in over 30 countries. In Australia, the App remains number one in the medical category for both android and iPhone.

Consistent with their translational research agenda, the team at Monash has launched the Monash University Low FODMAP Certification Program. The certification program aims to make it easier for consumers with medically diagnosed IBS to identify and select low FODMAP food choices. Membership of the certification program enables food manufacturers to have their brand specific product information (including product pictures and website links) included in the App, thus low FODMAP certified food products display a green light against their branding to clearly indicate to consumers that the food is low in FODMAPs. Some food manufacturers may also display the Monash University Low FODMAP Diet Stamp  on their food packaging, enabling consumers to quickly and easily identify low FODMAP food choices on the supermarket shelves.

The certification program seeks to promote the consumption of high quality, healthy foods, thus only foods which meet strict nutrient criteria for FODMAPs, fat, saturated fat, sugar, salt and fibre are eligible. Major categories of foods that are suitable for the certification program include: cereal grain products; legumes, nuts and seeds; fresh fruit and fruit products; fresh vegetables and vegetable products; milk, dairy products and alternatives, and quality convenience foods.

The certification program will be launched in October 2014. Should food manufacturers wish to learn more about this exciting new initiative, they should contact med-lowfodmap.certified@monash.edu

Low Carbohydrate High Fat Diets

The evolution of low carb
In recent times the low carbohydrate trend has evolved from a short term weight loss diet to being promoted as a long term “lifestyle”.

In line with this trend, the low carbohydrate high fat (LCHF) lifestyle has emerged as the latest diet philosophy being hailed in the media as the secret to long term weight loss, health and wellbeing. In fact, some LCHF proponents are now calling for all Australians to adopt a LCHF eating pattern, which represents a radically different diet to those recommended within evidenced based Australian and International Dietary Guidelines.

Here we explore the LCHF diet, review the evidence behind some of the recent headlines and discuss how a LCHF eating pattern stacks up against evidenced based guidelines which promote adequate nutrition and reduced risk of disease over the lifespan.  

What is a LCHF diet?
Due to the similarities with ‘Paleo style diets’ LCHF dieters often use the terms interchangeably or in concert when describing their diet philosophy.

The purpose of a LCHF diet is to achieve state of ‘ketosis’. This occurs when the body is starved of its primary fuel source (carbohydrates) and so is forced to use dietary fats as an alternative source of energy via ketosis.(7) Supporters of LCHF diets claim an eating pattern that imposes a metabolic shift towards ketosis reduces the risk of heart disease, diabetes and obesity as well as improves appetite control, weight management, immunity, sustained energy and mental alertness.(1-5)

As the name suggests, LCHF diets are characterised by very low carbohydrate intakes, generally less than 50g/day which is achieved through the elimination of selected foods from the five food groups including grain foods including whole grain or high fibre grain foods, legumes, fruit, low fat diary and starchy vegetables. (1-3) In addition, similar to the Australians Dietary Guidelines, LCHF dieters are instructed to limit or avoid discretionary choices such as sweetened beverages, cakes, biscuits, pastries and other carbohydrate containing discretionary food choices.

As a result LCHF diets contain relatively higher intakes of fat and protein through an abundance of dietary fats and oils, meats (often including processed meats such as bacon, sausages), seafood, eggs, nuts, seeds and full fat dairy. A typical LCHF daily meal plan recently published by advocates of LCHF diets delivers around 10,500kJ of energy,  42g carbohydrates (7% total energy), 20g fibre, 204g total fat (~72% total energy), 81g saturated fat (28% total energy), 78g monounsaturated fat and 28g polyunsaturated fat and 134g protein (~22% total energy).(3, 6)

To put this in context, the 2013 Australian Dietary Guidelines were developed using the NHMRC Nutrient Reference Values (NRV’s) for macronutrients. These NRV's are expressed as a percentage contribution of carbohydrate, protein and fat to daily energy intake (carbohydrate 45-60%: fat 20-35%: saturated fat no more than 10%: protein 15-20%). These NRVs provide the macronutrient ranges upon which the Australian Dietary Guidelines to ensure these recommendations allow a wide range of dietary patterns, which provide all of the essential nutrients and promote health.

Based on this analysis it’s clear that LCHF eating patterns are radically different to those endorsed by the Australian Dietary Guidelines and it follows that elimination of carbohydrate rich food groups also translates to lower intakes of the essential nutrients and health protective components these foods deliver. Indeed the example LCHF daily meal plan outlined above is lower in fibre than the adequate intake NRV and is significantly lower than the Suggested Dietary Targets (SDTs) for fibre recommended for reduced risk of chronic disease.

The latest science on LCHF
As with all science there is constantly new research being conducted leading to scientific debate. While it is important to consider the findings of new research, this must be done in the context of all the research in the area and not in isolation of single studies. As such systematic analysis of the total body of evidence is vital to guide the practise of health care professionals as is the critical analysis of new research to ensure that the findings are fair, unbiased and relevant in the real world.

With this in mind; in regards to weight management, while there is limited evidence that LCHF may offer short term benefits, robust scientific analysis including a recent meta-analysis consistently demonstrates that low carbohydrate or LCHF diet do not offer any long term weight loss benefits compared with an energy matched balanced diet.(7, 8)

A recently published trial which generated the headline in the New York Times “A Call for a Low-Carb Diet That Embraces Fat” clearly illustrates why critical analysis of new research is important. The study behind this headline was a 12 month trial of 148 obese people which compared a LCHF diet versus a higher carbohydrate diet and their respective effects on weight and heart health.(9) When interpreting studies which compare low carbohydrate diets versus a higher carbohydrate, it is important to keep in mind that not all carbohydrate foods are equal. As such it is important to examine the actual food choices and nutrient intakes of study participants to determine whether a low carbohydrate diet compared against a higher carbohydrate diet which actually reflects dietary guidelines, which emphasise nutrient and fibre rich carbohydrate foods.

This trial did not provide detail on the actual food choices of people on the higher carbohydrate diet, which was intended to reflect dietary guidelines. As many carbohydrate foods restricted on a LCHF diet are also fibre rich, it would be fair to assume the fibre intakes of the people on this diet would be significantly higher compared with a LCHF diet. However, in this study fibre intakes were almost identical and much lower than recommended intakes, with daily averages of 15g and 16g for the LCHF and higher carbohydrate diet respectively. This tells us that on average the higher carbohydrate group were not consuming fibre rich sources and so the group upon which the LCHF has been compared is unlikely reflective of a dietary guidelines. Given this analysis, it’s not surprising that those following the LCHF diet, which represented a radical change in diet, consumed less energy, losing more weight over 12 months and so experienced greater improvements in heart health when compared with a diet which did not reflect a healthy higher carbohydrate diet.

This limitation and others highlighted here by Dr David Katz, Director of the Yale Prevention Research Centre demonstrate the importance of the critical analysis of new research. As well as identifying critical flaws in the study design Dr Katz noted important factors for establishing a long term eating pattern which are commonly ignored in such studies including “Was the diet sustainable? Could families join in? Would the diet reliably improve health and prevent disease across a lifespan?”.

As Dr Katz points out, when it comes to achieving or maintaining a healthy weight the best approach is to establish an eating pattern and lifestyle which you can live with for a lifetime. In contrast a LCHF diet restricts many nutritious, affordable and culturally and socially acceptable foods and is yet to be proven to promote health in the long term.

In addition to research on weight management and heart health researchers have investigated the short term impact of LCHF diets on blood glucose control. In people with diabetes or an increased risk of diabetes a number of recent trials have reported positive outcomes of LCHF diets in the short term.(10, 11) Indeed, some researchers have cited such trials and challenged the current best practice guidelines for the treatment of diabetes in adults, making the case that low carbohydrate ketogenic diets as the primary dietary therapy.(12)

Despite this recent evidence, it should be noted that the evidence is limited and that the best practice guideline updated in 2013, provide recommendations based on the total body of evidence indicate that for improved blood glucose control for adults with diabetes as well as adequate nutrition and reduced risk of disease, macronutrient intakes should be individualised within the ranges which guide nutritionally balanced dietary guidelines.(13)

Potential long term risks of LCHF 
While there is some limited evidence of short term health effects of a LCHF diet, as a long term eating pattern LCHF diets are yet to be proven to provide adequate nutrition, be sustainable and prevent disease across the lifespan.

In contrast there is evidence that lower carbohydrate intakes in the long term may pose health risks. A 2013 meta-analysis found that compared with high carbohydrate intakes, long term low carbohydrate intakes  were linked with an increased risk of an early death in humans by 30%.(14) This observation has since been supported by a comprehensive study in animals; not possible in humans due to its complexity and for ethical reasons, which found that mice consuming a higher carbohydrate diet experienced a 30% increased life span and better health compared to mice consuming lower carbohydrate intake.(15)

LCHF diets may also negatively impact risk of heart health and type 2 diabetes through restriction of nutrient and fibre rich whole grains, high fibre grain foods and legumes.(16-23) And the abundance of saturated fat(3) observed in LCHF diets also contradicts recommendations from heart health authorities around the world who advise people to restrict intake of saturated fat in favour of polyunsaturated fat.(21, 24-26)

With respect to reducing cancer risk, LCHF diets do not align with key recommendations from the World Cancer Research Fund. LCHF diets appear to fall short of providing adequate fibre yet dietary fibre, particularly cereal fibre protects against bowel cancer, Australia’s second biggest cancer killer.(27, 28)The World Cancer Research Fund also cautions against high intakes processed meats which may be observed in a LCHF eating pattern due to the link between these foods  and some cancers.(27)

While the long term impact of a LCHF on disease and longevity is unknown, the 2013 Australian Dietary Guidelines are based on over 55,000 studies, demonstrates that an eating pattern relatively higher in good quality carbohydrate foods such as whole grains, high fibre grain foods, legumes, fruit and vegetables, moderate in protein and lower in saturated fats delivers adequate nutrition and reduces risk of diet related disease over the lifespan.(21)

The Bottom Line: Bring back the balance
Surveys indicate Australians are choosing discretionary grain foods more often than is recommended and are not choosing whole grain and high fibre grain foods often enough. Rather than following a fad diet, the total body of scientific evidence shows people would benefit from eating less discretionary foods and choosing whole grain and high fibre grain foods more often as part of a balanced diet.

In support of the evidenced based 2013 Australian Dietary Guidelines, GLNC encourages Australians to enjoy grain foods 3-4 times each day, choosing at least half as whole grain or high fibre and aiming to eat legumes at least 2-3 times each week.

References: 

1. Schofield G. THE SCIENCE OF HUMAN POTENTIAL 2014. Available from: http://profgrant.com/author/gschofie/.
2. Knoakes T. 2014. Available from: http://originaleating.org/.
3. Volek JS, Phinney SD. A New Look at Carbohydrate-Restricted Diets: Separating Fact From Fiction. Nutrition today. 2013;48(2):E1-E7 10.1097/NT.0b013e31828814eb.
4. Gunnars K. Available from: http://authoritynutrition.com/.
5. Evans P. Available from: http://www.thepaleoway.com/index.html.
6. FAO. CALCULATION OF THE ENERGY CONTENT OF FOODS - ENERGY CONVERSION FACTORS 2002. Available from: http://www.fao.org/docrep/006/y5022e/y5022e04.htm.
7. DAA. DAA Best Practice Guidelines for the Treatment of Overweight and Obesity in Adults. 2012.
8. Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J. Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk: A Systematic Review and Meta-Analysis. PloS one. 2014;9(7):e100652.
9. Bazzano LA, Hu T, Reynolds K, Yao L, Bunol C, Liu Y, et al. Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized TrialEffects of Low-Carbohydrate and Low-Fat Diets. Annals of internal medicine. 2014;161(5):309-18.
10. Tay J, Natalie D L-M, Thompson CH, Noakes M, Buckley JD, Wittert GA, et al. A Very Low Carbohydrate, Low Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial. Diabetes care. 2014.
11. Schwingshackl L, Hoffmann G. Comparison of the long-term effects of high-fat v. low-fat diet consumption on cardiometabolic risk factors in subjects with abnormal glucose metabolism: a systematic review and meta-analysis. British Journal of Nutrition. 2014;111(12):2047-58.
12. Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary Carbohydrate restriction as the first approach in diabetes management. Critical review and evidence base. Nutrition. 2014(0).
13. Dworatzek PD, Arcudi K, Gougeon R, Husein N, Sievenpiper JL, Williams SL. Nutrition Therapy -  Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Journal of Diabetes. 2013;37:S45-S55.
14. Noto H, Goto A, Tsujimoto T, Noda M. Low-Carbohydrate Diets and All-Cause Mortality: A Systematic Review and Meta-Analysis of Observational Studies. PloS one. 2013;8(1):e55030.
15. Solon-Biet Samantha M, McMahon Aisling C, Ballard JWilliam O, Ruohonen K, Wu Lindsay E, Cogger Victoria C, et al. The Ratio of Macronutrients, Not Caloric Intake, Dictates Cardiometabolic Health, Aging, and Longevity in Ad Libitum-Fed Mice. Cell metabolism. 2014;19(3):418-30.
16. Mellen PB, Walsh TF, Herrington DM. Whole grain intake and cardiovascular disease: a meta-analysis. Nutrition, metabolism, and cardiovascular diseases : NMCD. 2008;18(4):283-90.
17. Pereira MA, O'Reilly E, Augustsson K, Fraser GE, Goldbourt U, Heitmann BL, et al. Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med. 2004;164(4):370-6.
18. Bazzano LA, Thompson AM, Tees MT, Nguyen CH, Winham DM. Non-soy legume consumption lowers cholesterol levels: A meta-analysis of randomized controlled trials. Nutrition, metabolism, and cardiovascular diseases : NMCD. 2011;21(2):94-103.
19. Jayalath VH, de Souza RJ, Sievenpiper JL, Ha V, Chiavaroli L, Mirrahimi A, et al. Effect of Dietary Pulses on Blood Pressure: A Systematic Review and Meta-analysis of Controlled Feeding Trials. American Journal of Hypertension. 2014;27(1):56-64.
20. Ha V, Sievenpiper JL, de Souza RJ, Jayalath VH, Mirrahimi A, Agarwal A, et al. Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: a systematic review and meta-analysis of randomized controlled trials. Canadian Medical Association journal. 2014.
21. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.
22. Aune D, Norat T, Romundstad P, Vatten LJ. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. European journal of epidemiology. 2013;28(11):845-58.
23. Sievenpiper JL, Kendall CW, Esfahani A, Wong JM, Carleton AJ, Jiang HY, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia. 2009;52(8):1479-95.
24. Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-99.
25. Board J. Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3). Heart. 2014;100(Suppl 2):ii1-ii67.
26. NationsFaAOotU. Fats and fatty acids in human nutrition. . Rome: Food and Agriculture Organization of the United Nations 2010.
27. WCRF. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.
28. Aune D, Chan D, Lau R, Vieira R, Greenwood D, Kampman E, et al. Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies. British medical journal. 2011;343.

Code of Practice for Whole Grain Ingredient Content Claims

The Code of Practice for Whole Grain Ingredient Content Claims (Code) was successfully launched by GLNC in July 2013. The Code provides guidance for the food industry for consistent messages about whole grain. It covers the use of the GLNC whole grain Daily Target Intake statement, whole grain ingredient content claims (contains whole grain, high in whole grain, very high in whole grain) as well as GLNC certification of grain and legume foods.

The Code has established consistent whole grain messages to help consumers make informed choices. It also provides a public health benefit by encouraging the food industry to increase the whole grain content of foods to meet the claim levels, improving the nutritional quality of the grain food supply.

The Code has been well received by industry with 12 manufacturers signing up to date, and over 200 products currently registered. GLNC supported the launch with communications to key stakeholders including the food industry, government and academia and health care professionals and is building strong media engagement and support to drive increased consumer awareness and understanding of the claims. GLNC will continue to work with the food industry to encourage widespread uptake of the Code to ensure consumers are able to make informed decisions by comparing products on shelf.

As required under the Code, an annual review was conducted in early 2014 to assess the performance of the Code against its objectives and to recommend any amendments required to address implementation or administration issues identified by stakeholders. The 2014 annual review of the Code included two rounds of public consultation for consideration by the Code Steering Committee. The GLNC Board approved the amendments to the Code in May 2014. The 2014 Code is binding on GLNC and all Registered Users as of 1 July 2014.

To support the communication of the Code GLNC has developed a factsheet for health care professionals to help them understand how the Code aligns with the Australian Dietary Guidelines and the 48g whole grain Daily Target Intake. Also available is a factsheet that health care professionals can use with their clients to help people understand what to look for to make better whole grain food choices. To download a copy of the factsheets visit the resources section of the GLNC website.

Current Registered Users of the Code include a range of grain food manufacturers:  Bakers Delight, Cereal Partners Worldwide/Nestle, Continental Biscuit Manufacturers, General Mills, George Weston Foods, Goodman Fielder, Griffins Foods, Mondelez International, Sanitarium Health & Wellbeing Australia, Sanitarium Health & Wellbeing New Zealand, Tucker’s Natural, Woolworths.

For more information and an electronic copy of the 2014 Code visit the GLNC website
www.glnc.org.au

Sorghum – the new whole grain on the block

Anita Stefoska-Needham, APD and PhD Candidate at University of Wollongong provides an introduction to this traditional grain that is becoming the new star in whole grains.

Sorghum is a naturally gluten free cereal crop that is grown locally and represents a novel high value food ingredient in the manufacture of new grain products for the Australian food sector. Being highly drought adaptable, Sorghum is ideally suited to the Australian climate, with the added value of being relatively cheap to grow. To date sorghum’s unique nutritional and agronomic benefits have not been fully exploited in Australia, largely due to its reputation as a livestock feed, however, Sorghum may provide similar nutritional benefits as other whole grains. With growing consumer interests in healthy eating and wellbeing and increasing commercial investment in cereal grain product development, this lesser-recognised whole grain is drawing more attention from researchers, the food industry and gradually from consumers.

The nutritional composition of sorghum grain is similar to other cereals such as wheat. Sorghum grain contains starches, dietary fibre including resistant starch, protein, lipids and a vast array of anti-oxidant rich phytochemicals. These grain components may have functional properties that are beneficial for health. Due to its lower starch digestibility, it has been suggested that Sorghum may be a valuable lower-energy grain alternative, presenting an exciting new opportunity for developing products targeted at weight management.

Like most cereals, sorghum is a source of B-complex vitamins such as thiamin, riboflavin, vitamin B6, biotin, and niacin. The mineral composition in sorghum is similar to millet and is predominantly composed of potassium and phosphorus, with low levels of calcium. Sorghum-based foods are also a good source of both iron and zinc.

Despite its reputation as a livestock feed, Sorghum has been included in the human diet for thousands of years and today is used in a variety of traditional foods world-wide including breads, porridges, steamed products, boiled products, beverages and snack foods (popped sorghum). In more recent years, sorghum has been increasingly utilised as a key ingredient in novel non-traditional food products and beverages, mainly as whole grain and flour, due to its light colour (some cultivars), neutral flavour and pleasing texture. In the US, sorghum is widely used as a key ingredient in ready-made foods such as cookies, breakfast cereals, bagels, and bars; baking mixes for bread, brownies, cakes, and pancakes; gluten-free bread; and gluten-free beer.

Sorghum is a traditional grain that is ideal for the modern Australian diet. It is a locally grown, gluten-free, whole grain which is versatile to use in different food applications and presents an exciting innovation opportunity in developing health promoting, commercially viable food.

Whole grain reduces inflammation in overweight children

Being overweight or obese is linked with higher levels of systemic inflammation, which is now recognised as an underlying risk factor of heart disease and diabetes in the long term. A recently published study reinforces the benefits of children consuming whole grains finding that a whole grain-rich diet lowered biomarkers of inflammation in overweight and obese children.(1) With one in four Australian children currently overweight or obese, and likely to be experiencing high levels of inflammation, this is another potential benefit from enjoying whole grain foods more often.

Whole grain foods contain a number of bioactive components which may work to reduce inflammation including vitamins B and E, magnesium, selenium, zinc, fibre and other phytonutrients.(1) Being such nutrient dense foods, researchers have been keen to investigate the impact of whole grains on inflammation, however until now studies had focused on adults not children.

This recent study included 44 overweight or obese Iranian girls aged 8–15 years who were randomly assigned to either a group which was encouraged to obtain half of their daily grain serves from whole grain foods for six weeks or a control group who were instructed to eat refined grain foods only, and avoid whole grain foods. After the initial six week period each participant was then instructed to avoid whole grain foods during a four week ‘washout period’ before crossing over to the alternate group for an additional six weeks.

While participants were assigned to the whole grain arm of the study they ate an average of 98 grams of whole grain foods each day from a wide variety of whole grain foods, which was one half of their total grain food intake. Converted to serves this equates to around 3 serves of whole grain foods each day, where one serve is equal to 1 slice of bread, 2/3 cup of flaked breakfast cereal or ½ cup cooked brown rice, oats.

Based on the blood measurements taken at the end of the six week diets, the authors found that consumption of whole grain foods significantly reduced levels of inflammatory biomarkers including C-reactive protein (CRP) and leptin in overweight and obese children.

What have other studies reported?
Previously observational studies have indicated an association between diets high in whole grains and lower CRP levels, a marker of inflammation.(2, 3) While this most recent study in overweight children found that a whole grain rich diet significantly reduced markers of inflammation, other intervention studies in adults have not yet clearly demonstrated this effect.(2, 3) Where possible it is also important that associations identified in observational studies are then compared with interventional studies to allow an interpretation of cause and effect.

What to make of this?
There are limited studies on this topic and, as is the case in many areas of nutrition science, “more research is needed” before conclusions can be drawn about the mechanisms by which whole grains may protect health and potentially lower inflammation.

Despite this gap, observational studies consistently link higher intakes of whole grains with reduced risk of heart disease, diabetes, obesity and some cancers.(4, 5) Whilst more research is needed, Australians should heed the Australian Dietary Guidelines and aim to make at least half their grain foods choices whole grain or high fibre within a balanced diet.


References:

1. Hajihashemi P, Azadbakht L, Hashemipor M, Kelishadi R, Esmaillzadeh A. Whole-grain intake favorably affects markers of systemic inflammation in obese children: A randomized controlled crossover clinical trial. Molecular nutrition & food research. 2014;58(6):1301-8.
2. Lefevre M, Jonnalagadda S. Effect of whole grains on markers of subclinical inflammation. Nutrition reviews. 2012;70(7):387-96.
3. Buyken AE, Goletzke J, Joslowski G, Felbick A, Cheng G, Herder C, et al. Association between carbohydrate quality and inflammatory markers: systematic review of observational and interventional studies. The American journal of clinical nutrition. 2014;99(4):813-33.
4. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.
5. GLNC. The Grains & Legumes Health Report. Grains & Legumes Nutrition Council, 2010.

UK Scientific Advisory Committee on Nutrition (SCAN) – Health Benefits of Carbohydrates

In 2008 the Scientific Advisory Committee on Nutrition (SCAN) was requested by the UK Food Standards Agency to provide clarification of the relationship between carbohydrate foods, including grain foods and health. In June 2014, SCAN published its draft report which provides a comprehensive evaluation of the available scientific evidence on the health effects of total carbohydrates and carbohydrate foods. Here GLNC outlines the key findings reported on the health benefits of whole grain and high fibre grain foods.

In developing this report the SCAN only reviewed evidence from prospective cohort studies and randomised controlled trials (RCT). As such the Carbohydrates and Health Report 2014(1) report provides the highest level of available evidence from observational and interventional studies respectively.

Not surprisingly the findings of this comprehensive report align directly with the findings of the review of the scientific evidence which underpins the Australians Dietary Guidelines(2), indicating that a number of biologically significant health benefits can be achieved through making healthier grain food choices, particularly choosing whole grain and/or high fibre grain foods more often. Here is a top line summary of the key findings of the Report in relation to chronic diseases which are of public health importance:

Cardiovascular disease

• Higher intakes of whole grain and high fibre grain foods is linked with a reduced risk of cardiovascular disease – which includes a wide range of diseases that involve the heart, the blood vessels or both.
• In particular, higher intake of whole grains, total cereal fibre and higher fibre breakfast cereals are also associated with a reduced risk of coronary events – any severe or acute heart condition.
• Higher intake of whole grains is also associated with a reduced risk of stroke and incidence of high blood pressure.
• Higher intakes of oat bran and β-glucans, found in whole grain oats and barley is associated with lower blood pressure, lower total cholesterol, lower LDL cholesterol and lower triglycerides – each a risk factor for cardiovascular disease.    

Type 2 Diabetes

• Higher intakes of whole grains, whole grain breads, total cereal fibre and higher fibre breakfast cereals are associated with a lower risk of type 2 diabetes.

Bowel Cancer and Digestive Wellbeing

• Higher whole grains and total cereal fibre intakes are associated with lower risk of bowel cancer which is Australia’s second biggest cancer killer. 
• Cereal fibre from whole grains and high fibre grain foods also promotes digestive regularity and reduces the risk of constipation. 

In support of the international and Australians Dietary Guidelines GLNC recommends all Australians enjoy grains foods 3-4 times each day, choosing at least half as whole grain or high fibre. Following this recommendation will help ensure you increase or meet your daily whole grain needs and reap the health benefits of a balanced diet rich in whole grains.

A note on whole grain foods…
It is important to note that while many people think of ‘whole grains’ as intact, rolled, flaked or cracked grains (i.e. rolled oats, bulgur, barley or brown rice), whole grain foods also includes wholemeal breads, whole grain breakfast cereals, whole grain crispbreads and wholemeal pasta.

In fact, based on GLNC’s 2014 Australian Grains and Legumes Consumption and Attitudinal Study(3), whole grain breads and whole grain breakfast cereals are the greatest contributors to whole grain intakes in the Australian diet.(3) As these common whole grain foods are the greatest contributors to whole grain intakes in the Australian diet it is likely they are making the most significant contribution to disease risk reduction from whole grains in Australians’ diets.

So while choosing a variety of whole grain or high fibre grain foods is important as part of a balanced diet, don’t discount the benefits of whole grain from commonly enjoyed foods such as breads and cereals.

The full draft report can be viewed at:
http://www.sacn.gov.uk/pdfs/draft_sacn_carbohydrates_and_health_report_consultation.pdf

References:

1. SCAN. Draft Carbohydrates and Health report. 2014.
2. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.
3. GLNC. 2014 Australian Grains and Legumes Consumption and Attitudinal Report. Unpublished: 2014.

Whole grain intake linked to better diet quality

Whole grains are nutrition powerhouses containing over 26 nutrients and bioactive substances including dietary fibres, vitamins, minerals, and a range of protective phytonutrients. Studies have shown that adults and children who consume higher intakes of whole grain foods each day have better diet quality and nutrient intakes(1, 2) including higher intakes of fibre, all vitamins and most minerals as well as lower intakes of added sugar and saturated fat.(1)

Overall, studies show that consuming 2-3 serves of whole grain foods each day reduces the risk of cardiovascular disease, type 2 diabetes, colon cancer and obesity by around 20-30%.(3, 4)

Interestingly the disease risk reduction which whole grains appear to offer far exceeds the protection expected from the individual nutrient found in whole grains.(5) As such, it is likely the beneficial nutrients and phytonutrients found in whole grains have individual, synergistic and additive actions that positively affect health.(6, 7)

Here is an outline of some of the many possible mechanisms by which whole grains reduce risk of disease(5):

• The actions and interactions of the many phytonutrients, including antioxidant compounds and polyphenols found in whole grains.
• The ‘prebiotic effect’ of whole grains which results in beneficial changes in the good bacteria which live in our gut.
• Beneficial pH changes in the colon.
• Through a positive influence on blood glucose control, particularly with low glycemic index (GI) whole grain foods including oats, rye, barley and quinoa based foods.
• Through the beneficial effects of the different types of dietary fibres which promote digestive regularity and digestive wellbeing.  

For a guide to boost your whole grain intake, check out GLNC’s Fact Sheet Whole grain foods - A hallmark of a healthy diet.

References:

1. O'Neil CE, Nicklas TA, Zanovec M, 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. 2010;110(10):1461-8.
2. O'Neil CE, Nicklas TA, Zanovec M, Cho SS, Kleinman R. Consumption of whole grains is associated with improved diet quality and nutrient intake in children and adolescents: the National Health and Nutrition Examination Survey 1999-2004. Public health nutrition. 2011;14(2):347-55.
3. NHMRC. A Modelling System to Inform the Revision of the Australian Guide to Healthy Eating. . Canberra Department of Health and Ageing, 2011.
4. GLNC. The Grains & Legumes Health Report. Grains & Legumes Nutrition Council, 2010.
5. Slavin J. Why whole grains are protective: biological mechanisms. The Proceedings of the Nutrition Society. 2003;62(1):129-34.
6. Okarter N, Liu RH. Health Benefits of Whole Grain Phytochemicals. Critical reviews in food science and nutrition. 2010;50(3):193-208.
7. Liu RH. Potential Synergy of Phytochemicals in Cancer Prevention: Mechanism of Action. The Journal of nutrition. 2004;134(12):3479S-85S.

75% of Australians are not eating enough whole grains

According to preliminary results of a nationally representative survey conducted by GLNC the majority of Australians, 75 per cent, may be putting their health at risk by not eating the recommended amount of whole grains each day.(1) 

Whole grain foods such as whole grain breads, breakfast cereals, crispbreads and intact whole grains (i.e. oats, brown rice) are significant contributors to dietary fibre, vitamin and mineral intake in the Australian diet.(2) 

As nutritious foods the Australians Dietary Guidelines (ADG)(3) encourage Australians ‘to enjoy a variety of grain foods each day, mostly whole grain or high cereal fibre varieties’. In addition, GLNC encourages Australians to aim to meet the whole grain Daily Target Intake (DTI) which is 48 grams each day for adults. These recommendations are underpinned by the significant nutrition contribution whole grain foods make within a balanced diet and the body of scientific evidence which shows that three or more serves of whole grain foods each day is linked with a reduced risk of heart, diabetes, bowel cancer and weight gain.(3, 4)

To compare Australians’ whole grain intakes with current dietary recommendation the 2014 Australian Grains and Legumes Consumption and Attitudinal Study(1), due for full release in October, investigated the eating habits of 3,031 Australians aged 2 to 70 years. The survey reported the daily serves of whole grain foods of Australians and for the first time also reported daily grams of whole grain intakes. 

This recent survey found that 3 in 4 Australians are not consuming three or more serves of whole grain foods each day, and so are not meeting ADG whole grain recommendations or their respective whole grain DTI. Of particular concern is that this is driven by a large proportion of the population (over 40% of adults and over 50% of children) who are eating less than one serve or zero serves of whole grain foods each day. In addition, overall daily consumption of whole grain for Australian adult’s foods has declined since 2011. Clearly there is room for Australians to improve grain food choices to meet whole grain recommendation and reduce risk of disease. 

While this survey found that most Australians are aware that the whole grain content in food varies(1), one key reason which may be influencing Australians whole grain intake is that it can be hard for consumers to identify and choose better quality whole grain foods due to inconsistent labelling. As such it is clear there is a need for greater awareness of the nutritional benefits of grain foods accompanied with an industry standard to help people better understand the whole grain content in foods, and ultimately to make better food choices when filling their supermarket trolleys.   

To support national dietary recommendations and to set the record straight about foods labelled as whole grain, the Grains & Legumes Nutrition Council (GLNC) is collaborating with the Australian food industry to roll out the voluntary Code of Practice for Whole Grain Ingredient Content Claims.  

Until recently there has been no industry standard for how whole grain content of foods were defined and so for the first time consumers will begin to see consistent descriptions on foods labelled as whole grain – and can choose better products that say ‘contains’, ‘high’ or ‘very high’ in whole grain. This new industry standard will help people identify which foods actually contain a significant or higher amount of whole grain.

To date twelve major food companies have already signed up to GLNC’s Code of Practice to align their labelling of whole grain products with the new standard. Current Registered Users of the Code include a range of grain food manufacturers:  Bakers Delight, Cereal Partners Worldwide/Nestle, Continental Biscuit Manufacturers, General Mills, George Weston Foods, Goodman Fielder, Griffins Foods, Mondelez International, Sanitarium Health & Wellbeing Australia, Sanitarium Health & Wellbeing New Zealand, Tucker’s Natural, Woolworths.

References:

1. GLNC. 2014 Australian Grains and Legumes Consumption and Attitudinal Report. Unpublished: 2014.
2. ABS. Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011-12. Australian Bureau of Statistics, 2014.
3. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.
4. Griffiths T. Towards an Australian ‘daily target intake’ for wholegrains. Food Australia. 2007.

Trends for grains & legumes in 2014 - update

With a constantly evolving range of foods on our supermarket shelves and a huge number of product launches every week, we take a look behind the global trends that are influencing what we will see in our supermarkets in 2014 and beyond. Sarah Hyland, Research Director at Colmar Brunton, provides an update on the key trends, together with some consumer insights and the potential implications for grain and legume foods.

‘Free From’ movement continues to grow
Although it has often been dismissed as a “fad”, the consistent growth in sales of gluten-free products over the last decade has proven that there is enduring consumer interest in the ‘free from’ movement. The segment is moving mainstream, as product development widens into new categories, and supermarkets are responding with launches of own label. The same trend can be seen in the milk category, with increased launches of soy and almond milks, new variants emerging such as rice, quinoa, and coconut milks, and the expansion into new sub-categories with the launch of added fibre milks. Growing consumer interest and self-diagnosis of other allergies and intolerances are driving expansion beyond gluten and lactose, to GM, additive, preservative free.

Growth in this industry is being driven by to two factors: taste and health. Improved palatability has taken these foods beyond the niche of people who for medical reasons have no choice but to eat gluten-free products and made them accessible to consumers who choose to eat gluten-free. The interest in health has spread from those diagnosed with specific allergies and intolerances, via the self-diagnosed, to those with a more general interest in health and wellbeing.

It is clear that the free-from sector is set for further growth, and this has several implications for food manufacturers. Because taste remains the key to success even for foods that focus on better-for-you nutrition, gluten free foods must be palatable in order to succeed. Although consumer acceptance of higher pricing for gluten free foods can prove lucrative for some manufacturers, the costs of formulating gluten-free products, preventing cross-contamination and guaranteeing traceability can be substantial. Manufacturers of grain based foods are increasingly exploring alternative (gluten-free) grains, such as rice, tapioca and potato flours to satisfy this growing demand.

Protein – focus shifting to weight management
Whilst protein for weight management isn’t a new trend, it has certainly undergone an evolution. High protein foods have transitioned from body-builder niche through to weight management and health-conscious consumers. There is steadily increasing consumer understanding that protein is a “good thing” to have in a healthy diet and an increased emphasis given to protein by weight management regimes. This is reflected in the use of protein as something you expect to find in a variety of regular foods, not only as part of a main meal.

Protein rich ingredients are being added to foods in other categories, e.g. cereal bars, powdered shakes, soups, pastas, ready-to-drink beverages, cereals and sweet and savoury snacks and new product formulations, e.g. high protein breads, higher protein cereals, are substituting or combining grains to increase the protein content. Plant proteins such as pea, potato, chickpea, banana, sprouted brown rice and also microalgae are emerging as a way to bolster protein to meet this demand, particularly among vegetarian consumers. In keeping with the ‘free from’ movement, a ‘natural’ identify is being legitimised by pairing with familiar ingredients, such as oats and honey.
Messages around the benefits of protein for weight management, satiety and sustained energy are resonating well with consumers and this is reflected in brands calling out protein content on pack. Improvements in the taste and texture of high protein products continue, as this trend widens to a more mainstream audience whose consumption is driven by more than simply sporting performance.

‘Weight Wellness’ – it’s all about how you feel
A more holistic approach to nutrition is being seen with the emergence of a trend towards ‘weight wellness’. This approach is centred around eating right for optimal health and the emotional outcome of eating foods to ‘feel good’ and ‘energised’. An optimal weight is viewed as being one at which our bodies feel healthy and happy and is not defined or dictated by aesthetic, shape, or weight. Coupled with this focus on the emotional outcomes of health and nutrition, is the demand for highly individualised choices. This is reflected in the growth of apps and online programmes, whilst structured weightloss programmes and meetings are in decline. Consumers are guided by what friends and family are doing and a general sense of doing what they believe actually works for them. Choices are highly influenced by information online, which typically discourage eating processed foods, grains, dairy and refined sugar, and position them as allergens. Companies appealing to the wellness segment are typically blending a natural and weight management position.

‘Slow Energy’ – a complex message for consumers
Whilst there has been a sharp increase in the number of products launches and claims around ‘slow energy’, this remains relatively niche. Previously ‘energy’ was monopolised by the energy drinks sector, which was built around providing additional energy often in the form of caffeine. The emerging ‘slow energy’ is differentiated in that it focuses on sustaining energy, i.e. not adding extra, just making it last longer.

Messages of ‘slow release energy’ resonate strongly with consumers, but claims are complex and difficult to communicate effectively. Consumers are highly fragmented in how they interpret the health benefits, varying from ‘healthy’, to blood sugar control, and sustained energy. Most consumers are thinking about their weight and their energy levels, but they don’t yet see themselves as in a disease state and they make their choices from “regular foods”

Selecting ingredients to deliver the slow energy effect typically leads product developers to slowly digestible carbohydrates, of which oats and barley are well known, but there may also be opportunities for lesser grains such as sorghum and millet.

Low FODMAP diets - recommendations

FODMAPs refer to a group of small chained carbohydrates which are poorly absorbed in the small intestine and so pass into the large intestine where they are fermented by gut bactieria (1). Grain foods and legumes contain FODMAPs including fructans found in wheat and rye, and galacto-oligosaccharides (GOS) found in legumes (1). Fructans and GOS, together with other FODMAPs, may cause symptoms such as gas and bloating in people that suffer from irritable bowel syndrome (IBS) (1,2).

Recent research from Monash University has concluded that a low FODMAP diet can effectively reduce the symptoms of Irritable Bowel Syndrome (IBS) (3). As a treatment for IBS, people may follow a low FODMAP diet that excludes foods containing fructans and GOS (i.e. wheat, rye and legumes) for a period of time.

GLNC supports the findings of the valuable research conducted by Monash University and appreciates that to manage symptoms of IBS, people may follow a low FODMAP diet for a short period of time. However, GLNC also recognises that a low FODMAP diet is not recommended as a long term diet, nor is it recommended for the general population.

A low FODMAP diet is designed to be followed for a 2-6 week period to alleviate symptoms associated with IBS, after which individuals are advised to slowly re-introduce foods containing FODMAPs, under the guidance of an Accredited Practising Dietitian, to identify their tolerance level of these foods to maintain a healthy diet.

Research indicates that FODMAPs are probably essential for maintaining a healthy population of gut bacteria which has implications on long term health (4,5). Grain-based foods are important sources of protein, dietary fibre, vitamins and minerals. Whole grain and high fibre grain foods and legumes also contain essential nutrients and phytonutrients that promote health and help protect against disease (6).

For this reason, GLNC maintains that a low FODMAP diet is not a diet for the long-term, nor is it a diet recommended for the general population. Australians should eat a wide variety of grains and legumes as part of a balanced diet (3); grain foods 3 - 4 times a day, choosing at least half as whole grain or high fibre grain foods and legumes at least 2 - 3 times each week.

GLNC recommends that individuals with symptoms of IBS see an Accredited Practising Dietitian experienced in IBS management.


References

1. Biesiekierski JR, Rosella O, Rose R, et al. Quantification of fructans, galacto-oligosacharides and other short-chain carbohydrates in processed grains and cereals. J Hum Nutr Diet. 2011;24:154-176.
2. Gibson et al. J Gastroenterol Hepatol. 2010;25(2):252-8
3. Gibson PR, Barrett JS, Muir JG. Functional bowel symptoms and diet. Internal Medicine Journal. 2013;43(10):1067-74.
4. Staudacher et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. Journal of Nutrition, 2012;142;1510-8
5. Dr Jane Muir, J et al. Conference Presentation: What are the risks/benefits of fermentable carbohydrates? The FODMAP story. Accessed online http://www.glnc.org.au/4th/events/ilsi-presentations/ 4th April 2013.
6. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.

The whole grain gap - comparing whole grain intakes to recommendations

At the Dietitians Association of Australia National Conference in Brisbane in May 2014 Chris Cashman, GLNC Nutrition Project Officer, presented the whole grain findings from the GLNC 2014 Consumption and Attitudinal Study which investigated Australians whole grain intakes compared with recommendations – the whole grain gap (1).

Whole grain foods such as wholemeal breads, breakfast cereals, porridge, crispbreads, wholemeal pasta and brown rice are recommended around the world as part of a healthy diet. In Australia recommendations encouraging whole grain foods include the Australian Dietary Guidelines (ADG) and the 48 gram whole grain Daily Target Intake (DTI) for adults. Each of these recommendations is underpinned by evidence that eating at least three serves of whole grain foods each day is linked with improved nutrition and a reduced risk of weight, heart disease and type 2 diabetes.(2,3)

To compare Australians whole grain intakes to recommendations, GLNC conducted its third national Consumption and Attitudinal Study in March 2014, collecting two days of food intake data from 3,031 Australians aged 2 – 70 years. (2)

The survey found that 65% of Australians eat whole grain foods daily, with whole grain or wholemeal breads, porridge and breakfast cereals being the most common choices. On average Australians eat only 1.69 serves of whole grain foods each day (less than 2 slices of bread) this is less than half of the average 3.88 daily serves of core grain foods (grain foods recommended as part of the Australian Guide to Healthy Eating).

Overall the key finding of this survey was that 75% Australians are not meeting the whole grain recommendations of 3 serves or more each day and the 48 gram whole grain DTI.  Of particular concern is that this is being driven by 40% of adults and 50% of children eating less than one serve of whole grain foods each day

This finding clearly demonstrates that the whole grain gap continues to exist and suggests many Australians are not may benefit from the reduced risk of heart disease and type 2 diabetes associated with increasing whole grain intakes. As such there is an ongoing need to encourage Australians to enjoy a variety of grain foods, choosing mostly whole grain and high fibre grain foods.

To help Australians choose higher in whole grain foods GLNC has taken an active role by establishing an Industry Standard through the Code of Practice for Whole Grain Ingredient Content Claims. This Industry Standard requires foods to contain a minimum amount of 8 grams or more of whole grain per serve to carry a whole grain claim on its packaging.

To register your interest in GLNC’s publication of the 2014 Consumption and Attitudinal Study Report available from October 2014, please email contactus@glnc.org.au.

References

1. Grains & Legumes Nutrition Council. 2014 Australian Grains and Legumes Consumption and Attitudinal Report. Unpublished: 2014.
2. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.
3. Griffiths T. Towards an Australian ‘daily target intake’ for wholegrains. Food Australia. 2007

Almost one million Australians may be self-diagnosing wheat intolerance

At the Dietitians Association of Australia National Conference in Brisbane in May Michelle Broom, GLNC Nutrition Program Manager, presented the findings of the GLNC 2011 Consumption and Attitudinal Study related to trends in avoidance of grain foods (1).

The GLNC Study found many Australians may be cutting wheat from their diet based on self diagnosis without seeking guidance from dietitians or nutritionists. The aim of this study was to determine Australians attitudes and behaviours towards grains, particularly reasons for limiting grains in the diet.

A 30 question survey was conducted in 2011 of a nationally representative sample of 1,204 Australians, aged 15–80 years, 44% women. 16% of participants reported limiting or avoiding wheat. Limiting wheat was more common in women (22%) than men (12%). Of those reporting to have a wheat intolerance, self-diagnosis was cited by 35%. Compared to other age groups, 25-34 year olds were significantly more likely to self diagnose. Health care professional diagnosis was reported in 31% of cases, including 5% by a dietitian. The age group most commonly diagnosed by a dietitian was 15-24 years. Only 17% of those limiting wheat in their diet had sought dietary advice from a dietitian or nutritionist. Men and people aged 35-49 were more likely to seek guidance. The true prevalence of wheat intolerance in Australia is not well established. However, this survey indicates potentially 3.6 million Australians are avoiding wheat, with over one million people doing so based on self-diagnosis of intolerance and many are not seeking professional dietary guidance to ensure they are following a healthy, balanced diet.

To prevent people cutting grain foods out of their diet unnecessarily it is essential Australians understand the importance of grain foods in the diet beyond the contribution of carbohydrate. Recent results of the 2011 Australian Health Survey indicate grain based foods are the key contributor of seven key nutrients in the Australian diet including fibre, iron, magnesium, iodine and B vitamins including folate (2).

References

1. Grains & Legumes Nutrition Council. 2011 Australian Grains and Legumes Consumption and Attitudinal Report. Unpublished: 2011.
2. ABS. Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011-12. Australian Bureau of Statistics, 2014.

Gluten free – be wary of the health halo

While a gluten-free diet is essential for people with coeliac disease, the scientific evidence indicates the avoidance of gluten offers little benefit for most people read more here. Despite a lack of conclusive scientific evidence, the gluten free trend continues to grow off the back of high profile celebrity endorsements, anecdotal evidence and clever marketing. As this global trend is set to continue to influence Australian’s food choices here are some insights and tips to making healthy grain food choices gluten free or otherwise.

Be wary of the gluten free ‘health halo’
The skyrocketing demand for gluten free products from consumers in recent years is likely a reflection that many people’s take home message on gluten is that ‘gluten is bad’. This explains why gluten free claims on food packaging have a “health halo” effect, meaning people perceive a product with a gluten free claim on its packaging as being healthier than other similar products.

In contrast to this perception that gluten free foods may be healthier, a recent investigation of gluten free products by CHOICE indicates that gluten free products often require extra ingredients such as additional fat, extra sugar to create a palatable texture or flavour. In addition, a recent analysis by GLNC of breads and breakfast cereals found that gluten free options tended to be lower in whole grain, fibre and protein, while higher in fat content compared with products not carrying a gluten free claim.(1)

The gluten free “health halo” helps to explain why some people link gluten free foods or a gluten free diet with weight loss. However, it is unlikely that the gluten protein plays a direct role in weight loss, rather weight loss which may be reported after adopting a gluten free diet is in fact a result of a reduced overall energy intake through the ‘cutting out’ of foods which is commonly associated with going gluten free.

Gluten free doesn’t mean grain free
Did you know that grain foods including breads, breakfast cereals, crispbreads and intact grains (oats, rice, quinoa etc), gluten free or otherwise are the number one source of fibre, folate, thiamine, iron, magnesium, iodine, and carbohydrates(2) within the Australian diet?

While ‘cutting out’ or reducing intake of foods higher in added fats, sugars and sodium like biscuits, cakes and take away is a good outcome, cutting out core grain foods recommended as part of a balanced diet  may increase your risk of not meeting your requirements of a range of essential nutrients. This is why it is so important to note that ‘gluten free’ doesn’t mean grain free.

The great news for people with coeliac disease as well as people looking to add variety to their diet is that today there is a wide range of grains available to Australians. These include grains which are naturally gluten free such as rice, quinoa, millet, buckwheat, amaranth and sorghum. Besides being gluten free these grains are nutritionally similar to gluten containing grains which means they too deliver the essential nutrients we need for health within a balanced diet. They are also prepared and used in much the same way and so are suitable for all meal occasions in a range a cuisines and dishes.

So which grain foods are actually healthier?
Dietary Guidelines around the world recommend a variety of grain foods, mostly whole grain and high fibre grain foods as part of a healthy diet. These recommendations are based on the important nutrient’s these foods provide and the evidence from large population studies which associate eating grain foods, particularly whole grains and high fibre grain foods with a reduced risk of weight gain, heart disease, type 2 diabetes and bowel cancer.(3)

As breads and breakfast cereals made with wheat, oats, barley or rye are the most commonly eaten grain foods in Australia, it’s clear that these foods make a significant contribution towards Australians nutrient intakes and have lots of potential to reduce risk of disease as part of a balanced diet.

The future…
As demand for gluten free products continues to grow in the coming years, you will no doubt see more and more products making gluten free claims. It is important to be mindful of the “health halo” effect and in line with the dietary guidelines aim to choose higher in whole grain and fibre grain foods more often while limiting discretionary choices like biscuits, cakes and take aways.

The good news is that the demand for healthier options is leading food manufacturers to innovate and develop more nutritious grains foods using gluten free grains and other gluten free ingredients such as legumes. As such the future will no doubt have healthier gluten free options than those products previously available.

References

1. GLNC. 2014 Audit of Core Grain Foods on Shelf in Australia. Unpublished: 2014.
2. ABS. Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011-12. Australian Bureau of Statistics, 2014.
3. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014

Cereal fibre – key to healthy living

A walk down the ‘health aisle’ of your local supermarket is a powerful demonstration of the popularity of the ‘free-from’ movement, including gluten-free and grain-free. But in the pursuit of health by cutting out grains many people may be missing out on a key source of fibre and actually increasing their risk of chronic disease.

A recent study in the US found a diet higher in whole grain foods is more likely to be higher in fibre. While this may not seem like new news to most health care professionals, it seems many consumers may have forgotten the importance of these foods as a source of fibre.

The study found a strong association between the intake of whole grain foods, such as bread and breakfast cereal, with total dietary fibre intake for both children and adults. Compared to those who ate no whole grain, adults who ate at least 3 serves per day were 76 times more likely to fall into the highest fibre intake group. The major whole grain sources included bread/rolls, oatmeal, breakfast cereals, and popcorn. Among those with the highest whole grain intake, whole grain breakfast cereals were the greatest contributor to total dietary fibre.

To help Australians boost their fibre intake it is important to remind people of the importance of eating whole grain foods and high fibre grain foods in line with the Australian Dietary Guidelines recommendation to enjoy grain foods each day, choosing mostly whole grain and/or higher fibre varieties.

While fruit and veggies are an important part of the diet and key sources of fibre, two recent study highlight the importance of cereal fibre in the diet. These studies add to the significant body of evidence that higher intakes of cereal fibre reduce risk of a range of chronic conditions including obesity, heart disease, diabetes and colorectal cancer.

In the first study, a meta analysis of 17 prospective cohort studies found higher cereal fibre intakes were associated with a 23% reduced risk of type 2 diabetes. The risk reduction from cereal fibre was stronger than both total fibre (19%) and fruit fibre (6%). In comparison, there was no significant reduced risk with higher fibre intakes from vegetables.

Interestingly, this is the first study to determine the dose of fibre associated with reduced risk of type 2 diabetes. A reduced risk was seen with as little as 3 grams of cereal fibre per day and the risk decreased by 6 % for each additional 2 grams per day.  In comparison a threshold of 25 grams of total fibre was needed before a significant risk reduction was seen.

The second study, an analysis of two large US cohort studies, found heart attack survivors with higher cereal fibre intake had a 25% lower risk of dying in the nine years following their heart attack. Cereal fibre intake in particular demonstrated the greatest protection compared to other sources of fibre.

The current Nutrient Reference Values for dietary fibre are based on an estimated adequate intake for gastrointestinal function and adequate laxation. However this study adds to the significant body of evidence that higher intakes of cereal fibre reduce risk of a range of chronic conditions including obesity, heart disease, diabetes and colorectal cancer. Encouraging Australians to choose foods high in cereal fibre more often and ensuring whole grain foods are available may assist people to meet and/or exceed the adequate intakes for dietary fibre and achieve health benefits beyond the effects of fibre on gastrointestinal function and laxation.

1. Li S, Flint A, Pai J, Forman J, Hu F, Willett W, Rexrode K, Mukamal K, Rimm E. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study. BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g2659 (Published 29 April 2014)
2. Reicks M, Jonnalagadda S, Albertson AM, Joshi N. Total dietary fibre intakes in the US population are related to whole grain consumption: results from the National Health and Nutrition Examination Survey 2009 to 2010. Nutrition Research. 2014,34(3):226-234. 
3. Yao B1, Fang H, Xu W, Yan Y, Xu H, Liu Y, Mo M, Zhang H, Zhao Y. Dietary fiber intake and risk of type 2 diabetes: a dose-response analysis of prospective studies. Eur J Epidemiol. 2014,29(2):79-88.