Wednesday, October 13, 2010

Wholegrain goodness

Study finds those who eat more wholegrains have a better diet overall

We know that something in wholegrains is good for us. Whether it’s the fibre, phytochemicals or more likely a combination of multiple components working together in the wholegrain. Whatever the mechanism, there is something good in wholegrains that makes them really special.

Despite strong growth in wholegrain products, there is limited information about wholegrain intakes in the Australian population. A recent study just published has assessed the consumption of wholegrains and association with nutrient intake in a nationally representative US population.

The data was collected from a secondary analysis of cross-sectional data from the US National Health and Nutrition Examination Survey in 1999-2004. In the absence of Australian consumption data for wholegrains at a nationally representative level, this study may give some indication about the level of wholegrain intake in developed countries such as Australia. The US study investigated over 7000 adults, aged 19 to 50 year olds and over 6000 adults, 51 years and over. Participants were divided into four wholegrain consumption groups 0-0.6, 0.6-1.5, 1.5-3.0, and >3.0 serves a day. Serve sizes are calculated based on ounce equivalents of grains (one serve). One ounce equivalent is equal to the amount of food considered equivalent to ½ cup cooked rice, pasta or cooked cereal, 1 slice of bread or 1 cup of breakfast cereal. Note that Australian and US serve sizes are different. Australian serve sizes are larger, for example, one serve is equal to 2 slices of bread.

The study found that Adults aged 19 to 50 and 51+ years consumed a mean of 0.63 and 0.77 servings of wholegrains per day respectively. Seventy two percent of 19 to 50 year olds, and 70% of 51+ year olds consumed less than 0.6 servings of wholegrains or less daily, with only 4.8% and 6.6% of individuals in these age groups, respectively, eating the recommended 3 serves of wholegrains daily.

For both age groups, diet quality and intake of energy, fibre and polyunsaturated fatty acids were significantly higher in those consuming the most servings of wholegrains. Intake of negative nutrients such as total sugars, added sugars, saturated fatty acids, and cholesterol was significantly lower in those consuming the most servings of wholegrains, as was monounsaturated fatty acids. Apart from Vitamin B12 and sodium, the intake of all micronutrients was higher among those individuals who consumed the most servings of wholegrains.

Although these are positive results, unfortunately the majority of the Adult US population was not consuming enough wholegrains, which is likely to be the similar story in Australia. What we do know is US adults who consumed the most servings of wholegrains had better diet quality and nutrient intakes.

The researchers in this study used a stricter definition for wholegrain than many previous studies. Known as the My Pyramid Equivalents Database (MPED), this definition excludes added bran and pearled barley, which are not technically wholegrain; most published studies have not used this newer definition. The intake of wholegrains was slightly lower in this study compared to other US studies, however this is likely due to the change in the definition of wholegrains used.

Some of the well documented barriers to wholegrain consumption include lack of familiarity and preparation, lack of understanding of the health benefits, the higher price associated with some wholegrain foods, an inability to identify wholegrains and a reported preference for refined grain foods. The authors conclude how important it is for health professionals, industry, government and public health campaigns to promote the consumption of wholegrains more vigorously. They state that dietitian’s need to know more about wholegrains and ways to promote them; health claims could be another way to help increase wholegrain consumption and they also stress the importance of a national wholegrain campaign such as the 2&5 fruit and vegetable campaign.

Go Grains Health & Nutrition is actively involved in many similar strategies aimed to ultimately increase wholegrain consumption and the results of this study help to support the work of Go Grains in Australia.

Source:

O’Neil C, Nicklas T, Zanovec M and Cho S. Whole-grain Consumption is Associated with Diet Quality and Nutrient Intake in Adults: The National Health and Nutrition Examination Survey, 1999-2004. Journal of the American Dietetic Association. Oct 2010, Vol 110, (10) 1461-1468.

Risk of skipping breakfast

Skipping breakfast is linked to risk factors for heart disease, diabetes and obesity

A recent Australian study has found people who regularly eat breakfast are less likely to develop heart disease, diabetes or become obese, than people who start the day on an empty stomach.

A twenty year follow up national study of Australian school children, found that that those who skip breakfast in both childhood and adulthood have a significantly larger waist circumference, BMI (indicator of healthy weight), higher fasting insulin, total cholesterol, and LDL cholesterol compared to those who eat breakfast.

The study suggests that skipping breakfast over a long period may alter metabolism which may result in a greater storage of fat. The higher waist circumference in adults who miss breakfast in childhood and adulthood, may be as a result of higher energy intakes over the course of the day during the 20 year follow up, a factor that has been highlighted by other researchers.

Researchers believe that not eating breakfast seems to be more common, possibly because of efforts to lose weight or due to lack of time. Children and adults who skip breakfast are less likely to meet dietary recommendations for breads and cereals, fruit and dairy, and are more likely to eat takeaway food more than once per week.

Regardless of age, race, socioeconomic status and other lifestyle factors research shows that not only is eating breakfast important but the type of breakfast eaten may play a role in BMI. Eating cereal (cooked or ready to eat cereal) or certain breads for breakfast, is associated with a significantly lower BMI in adults compared to those who skip breakfast or eat other types of breakfast.

Those who eat breakfast that consists of grains (cereals and breads) may have similar energy intakes to other food types, however have lower BMIs, than those who do not eat breakfast or eat meat and eggs for breakfast. Cereals and bread not only provide energy, protein, vitamins and minerals, but some contain insoluble fibre which contributes to a longer lasting feeling of fullness, making them a suitable option for breakfast.

Source:

Smith KJ et al. Am J Clin Nutr 2010. Doi: 10.3945/ajcn.2010.30101. Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study.

Farshchi HR et al. Am J Clin Nutr 2005;81:388-96. Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women.

Sungsoo C et al. JACN 2003;22(4):296-302. The Effect of Breakfast Type on Total Daily Energy Intake and Body Mass Index: Results from the Third National Health Examination Survey (NHANES III).

Wednesday, September 15, 2010

Eating habits and psychological disorders

Mediterranean diet linked to lower depression and anxiety

Healthy diets are commonly linked to a reduced risk of chronic disease such as heart disease, diabetes and cancer. Now research has linked dietary intake to psychological disorders such as depression and anxiety.

An Australian study of 1046 women, aged 20-93 years old, found that those who habitually eat vegetables, fruit, beef, lamb, fish and wholegrain foods (a traditional diet) are less likely to have depression and anxiety disorders compared to those who consume a western diet. A western diet consisted of processed or fried foods, refined grains, sugary products and beer. Women who ate a traditional diet were 35% less likely to have major depression or dysthymia and 32% less likely to have anxiety disorders, whereas the western diet was linked to depressive disorders.

The ATTICA study of 853 men and women from Greece, found that more anxious men and women had different eating habits compared to those less anxious. Women who eat sweets as well as meat and meat products were more likely to be anxious while men who ate legumes and cereals were less likely to be anxious.

Depressive illness is influenced by genetic, hormonal, immunological, biochemical, and neurodegenerative factors. Diet affects each of these factors and possibly the development of depression. Inflammation is thought to play a role in the onset and maintenance of depressive disorders as well as chronic disease such as cardiovascular disease, diabetes and cancer. Adhering to a Mediterranean diet, high in vegetables, fruits, legumes, wholegrains, fish, olive oil and low fat dairy products, ensures an adequate intake of folate, B vitamins, antioxidants and healthy fats. A Mediterranean diet is linked to less inflammation compared to a western diet and may therefore protect against depression and anxiety.

Sources:

Jacka FN et al. 2010. Association of Western and Traditional Diets with Depression and Anxiety in Women. Am J Psychiatry; AiA:1-7.

Sanchez-Villegas A et al. 2009. Association of the Mediterranean Dietary Pattern with the Incidence of Depression. Arch Gen Psychiatry;66(10):1090-1098.

Yannakoulia M et al. 2008. Eating habits in relation to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA study. Appetite; 51:519-525.

Wholegrains and young healthy women

A new study shows wholegrains eaten daily can potentially lead to better health in women

The liver secretes C-reactive protein (CRP) which flags inflammation. Spikes in the level of CRP are also linked to chronic diseases in women such as diabetes, cancer and disorders of the heart and blood. Increased problems with fertility and general reproduction, hypertension and premature birthing can also occur when CRP levels are high. A new US study suggests eating wholegrains every day can lower CRP levels and potentially lead to better health in young women.

The study of 259 young healthy women aged between 18-44yrs, shows that eating wholegrains daily, significantly and inversely reduces levels of CRP. Women who ate half a serve of wholegrains daily, equal to 1 slice of wholegrain or wholemeal bread, had 11.5% significantly lower levels of inflammation, compared to those who did not. Those who ate more than half a serve of wholegrains per day had 12.3% significantly lower levels of inflammation, compared to those that did not eat any wholegrains. The study shows that eating more than half a serve of wholegrains daily, significantly lowers levels of CRP and the chance of moving to a more severe cardiovascular risk category , as classified by the American Heart Association, regardless of any dietary or metabolic factors.

The results of this study highlight the benefits of even a moderate intake of wholegrains per day as part of a healthy diet, with the potential to improve short and long term health outcomes in young healthy women. Scientific research shows that people who eat 48g of wholegrains a day, reduce the risk of developing chronic disease by 20-30%.

Sources

Gaskins AJ et al. Wholegrains are associated with serum concentrations of high sensitivity C-reactive protein among premenopausal women. J Nutr 140: 1669-1676, 2010.

Assoc Prof P. Williams & Go Grains Health and Nutrition Ltd. The Grains & Legumes Health Report. A Review of the Science. 2010.

Thursday, August 19, 2010

Sugar in breakfast cereals

How concerned should you be?

There has been a lot of attention around the nutrient content of our food, in relation to fat, sodium and sugar, with recent media coverage focusing on the level of sugar in breakfast cereals. Breakfast cereals make a significant contribution to our daily intake of protein, carbohydrate, fibre, vitamins, minerals and some antioxidants and should not be grouped with ‘high sugar foods’ such as sweets, soft drinks, cakes and sweet biscuits (which offer little nutrition and are energy dense).

About sugar
‘Sugars’ on a nutrition information panel of a product label is a total of naturally occurring and added sugars. Sugars occur naturally in fruit and dairy foods in the form of fructose and lactose. Fruit in a product, adds to the sugar content. Sugar is also more concentrated in dried fruit as it loses its water content during the drying process. Products containing dried fruit will therefore have higher sugar content, such as breakfast cereal, but this does not mean it is bad for you. Dried fruit also provides beneficial nutrients including dietary fibre, vitamins, minerals and antioxidants. Products labelled ‘no added sugar’ may contain naturally occurring sugars such as fructose and lactose, but no further sugars have been added to the product. ‘Sugar’ will appear in the ingredients list for foods with added sugar.

The sugar concern
The concern with eating too much sugar is that it provides empty kilojoules and can contribute to weight gain. However, this is also a concern for other nutrients such as fat and total energy which can also contribute to weight gain, in particular because we tend to be inactive, sit for so long, and generally eat too much. Placing blame on a particular nutrient alone surely is not the solution to the obesity problem. We must also consider our energy balance that is energy input versus energy output. The quality of a food should therefore be determined by its total composition and not by a single ingredient.

Choosing a breakfast cereal
Breakfast cereals are not necessarily ‘healthier’ if they are lower in sugar. The Glycaemic Index (GI) of a breakfast cereal is also not the only indicator of a healthier choice, as the GI value of a breakfast cereal will tend to be lower when you add milk or yoghurt. Consider the total composition of breakfast cereal, as it should be rated on how nutrient rich it is. Look for those that are higher in fibre per serve, preferably contain ‘wholegrain’ in the ingredients list and are less energy dense. Some nutrients to consider when selecting breakfast cereals:










(Source: National Heart Foundation of Australia, 2009)

Wholegrains and cardiovascular disease

Study finds blood pressure decrease in healthy participants

A brand new intervention study from the UK has found two serves of wholegrain foods a day can significantly lower cardiovascular disease risk in free-living, healthy middle-aged people, mainly by lowering blood pressure. Replacing white bread and refined breakfast cereal with just two slices of wholegrain bread and a cup of oats a day for twelve weeks was enough to reduce blood pressure and potentially reduce the risk of cardiovascular disease – one of Australia’s most costly and deadly diseases.

Two hundred and thirty three virtually healthy men and women aged between 40 and 65 were randomly sorted into one of three groups; refined grain group (control), wholegrain wheat, or wholegrain wheat + oats group. The authors designed this study to be practical and realistic for free-living individuals to achieve with little alteration to their usual lifestyle. Therefore, refined cereals and white bread where simply substituted for two slices of wholegrain bread and a cup of wholegrain breakfast cereal or a cup of oats and either two slices of wholegrain bread or a cup of breakfast cereal.

After only six weeks of the intervention, participants in both the wholegrain wheat and wholegrain wheat +oats group significantly decreased their systolic blood pressure by around 5mm Hg. This decrease is similar to the average reduction observed in twenty seven pharmacologic trials and could translate to a 15% decrease in the risk of coronary artery disease and 25% decrease of stroke. Using wholegrain foods to help maintain healthy normal blood pressure has worthwhile benefits, including a reduction in drug-related side effects of blood pressure lowering medication and significant cost savings for Australia’s healthcare system. The other great thing about this study is that the wholegrain products used are similar to those widely available from Australian supermarkets in contrast to supplements or specifically formulated foods.

The study did not show a favourable effect for cholesterol reduction or any other blood lipids, including inflammatory markers. These results are similar to that of the recently published sixteen week WHOLEheart study involving just over three hundred overweight adults. As suggested in the WHOLEheart study the findings of both these intervention trials do not question the efficacy of increasing wholegrain foods as a public health measure for disease risk reduction, but instead highlight some of the limitations associated with randomised controlled trials when investigating complex food synergies and nutrients, especially in otherwise healthy individuals. Lipid-lowering interventions commonly fail to show an effect in subjects with normal lipid levels, which was the case in this intervention and the WHOLEheart trial. Perhaps the results would have been even more favourable for all biomarkers of cardiovascular disease in an unhealthy population.

Although the exact mechanisms by which wholegrains can reduce blood pressure still remain unclear, the results of this study provide solid evidence for recommending the consumption of two serves of wholegrain foods a day to help reduce the risk of cardiovascular disease. Australian dietary guidelines recommend Australians eat 4+ serves of grain-based foods a day (including breads, breakfast cereals, rice and pasta). At least half of your serves should be wholegrain. Commonly available wholegrain foods include wholegrain bread and breakfast cereals, oats, brown rice, wholegrain pasta, popcorn, wholegrain crispbreads and rice cakes/crackers.

Sources:

Effect of increased consumption of wholegrain foods on blood pressure and other cardiovascular risk markers in healthy middle aged persons – a randomised controlled trial. Tighe P and Duthie G et al. Am J Clin Nutr. 2010. Published ahead of print.

Wednesday, July 14, 2010

The beauty of brown rice

Recent findings suggest it may reduce diabetes risk

Brown rice may be something you have never tried or wouldn’t typically buy; it may also receive a few crinkled noses from the kids. But that tiny brown grain of rice might do more for you and your family’s health than you imagine. Wholegrain brown rice has been a standout in the crowd lately, with two recent scientific studies finding a special compound in brown rice may help guard against high blood pressure, cardiovascular disease and type 2 diabetes.

Retaining the bran and germ, brown rice contains more nutrients and fibre than white, however both brown and white varieties of rice both contain essential vitamins and minerals, including B-group vitamins such as thiamine and niacin, zinc and phosphorus. Brown rice is a wholegrain food, as are mixed-grain breads, wholegrain breakfast cereals, rolled oats, wholemeal pasta, corn and popcorn.

One cup of brown rice contains around 2.4g of dietary fibre, which equates to around 10% of an adults daily fibre needs and around 80g of wholegrains, which is close to double the suggested daily wholegrain intake. In the absence of an official government recommendation for wholegrains intake, Go Grains Health & Nutrition has reviewed the research and suggests all Australian adults aim for 48g of wholegrains per day.

An excellent source of energy, rice is full of energy-giving carbohydrates - used by the body for brain performance, physical activity and everyday bodily functions including growth and repair. Rice is low in fat, cholesterol free (as are all plant foods) and virtually salt free with less than 5mg of sodium per 100g is therefore great for those who need to watch their salt intake.

A new study has just been published that analysed diet, lifestyle and disease data collected from 39,765 men and 157,463 women from 3 large cohort studies; the Health Professionals Follow-up Study and the Nurses Health Study I and II. The researchers found people who ate high amounts of white rice also enjoyed plenty of fruits and vegetables, but not many wholegrains, cereal fibre and (bad) trans fats. Those people who enjoyed brown rice were more likely to be health conscious; more physically active, leaner and less likely to smoke or have a family history of diabetes and had higher intake of fruits, vegetables and wholegrains and lower intakes of red meat and trans fats. After adjustments were made, more than two servings of brown rice a week was associated with a lower risk of type 2 diabetes. Due to low intakes of brown rice amongst the study participants it remains unclear whether higher intakes of brown rice are associated with further disease reductions. Nonetheless the researchers found simply switching white rice for brown rice was associated with a significantly lower risk of developing diabetes. The researchers also looked at wholegrain consumption overall and found stronger associations when analysing wholegrains as a group, rather than brown rice on its own.

Brown rice can be cooked the same way as white rice in the pot, in the microwave or a rice cooker usually for just a little bit longer. You can now even buy microwave pouches – great for the lunch box, workplace or a quick meal for one or two. Next time you are having rice for dinner, why not give brown rice a go. You may find you actually like the tastier, slightly more nutty version, especially now you know how much better it is for you. If you need help acquiring the taste, mix half white with half brown rice, cooking separately of course.

Sources
Qi et al, White Rice, Brown Rice, and Risk of Type 2 Diabetes in US Men and Women, Arch Intern Med. 2010;170(11):961-969