Myths and Realities Involving Grain Food Consumption What Does the - PowerPoint PPT Presentation

Myths and Realities Involving Grain Food Consumption What Does the Scientific Evidence Say? Yanni Papanikolaou, PhDc, MHSc Joint 2018 CWFHB and CWS Conference, Winnipeg, MB

Current environment leaving many to think enriched grains and/or all grains are not part of a healthy diet…but where is the evidence? 2

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What lessons can we learn from the past? These foods were once considered to be unhealthy? 4

2015-2020 Dietary Guidelines no longer include a limit on cholesterol Eggs are included in the recommended dietary patterns 5

We once believed nuts made us fat! 6

Dairy also had a bad reputation, until…. 8

2015-2020 Dietary Guidelines: Dairy products included in all 3 recommended dietary patterns 9

So let’s talk about grains and how they fit into the diet… 10

Rationale for conducting grains research in American kids and adults…. is this needed and does it fill a gap in the literature and advance public health?

7 studies completed to date 5 have been published in peer-review journals 12

How do American adults and children consume grain foods? Are grain foods associated with overall nutrient intakes and shortfall nutrients (i.e., dietary fiber)? Are grain food patterns of consumption linked to BMI? Are grain food patterns linked to diet quality?

Adult Study 14

All Grain Consumption (Whole and Refined/Enriched Grains)

8 Unique Grain Food Patterns Identified in US Adults, 19+ Years-Old No Grains Grain Patterns (whole/enriched) Bread/ Mixed Rolls Grains Cereals Crackers Pasta/ & Salty Cakes, Quick Cooked Grains Cookies, Breads Cereals/ Pies Rice 16

What are Adults in the No Grains Group Consuming? What are adults consuming in the no grain foods group? 17

Comparison of Energy Intake Based on Grain Clusters In Those 19+ Years 2500 * * * * * * * 2000 Energy Intake, kcal/day Pasta/Cooked Cereals/Rice Crackers/salty snacks Cakes/cookies/pies Miscellaneous 1500 Quick bread Bread/rolls Pasta Cereals 1000 None 500 0 Adults 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2016 Food and Nutrition Sciences 18

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Adults Consuming Enriched Grains Had Reduced Risk of Being Overweight or Obese and Smaller Waist Sizes 27% reduced risk of being 7.6 lbs and 1.2 inches in obese in adults adults consuming consuming pasta/cooked pasta/cooked cereals/rice vs. no grains cereals/rice vs. no grains (p<0.01, vs. no grains) (p<0.03 vs. no grains) 20

Certain Grains are Associated with a Better Diet Quality, Adults 19+ Years Old, NHANES 2005-2010 Pasta/Cooked Cereals/Rice * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2016 Food and Nutrition Sciences 21

Certain Grains are Associated with Higher Dietary Fiber Co Comparis ison of f Die ietary ry Fibe iber In Intake Ba Based on Grain in Clu Clusters In Th In Those 19+ Years 25 * Dietary Fiber Intake, g/day 20 * * 15 Crackers/salty snacks Cakes/cookies/pies Quick bread Miscellaneous Cereals Bread/rolls Pasta None 10 5 0 Adults 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2016 Food and Nutrition Sciences 22

Co Comparis ison of f So Sodiu ium In Intake Ba Based on Grain in Clu Clusters In Th In Those 19+ Years 4000 * 3500 * Sodium Intake, mg/day 3000 Crackers/salty snacks Cakes/cookies/pies 2500 Miscellaneous Quick bread Bread/rolls 2000 Cereals Pasta None 1500 1000 500 0 Adults 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2016 Food and Nutrition Sciences

Comparis Co ison of f Fola late In Intake Ba Based on Grain in Clu Clusters In Th In Those 19+ Years 900 * 800 Folate Intake, µg DFE/day 700 * * 600 * Crackers/salty snacks * 500 Cereals Cakes/cookies/pies Miscellaneous 400 Quick bread Bread/rolls Pasta 300 None 200 100 0 Adults 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2016 Food and Nutrition Sciences

Unintended consequences of a low carb diet… women with restricted carbohydrate intake were 30% more likely to have an infant with NTB 25

Comparis Co ison of f Whole le Grain in In Intake Ba Based on Grain in Clu Clusters In In Th Those 19+ Years 1.40 * Whole grain Intake, oz. equivalent/day 1.20 * * 1.00 * Crackers/salty snacks * 0.80 Cakes/cookies/pies Pasta Miscellaneous Cereals 0.60 * Quick bread Bread/rolls 0.40 None 0.20 0.00 Adults 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2016 Food and Nutrition Sciences

Children & Adolescent Study 27

8 Unique Grain Food Patterns Identified in US Children, 2-18 Years of Age No Grains Grain Patterns (whole/enriched) Quick Bread/ Breads Rolls Cakes, Pancakes, Cookies, Waffles, Pies Cereals etc. Pasta/ Crackers Cooked & Salty Cereals/ Grains Rice 28

What are Children in the No Grains Group Consuming? 29

Most Grain Patterns are Associated with Greater Calories 2500 * * * * * * 2000 Energy Intake, kcal/day Pasta/Cooked Cereals/Rice Pancakes/waffles/etc. Crackers/salty snacks Cakes/cookies/pies 1500 Quick bread Bread/rolls Pasta Cereals 1000 None 500 0 Children 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2017, Nutrition Journal 30

Body Mass Index (BMI) Scores in Children and Adolescents  Children and adolescents consuming yeast breads and rolls had lower BMI z-scores compared to children and adolescents not consuming grains  No increases in BMI z-scores were seen with any grain pattern of consumption vs. no grains

Children Consuming Grain Patterns Tend to Have Higher Dietary Fiber Intake 16 * * * 14 * * Dietary fiber Intake, g/day Pasta/Cooked Cereals /Rice 12 Pancakes/waffles/etc. Cakes/cookies/pies 10 Crackers/salty snacks Bread/rolls Cereals 8 Pasta Quick bread None 6 4 2 0 Children 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2017 Nutrition Journal 32

Comparison of Sodium Intake Based on Grain Clusters In Those 2-18 Years 4000 3500 Pasta/Cooked Cereals/Rice Sodium Intake, mg/day 3000 * Pancakes/waffles/etc. Crackers/salty snacks 2500 Cakes/cookies/pies Quick bread Bread/rolls 2000 Pasta Cereals None 1500 1000 500 0 Children 0 1 2 3 4 5 6 7 Grain Cluster * Significantly different from None, p<0.01; Papanikolaou & Fulgoni, 2017, Nutrition Journal 33

Current study in progress… 34

Kids Who Include Grains in Morning Eating Patterns Get More Fiber 16 * * * * RF-Milk/Pancakes/Waffles/Sauces RF-Milk/All Cereals/Breads/Juice 14 Dietary Fiber (g/day) RF-Milk/Higher Sugar RTEC 12 RF-Milk/Sweet Pastries 10 Eggs/Protein/Juice No Morning Foods No Morning Foods 8 6 4 2 0 Morning Food Patterns NHANES 2011-2014; Children 2-18 Years-Old; n=5,876 * Significantly different from No Morning Foods, p<0.0025; (unpublished data) 35

Kids Who Include Grains in Morning Eating Patterns Get More Fiber 16 * * * * RF-Milk/Pancakes/Waffles/Sauces RF-Milk/All Cereals/Breads/Juice 14 Dietary Fiber (g/day) RF-Milk/Higher Sugar RTEC 12 RF-Milk/Sweet Pastries 10 Eggs/Protein/Juice No Morning Foods No Morning Foods 8 6 4 2 0 Morning Food Patterns NHANES 2011-2014; Children 2-18 Years-Old; n=5,876 * Significantly different from No Morning Foods, p<0.0025; (unpublished data) 36

Conclusions • Encouraging certain grain food patterns in the diet of US children and adults, including selecting a mix of enriched and fortified grains is linked to increased nutrient intakes , including several shortfall nutrients • Several grain food patterns are linked to a better diet quality in kids and adults • As we have shown that grain foods can be nutrient-dense foods, eliminating grains from the US diet may lead to nutrient intake and health conseq uences.

Canadian Study in Kids & Adults 38

• To determine daily energy and nutrient contribution from all grain products and sub-categories of grains (i.e., breads, ready-to-eat cereals, etc.) in the Canadian diet of children and Objectives of adults. the Canadian • To identify patterns of grain Study consumption and compare nutrient intakes and weight-related variables relative to no main gain foods intake, among Canadian children and adults. 39

All Grain Foods Provide Nutrient Density in the Canadian Adult Diet For 25% of daily calories, 50 grains (whole and enriched) 45 provide 45% of folate, 41% of iron and 35% of fiber in the 40 total diet 35 Percent (%) 30 25% 25 20 15 10 5 0 40

When compared to the no grain group, those consuming several Eliminating grains may have grain food patterns had: nutrient intake consequences Significantly higher daily intake of in adults and children… folate, dietary fiber, folic acid, niacin, thiamin, calcium & magnesium 41