Australians Are Falling Short on Cereal Fibre

by Eden Barrett,  Accredited Practising Dietitian and PhD candidate from the University of Wollongong 

When we think about the benefits of fibre, we typically think about its role in digestive health and staying regular. While this is certainly one of fibre’s great benefits, there are many more you may be less familiar with. For example, did you know that a diet high in fibre has also been found to protect against heart disease, type 2 diabetes and some cancers (1,2,3). Additionally, fibre helps you to feel full eating fewer calories, which may explain why higher intakes of fibre are also associated with lower body weight (4).

What is particularly interesting is that these associations are often found to be strongest with high intakes of cereal fibre specifically (3,5,6,7), meaning the fibre that comes specifically from grain foods such as breads, pasta, rice and breakfast cereals.

To understand how much cereal fibre Australians are currently eating, we recently conducted some research with the University of Wollongong to develop a database of more than 1,900 foods containing cereal fibre, expanding on the current AUSNUT 2011-13 food composition database. This database allowed us to estimate how much cereal fibre Australians are getting through the foods they eat. In addition, we were also able to determine the main foods which were contributing to cereal fibre intake as well as how the amount of cereal fibre a person is eating may be related to their likelihood of meeting daily total fibre targets.

On average, Australian adults ate 6.4g of cereal fibre each day, while Australian children and adolescents ate 6.2g each day (8). This is the equivalent of about 2-3 slices of whole grain bread or 1 cup of wholemeal pasta. The main food items contributing cereal fibre within the Australian diets were:

• Breads and bread rolls (29% of adult intake and 27% of child intake)
• Ready to eat breakfast cereals and porridge (29% of adult intake and 22% of child intake)
• Cereal-based mixed dishes (e.g. spaghetti bolognaise or risotto) (13% of adult intake and 16% of child intake).

Australians who ate the most cereal fibre were not only eating more cereal foods in general but were also choosing higher-fibre varieties, such as whole grain breads and breakfast cereals, porridge, whole wheat pasta and bran-based products.

Interestingly, those who ate the most cereal fibre also ate the most total dietary fibre and were more likely to meet the recommended daily target for dietary fibre (30g/day for men and 25g/day for women):

• Men with diets highest in cereal fibre were 4.4 times more likely to meet the recommended target for total dietary fibre.
• Women with diets highest in cereal fibre were 3.1 times more likely to meet the target for total fibre.

With that in mind, how much cereal fibre should you be eating, and how can you increase your intake? Within Australia, there is no guideline on how much cereal fibre to eat. However, the Australian Dietary Guidelines suggest adults should aim for four to six serves of grain foods each day and we should aim to choose whole grain, high-fibre options at least half of the time.

While different grains differ in the amount of fibre they provide, opting for whole grain cereal foods is a good way to increase your cereal fibre intake. Importantly, whole grain foods also contain other important nutrients such as magnesium and iron, as well as many B vitamins (thiamin, riboflavin, niacin and folate).

There are many ways to add whole grains in to your diet at every meal or snack. Here are just a few simple ideas to get you started:

• Use wholemeal or whole grain bread for your sandwich at lunch
• Go for plain popcorn or whole grain crackers as a high fibre snack
• Try porridge in the colder months or muesli in Summer as an easy breakfast option
• Give wholemeal pita breads a go for healthy homemade pizzas
• Substitute regular flour for oat flour when baking muffins or making pancakes
• Try wholemeal pasta or brown rice to boost the fibre content of your favourite family dinners

And remember, even small changes can have big benefits for your health. Just starting with one of these simple swaps to a higher fibre, whole grain option will help to boost your cereal fibre intake and contribute to a healthier you!

References

1 Yao, B. D., H. Fang, W. H. Xu, Y. J. Yan, H. L. Xu, Y. N. Liu, M. Mo, H. Zhang and Y. P. Zhao (2014). "Dietary fiber intake and risk of type 2 diabetes: a dose-response analysis of prospective studies." European Journal of Epidemiology 29(2): 79-88.

2 Wu, Y. H., Y. F. Qian, Y. W. Pan, P. W. Li, J. Yang, X. H. Ye and G. Xu (2015). "Association between dietary fiber intake and risk of coronary heart disease: A meta-analysis." Clinical Nutrition 34(4): 603-611.

3. Aune, D., D. S. Chan, R. Lau, R. Vieira, D. C. Greenwood, E. Kampman and T. Norat (2011). "Dietary fibre, whole grains, and risk of colorectal cancer: systematic review and dose-response meta-analysis of prospective studies." BMJ 343: d6617.

4 Du, H., H. C. van der A Dl Fau - Boshuizen, N. G. Boshuizen Hc Fau - Forouhi, N. J. Forouhi Ng Fau - Wareham, J. Wareham Nj Fau - Halkjaer, A. Halkjaer J Fau - Tjonneland, K. Tjonneland A Fau - Overvad, M. U. Overvad K Fau - Jakobsen, H. Jakobsen Mu Fau - Boeing, B. Boeing H Fau - Buijsse, G. Buijsse B Fau - Masala, D. Masala G Fau - Palli, T. I. A. Palli D Fau - Sorensen, W. H. M. Sorensen Ti Fau - Saris, E. J. M. Saris Wh Fau - Feskens and E. J. Feskens "Dietary fiber and subsequent changes in body weight and waist circumference in European men and women." (1938-3207 (Electronic)).

5 Hajishafiee, M., P. Saneei, S. Benisi-Kohansal and A. Esmaillzadeh (2016). "Cereal fibre intake and risk of mortality from all causes, CVD, cancer and inflammatory diseases: a systematic review and meta-analysis of prospective cohort studies." Br J Nutr 116(2): 343-352.

6. Schulze, M. B., M. Schulz, C. Heidemann, A. Schienkiewitz, K. Hoffmann and H. Boeing (2007). "Fiber and magnesium intake and incidence of type 2 diabetes - A prospective study and meta-analysis." Archives of Internal Medicine 167(9): 956-965.

7. Koh-Banerjee, M. F., M. Franz, L. Sampson, S. Liu, D. R. Jacobs, Jr., D. Spiegelman, W. C. Willett and E. Rimm (2004). "Changes in whole-grain, bran, and cereal fiber consumption in relation to 8-y weight gain among men." Am J Clin Nutr 80(5): 1237-1245.

8. Barrett, E. M, Probst, Y. C & Beck, E. J (2017). “Creation of a database for the estimation of cereal fibre intake”. Submitted to Journal of Food Composition and Analysis.

New Research Reveals That Eating Core Grain Foods Doesn't Affect Your Waistline!

 Key takeouts from the research:

• Australian adults with the highest intakes of core grain foods, which is the leading source of carbohydrate in our diets, had similar waist circumferences and BMI’s compared to those with the lowest intakes of core grain foods¹.

• Adults who avoid core grain foods are at risk of missing out on essential nutrients including fibre, which is beneficial for good gut health².

New results from a survey of over 9,000 Australian adults, published last week in the journal Nutrients, found that eating core grain foods isn’t linked to the size of your waistline. Adults with the highest intakes of core grain foods - which includes bread, breakfast cereals and pasta – had similar waist circumferences and BMI’s compared with adults who had the lowest core grain intakes.

This ground breaking analysis of the 2011-12 National Nutrition and Physical Activity Survey, commissioned by the Grains & Legumes Nutrition Council (GLNC), found that not only was higher consumption of these grain foods not linked to a higher waist size, but grain consumers actually had a healthier diet and lifestyle pattern compared to those who avoided core grain foods¹.

The analysis of this research also demonstrated what many people have forgotten – grain foods are an essential source of fibre in our diet and Australians who eat more core grain foods have significantly higher fibre intakes than those who limit or avoid them. Emerging evidence also suggests that fibre-rich carbohydrate foods promote good gut health², which may ultimately have a favourable effect on health and chronic disease risk.

Overall grain consumption has declined over the last decade, with many Australians actively limiting gluten or carbohydrates - 42% of Australians report that they limit grain foods to assist with weight loss³. Many of these worrying trends are driven by widespread misconceptions and a lack of understanding about the multiple health benefits of grain foods.  

Rebecca Williams, Nutrition Manager and Accredited Practising Dietitian at GLNC explains the risks of limiting grain foods “Adults who limit healthy sources of carbohydrate - including core grain foods - end up putting themselves at risk of missing out on essential nutrients, such as fibre, folate, thiamine, iron, magnesium and zinc.”

“This new research highlights that we don’t need to cut back on grain foods like bread and pasta for weight management and actually, by doing so, people are putting their health at risk by not getting enough fibre.”

“It’s important that we don’t blindly follow the latest diet trends in search of a quick fix - choosing quality grain foods can have favourable effects on nearly every area of our health.”

Core grain foods, particularly those which are whole grain or high in fibre, provide a multitude of health benefits and choosing just three of our six serves of grain foods a day as whole grain or high fibre options, can help to reduce our risk of cardiovascular disease and some cancers^4-8.

What’s more, it’s easy to get the recommended six serves of grain foods every day by enjoying a bowl of high fibre breakfast cereal in the morning, a wholemeal sandwich for lunch and a stir-fry with rice for dinner. Take a look at our serve size infographic below to see what constitutes a serve. 

Why not try a traditional Egg Sandwich on Wholemeal as a quick and delicious way to increase your whole grains!

To find out more about the benefits of grain foods and carbohydrates, watch GLNC’s myth-busting webinar on low-carb diets or visit our website.

References

1. Fayet-Moore F, Petocz P, McConnell A, Tuck K, Mansour M. The Cross-Sectional Association between Consumption of the Recommended Five Food Group “Grain (Cereal)”, Dietary Fibre and Anthropometric Measures among Australian Adults. Nutrients. 2017;9(2):157.
2. Jones JM, Peña RJ, Korczak R, Braun HJ. CIMMYT Series on Carbohydrates, Wheat, Grains, and Health: Carbohydrates, Grains, and Wheat in Nutrition and Health: Their Relation to Digestion, Digestive Disorders, Blood Glucose, and Inflammation. Cereal Foods World. 2016;61(1):4-17.
3. GLNC 2014 Consumption & Attitudes Study. Unpublished: 2014.
4. Zong G, Gao A, Hu FB, Sun Q. Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Meta-Analysis of Prospective Cohort Studies. Circulation. 2016;133(24):2370-80.
5. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. Bmj. 2016;353. 
6. Chen G-C, Tong X, Xu J-Y, Han S-F, Wan Z-X, Qin J-B, et al. Whole-grain intake and total, cardiovascular, and cancer mortality: a systematic review and meta-analysis of prospective studies. The American journal of clinical nutrition. 2016.
7. Wei H, Gao Z, Liang R, Li Z, Hao H, Liu X. Whole-grain consumption and the risk of all-cause, CVD and cancer mortality: a meta-analysis of prospective cohort studies. British Journal of Nutrition. 2016;116(03):514-25.
8. Benisi-Kohansal S, Saneei P, Salehi-Marzijarani M, Larijani B, Esmaillzadeh A. Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Advances in Nutrition: An International Review Journal. 2016;7(6):1052-65

Making the Most of the Whole Grain Opportunity

By Rebecca Williams

New research examining global whole grain intakes suggests that Australia is doing better than some countries for whole grain consumption⁽¹⁾. However we still have a long way to go to meet the amount of whole grain recommended for good health and chronic disease risk reduction.

According to the most recent National Nutrition Survey only 34% of grain food consumed came from whole grain or high fibre grain foods⁽²⁾. This aligns with GLNC’s own research, which shows that more than 40% of Australians eat less than one serve of whole grain food per day⁽³⁾. An intake of three serves of whole grain a day is recommended to promote health and reduce chronic disease risk^{(4, 5)}, however in Australia only one in three people meets this target⁽³⁾.

Whilst Australia is doing much better than the UK - where just 17% of people meet this target and the US where only 8% eat enough whole grain - we’re not doing nearly as well as countries like Denmark, Sweden and Norway⁽¹⁾. Residents in these countries typically consume twice as much whole grain as the average Australian and may experience fewer instances of chronic disease as a result.

One of the reasons Australians are not meeting whole grain recommendations may be because they are confused about which foods are whole grain foods. The 2014 GLNC Consumption Study found that less than half of survey respondents were able to identify that oats and wholemeal pasta were a source of whole grain⁽³⁾. One of the contributing factors to consumer confusion may be that unlike other nutrients, the Food Standards Code does not regulate whole grain content claims, and consequently foods making whole grain claims may vary in the amount of whole grain they contain. Data from the 2016 GLNC product audit showed that the whole grain content of packaged breads with whole grain content claims on pack varied from around 8g to 60g of whole grain per serve⁽⁶⁾.

To ensure consumers are getting consistent information on whole grain content, the Grains & Legumes Nutrition Council launched the Code of Practice for Whole Grain Ingredient Content Claims in 2013. The Code helps to regulate whole grain content claims through the establishment of a benchmark for the minimum amount of whole grain a product must contain to make a whole grain ingredient content claim.

A recent impact assessment revealed significant uptake of, and a high level of compliance with, the Code by food industry. This should instil confidence in the Australian public’s ability to identify foods which contain a significant amount of whole grain.

Since the Code was launched Registered Users of the Code have added over 100,000 tonnes or more than 400 Olympic swimming pools of whole grain to the Australian food supply through new and renovated products. This is great news as it means that with increasing innovation in the whole grain category, it’s easier than ever for Australians to choose foods that are high in whole grain. 

While food industry is doing its part to support consumer choice, quantified public health recommendations would encourage consumers to choose whole grain more often. Based on the evidence for better health outcomes, this recommendation should be to choose whole grain for at least three of your six serves of grain foods a day.

The average Australian would need an increase of just 1.5 serves of whole grain a day to meet the recommended three serves and reap the significant health benefits of higher whole grain intake. This could be as simple as swapping the white bread in your sandwich for a wholemeal variety, or opting for a whole grain breakfast cereal in the morning. If you're in need of some inspiration, why not check out some of the delicious whole grain recipes available on the GLNC website.

Registered Users of the GLNC Code of Practice in Australia and New Zealand include:

If you're interested in registering with the Whole Grain Code of Practice or simply want to find out more click here.

References

1. Mann KD, Pearce MS, Seal CJ. Providing evidence to support the development of whole grain dietary recommendations in the United Kingdom. The Proceedings of the Nutrition Society. 2016:1-9.

2. ABS. 2011-2012 Australian Health Survey: Consumption of food groups from the Australian Dietary Guidelines, 2011–12 — Australia. Australian Bureau of Statistics, 2016.

3. GLNC. 2014 Australian Grains and Legumes Consumption and Attitudinal Report. Unpublished: 2014.

4. NHMRC. Australian Dietary Guidelines Providing the scientific evidence for healthier Australian diets. 2013 Accessed online January 2014.

5. Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. Bmj. 2016;353.

6. GLNC. GLNC 2015-2016 Grains and Legumes Product Audit. Unpublished: Grains & Legumes Nutrition Council 2016.

Should We Eat Wheat?

Should We Eat Wheat?

Australians are increasingly mindful of the effect food has on health. In some cases this is a good thing as shown in a recent report where 40% of people stated one of their food priorities for the next 12 months was to eat more fruit and vegetables. Great news.

However, sometimes the temptation to label food as ‘good’ and ‘bad’ is too strong and people go in search of a single food that is the cause of all modern health problems.

Grains are not immune to this, and in recent times wheat has come into the spotlight. Some people, no doubt with all the best intentions, have become suspicious that eating wheat may be causing health issues. So, what are they concerned about and are their concerns valid?

Does eating wheat lead to obesity?

The key to this piece of the puzzle is to consider the quality of the food, not just the wheat it is made with. It’s true, wheat is found in many foods that if eaten in large quantities may lead to weight gain. Foods such as pies and sausage rolls, pizza, cakes and biscuits. However, wheat is also an important ingredient in core gain foods that provide essential nutrients in our diet. These are foods such as bread, breakfast cereal, pasta and couscous. Research in Australia has shown that people who eat the recommended six serves of these core grain foods, including those made from both refined and whole grain wheat, have similar BMI and waist circumference to those who eat the least amount of core grain foods. A large number of studies also show that people who eat more whole grain and high fibre core grain foods are less likely to be obese and less likely to gain weight over time. So it is the quality of the wheat-based foods that is important rather than the wheat itself.

Has wheat changed over time, causing increased rates of coeliac disease?

There is speculation that modern varieties of wheat contain higher levels of gluten than older varieties and this change is responsible for the apparent increase in coeliac disease during the second half of the 20th century. In an age of rapid technological advances it is no wonder people question the effect of technology on the food we eat. However, we cannot let suspicion take the place of evidence. Results from a comprehensive study examining data from the 20th and 21st centuries does not support the theory that wheat breeding has increased the gluten content of wheat.

There is also the suggestion that modern wheat is ‘created by genetic research’ and this has led to the inclusion of an unnatural protein, gliadin, which is responsible for stimulating appetite and causing weight gain.  In fact, gliadins are present in all wheat lines and in related wild species. Seeds of certain ancient types of wheat have even greater amounts of total gliadin than modern varieties.

Gluten should be avoided by everyone

Some theories suggest that even in healthy people gluten causes damage to the lining of the gut, increasing permeability of the gut wall and that this leads to an autoimmune response that can cause damage to the neurological system. The effect of gluten on the gut wall is well known in people with coeliac disease. However, there is no evidence to suggest this is true for people without coeliac disease.

In fact, research on the leaky gut concept suggests it may be caused by substances which damage the gut lining including an infection, alcohol, medications, or alternatively can be associated with inflammation, untreated coeliac disease or due to small intestinal bacterial overgrowth. Other than in the case of untreated coeliac disease grain foods and legumes are not identified as causes of leaky gut. 

In contrast to the suggestion that grains and grain foods cause a ‘leaky gut’, there is evidence shows fibre-rich grains contain prebiotic fibres which provide a surface for beneficial bacteria to thrive on producing short chain fatty acids, such as butyrate which has a demonstrated ability to enhance the intestinal barrier function

The Bottom Line – Should we Eat Wheat?

Stories from friends or even doctors about positive health changes resulting from cutting out a food can be very compelling. In fact, research from GLNC shows that family and friends are the second strongest influence over people’s health decisions after their GP. However as Oscar Wilde once said,  “The truth is rarely pure and never simple”. 

People are right to be making decisions about what they eat based on the effect on their health. But the key is not to make quick decisions based on the experience of a few people. Instead, we need to do the more difficult thing: think carefully about the information we receive and consider all the well-designed research, both negative and positive.

So, what does the whole picture tell us about wheat? It tells us that there are a number of reasons to eat wheat-based core foods, especially whole grain and high fibre choices: you’re more likely to be a healthier weight and get the essential nutrients you need, and you’re less likely to develop type 2 diabetes or heart disease than if you cut them out. In contrast, there is very limited evidence of the negative effects other than some compelling personal stories and anecdotes from doctors about patients.

The choice is yours.

References

IPSOS. FoodChats Annual Report 2015 – 2016. http://ipsos.com.au/wp-content/uploads/2016/05/Food-CHATs-report-abridged.2016.pdf

Grains & Legumes Nutrition Council (GLNC). Grains for Health. 2016. http://www.glnc.org.au/wp-content/uploads/2014/10/Grains-for-Health-Report-FINAL.pdf

Kasarda DD. Can an increase in celiac disease be attributed to an increase in the gluten content of wheat as a consequence of wheat breeding? J Agric Food Chem. Feb 13 2013;61(6):1155-1159.