Tuesday, February 9, 2016

Healthy Ageing with Grains and Legumes

By Julie Christy, Accredited Practising Dietitian

As Australia faces an ageing population, addressing health issues associated with ageing is becoming increasingly important. While most older Australians may understand they should be eating more fruit and vegetables for better health, many may not also recognise that higher intakes of core grain foods (mostly whole grain and high fibre) and legumes can be an effective strategy for preventing and managing chronic disease as well as for promoting longevity. With older Australians’ intakes of core grains and legumes falling below recommended intakes, many are missing out on the benefits these foods offer for healthy ageing.

How can grains and legumes benefit older Australians?
With older Australians experiencing the highest incidence of diet related chronic diseases – including heart disease, type 2 diabetes, obesity and cancers, such as bowel cancer – understanding the most powerful dietary strategies to reduce the risk of such diseases can help older Australians to make the best choices for themselves.

While many are aware that plant based foods offer the greatest protection against diet related diseases, it may come as a surprise that a recent comprehensive review, the first of its kind which included a pooled analysis of over 300 meta-analyses and systematic reviews, found that whole grain/high fibre grain foods appear to offer the greatest protection against diet related disease out of all plant based foods.(1) This is not the first study to highlight the potential that whole grain and high fibre foods can play against diet related diseases, as evidence based dietary guidelines from around the world widely recommend a balanced diet, with core grain foods (mostly whole grain and high fibre) and legumes being key components in such recommendations. (2-8)

At the recent Oldways “Finding Common Ground” Conference, a team of leading nutrition experts from a range of dietary research backgrounds reached a consensus on the fundamental principles of healthy eating. According to the OldwaysCommon Ground Consensus Statement, a healthy dietary pattern is one that is high in plant based foods such as whole grains and legumes, along with fruits, vegetables and nuts.(9) As part of this dietary pattern, grains and legumes represent a rich source of nutrients such as fibre, folate, thiamine, iron, magnesium and iodine(10) as well as protective components like phytonutrients that are important for wellbeing over the lifespan.

Not surprisingly, the benefits of incorporating grains and legumes into your diet extend beyond simply reducing the risk of disease but also help to promote longevity. A study from Harvard researchers found that people with the highest whole grain intakes had a 17% lower risk of death from all causes and an 11–48% lower risk of disease-specific mortality compared to people with the lowest intakes of whole grain.(11) Meanwhile, the role of legumes in contributing to a long life has been observed in the diets of long-lived cultures such as the Japanese, who regularly eat soy foods such as tofu, natto, and miso, and people from the Mediterranean, where lentils, chickpeas, and white beans are important components of the traditional diet.(12)

Despite these benefits, older Australians do not appear to be achieving recommendations. The GLNC 2014 Consumption Study found that on average, both men and women aged 51-70 years fell short of the daily core grain serves recommended by the Australian Dietary Guidelines and they also fell short of their 48g whole grain Daily Target Intake. Worryingly, the study also found that only 25% of 51-70 year old Australians overall reported legume consumption on one or both days of the survey. This suggests that older Australians are at risk of missing out on key nutrients important for good health and longevity.

Cultivating good health with grains and legumes
Making just a few small changes can make a big difference to the health of older Australians – eating 2-3 serves of whole grains daily can reduce the risk of developing chronic disease by 20-30%,(13) whilst just a 20g increase in daily legume intake can reduce the risk of death by 7-8%.(14) GLNC recommends that all Australians, including older men and women, enjoy grain foods 3-4 times a day, choosing at least half as whole grain or high fibre, and also aim to enjoy legumes at least 2-3 times each week.

Overall, making healthy choices with core grains and legumes as a priority in your diet is important to leading a long and healthy life. Simple changes older Australians could make to improve their grain and legumes choices toward meeting recommendations include:
  • Choosing whole grain crispbreads, unsalted air-popped popcorn, or wholemeal fruit toast as snacks over discretionary choices such as sweet biscuits, cakes or muffins
  • Adding barley, brown rice or other whole grains to soups, stews and casseroles
  • Swapping pastries and pies for a sandwich, made with whole grain or high fibre bread, at lunch
  •  Looking for breakfast cereals that are high in whole grain or fibre
  • Substituting serves of legumes into your favourite dishes such as kidney beans in casseroles, red lentils in spaghetti bolognaise or chickpeas into any salad.

For more information on the impact of grain and legumes on health and for lots of tasty recipe ideas visit GLNC’s website.

References
1.            Fardet A, Boirie Y. Associations between food and beverage groups and major diet-related chronic diseases: an exhaustive review of pooled/meta-analyses and systematic reviews. Nutrition Reviews. 2014 Dec;72(12):741-62.
2.            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.
3.            NHMRC. Australian Dietary Guidelines - Providing the scientific evidence for healthier Australian diets. 2013. Accessed online January 2014.
4.            Priebe MG, van Binsbergen JJ, de Vos R, Vonk RJ. Whole grain foods for the prevention of type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews.2008(1):Cd006061.
5.            Aune D NT, 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.
6.            Kushi LH, Meyer KA, Jacobs DR J. Cereals, legumes, and chronic disease risk reduction: evidence from epidemiologic studies. The American Journal of Clinical Nutrition. 1999;70(3 Suppl):451s-8s.
7.            Afshin A, Micha R, Khatibzadeh S, D M. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. The American Journal of Clinical Nutrition. 2014 Jul;100(1):278-88.
8.            Food and Agriculture Organization of the United Nations. Food-based dietary guidelines [cited 2016 January]. Available from: http://www.fao.org/nutrition/education/food-dietary-guidelines/regions/en/.
9.            Oldways. Oldways Common Ground Consensus Statement on Healthy Eating [cited 2016 January]. Available from: http://oldwayspt.org/common-ground-consensus.
10.          Australian Bureau of Statistics. Australian Health Survey: Nutrition First Results - Food and Nutrients, 2011-12. Canberra: Commonwealth of Australia; 2014.
11.          Tao Huang MX, Albert Lee, Susan Cho, Lu Qiu. Consumption of whole grains and cereal fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals. BMC Med. 2015;13(59).
12.          WHO. Life expectancy: Life expectancy by country [cited 2013 July]. Available from: http://apps.who.int/gho/data/node.main.688?lang=en.
13.          GLNC. The Grains & Legumes Health Report. Grains & Legumes Nutrition Council: 2010.

14.          Darmadi-Blackberry I, Wahlqvist ML, Kouris-Blazos A, Steen B, Lukito W, Horie Y, et al. Legumes: the most important dietary predictor of survival in older people of different ethnicities. Asia Pacific Journal of Clinical Nutrition. 2004;13(2):217-20.