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Association between whole grain food intake in Canada and nutrient intake, food group intake and diet quality: Findings from the 2015 Canadian Community Health Survey.

ABSTRACT: Whole grains have been associated with numerous beneficial health outcomes and are recommended in Canada's Food Guide; however, there is little research on whole grains specific to Canada. Therefore, the objective of this study was to characterize the association between Canadians' WG intake and nutrients, food groups and diet quality and to understand top sources of WG in the diets of Canadians. We used data from the Canadian Community Health Survey 2015: a cross-sectional survey that collected information on diet (using a 24-hour recall) and health from 20,487 Canadians 1 year and older. We classified study participants according to their WG intake: non-WG (n = 10,883) and three groups based on age-specific tertiles of WG intake, low-WG (n = 3,322), mid-WG (n = 3,180), and high-WG (n = 3,102). Results were analyzed using population-based survey methods and were adjusted for energy, age, gender, overweight/obesity, income, and supplement use. We found differences in nutrients and food groups by WG group: there was a significant linear trend across groups of increasing WG for increased fiber (children and adults), vitamin B6 (children), thiamin (adults), potassium (children and adults), zinc (adults), calcium (children and adults), iron (children and adults), magnesium (children and adults), fruit (adults), and legumes, nuts and seeds (adults); and decreased total fat (adults), saturated fat (adults), folate (children and adults), refined grains (adults and children), and meat and poultry (adults) intake. We found that there were no differences in total sugar or sodium intake across WG intake groups. The high WG intake group for both children and adults had higher diet quality, measured by the Nutrient Rich Food Index 9.3, compared to non-WG eaters. The top 2 food sources of WG across WG intake groups for children and adults were whole grain oat and high fiber breakfast cereal and whole grain and whole wheat bread. Other top sources of WG included rice, bread products, other breakfast cereals, salty snacks, cereal grains and flours, pasta, and sweet snacks. This research supports recommendations to increase WG foods intake as a means to improve diet quality of Canadians.

SUBMITTER: Smith J

PROVIDER: S-EPMC8248641 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Within epidemiological and intervention studies, whole grain consumption has generally shown positive associations with reductions in markers of overweight and obesity. However, studies use varied methods of determining whole grain intake, including different definitions of a whole grain food, which may explain varied results. This systematic review aimed to identify how different methods of reporting and calculating whole grain intake, including whole grain food definitions, affect reported associations between whole grain intake and body weight measures in adults. Systematic searching of PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register for Controlled Trials (CENTRAL), and MEDLINE (all years to 11 June, 2020) identified eligible studies. Cohort and cross-sectional studies assessing whole grain intake and body weight measures in adults were included. Studies that did not specify methods used to calculate whole grain intake were excluded. Twenty-one cross-sectional studies (from 24 articles) and 9 prospective cohort studies (from 7 articles) were included in the review. Many cross-sectional studies showed whole grain intake was, to some degree, significantly associated with body weight measures, whereas associations varied greatly among cohort studies. Studies calculating whole grain intake using total grams of intake, USDA databases, or ≥25% whole grain in combination with listing specific foods, showed consistent beneficial effects of increasing whole grain intake on body weight. Studies with general lists of foods included as "whole grain foods" or lower cut-offs for whole grain content were inconsistent. The majority of studies reported whole grain intake as servings/day or grams whole grain/day. This review suggests that an association between whole grain and body weight measures remains likely, although precise associations are difficult to determine due to heterogeneity in methodologies and an inability to formally compare studies. Moving forward, application of a standardized methodology to calculate whole grain intake is essential.

Project description:BackgroundFood purchasing is considered a key mediator between the food environment and eating behavior, and food purchasing patterns are increasingly measured in epidemiologic and intervention studies. However, the extent to which food purchases actually reflect individuals' dietary intake has not been rigorously tested. This study examined cross-sectional agreement between estimates of diet quality and nutrient densities derived from objectively documented household food purchases and those derived from interviewer-administered 24-h diet recalls. A secondary aim was to identify moderator variables associated with attenuated agreement between purchases and dietary intake.MethodsPrimary household food shoppers (N = 196) collected and annotated receipts for all household food and beverage purchases (16,356 total) over 14 days. Research staff visited participants' homes four times to photograph the packaging and nutrition labels of each purchased item. Three or four multiple-pass 24-h diet recalls were performed within the same 14-d period. Nutrient densities and Healthy Eating Index-2010 (HEI-2010) scores were calculated from both food purchase and diet recall data.ResultsHEI-2010 scores derived from food purchases (median = 60.9, interquartile range 49.1-71.7) showed moderate agreement (ρc = .57, p < .0001) and minimal bias (-2.0) with HEI-2010 scores from 24-h recalls (median = 60.1, interquartile range 50.8-73.9). The degree of observed bias was unrelated to the number of food/beverage purchases reported or participant characteristics such as social desirability, household income, household size, and body mass. Concordance for individual nutrient densities from food purchases and 24-h diet recalls varied widely from ρc = .10 to .61, with the strongest associations observed for fiber (ρc = .61), whole fruit (ρc = .48), and vegetables (ρc = .39).ConclusionsObjectively documented household food purchases yield an unbiased and reasonably accurate estimate of overall diet quality as measured through 24-h diet recalls, but are generally less useful for characterizing dietary intake of specific nutrients. Thus, some degree of caution is warranted when interpreting food purchase data as a reflection of diet in epidemiological and clinical research. Future work should examine agreement between food purchases and nutritional biomarkers.Trial registrationClinicalTrials.gov, NCT02073643 . Retrospectively registered.

Project description:BackgroundIn light of the publications (2008-2014) linking calcium intake, mainly from supplements, to the elevated risk of cardiovascular events, there is a need to determine if there have been any changes in usual intakes of calcium among Canadians.ObjectiveWe aimed to examine changes in dietary and total usual intake of calcium among Canadians aged ≥1 y over the period 2004-2015.MethodsWe used nutrition data from 2 nationally representative surveys conducted in 2004 and 2015 (CCHS 2004 Cycle 2.2 and CCHS-Nutrition 2015). This study included all the Canadians across 10 provinces, and the analyses were performed across different age/sex groups. We used the National Cancer Institute (NCI) method to estimate the usual intake of calcium and the prevalence of calcium inadequacy. Multiple logistic regression was performed to assess the relation between supplement uses and sociodemographic variables.ResultsFrom 2004 to 2015, the usual intake of calcium from food sources significantly decreased in calcium supplement nonusers (from 872 ± 18.2 mg/d to 754 ± 18.0 mg/d), but not in calcium supplement users. The contribution of calcium from the Milk and alternatives food group significantly decreased by 7.5% and 6.1% in calcium supplement users and nonusers, respectively. The prevalence of calcium supplement use significantly decreased from 2004 to 2015 in the Canadian population, from 27.5% to 22.0%. During this time, the percentage contribution of calcium from supplemental sources significantly decreased among Canadians, especially women. The prevalence of calcium inadequacy increased from 58.0% to 68.0% in supplement nonusers; however, among users of calcium supplements, the prevalence of calcium inadequacy remained at ∼31%.ConclusionsCalcium intake from both food and supplemental sources decreased in the Canadian population over an 11-y period, which must be addressed by policy-makers in their efforts to decrease the high prevalence of calcium inadequacy.

Project description:BackgroundWhile necessary for studying dietary decision-making or public health, estimates of nutrient supply based on self-reported food intake are barely accessible or fully lacking and remain a challenge in human research. In particular, detailed information on dietary fiber is limited. In this study we introduce an automated openly available approach to assess self-reported nutrient intake for research purposes for a popular, validated German food frequency questionnaire (FFQ).MethodsTo this end, we i) developed and shared a code for assessing nutrients (carbohydrates, fat, protein, sugar, fiber, etc.) for 53 items of the quantitative, validated German DEGS1-FFQ questionnaire implementing expert-guided nutritional values of diverse sources with several raters. In a sample of individuals (nGUT-BRAIN = 61 (21 female) overweight, omnivorous), we ii) cross-validated nutrient intake of the last 7 days and the last 24 h and iii) computed test-retest reliability across two timepoints. Further, iv) we reported newly computed nutrient intake for two independent cross-sectional cohorts with continuous weight status and different dietary habits (nMensa = 134 (79 female, 1 diverse), nGREADT = 76 male). Exploratively, we v) correlated computed, energy-adjusted nutrient intake with anthropometric markers and HbA1c and vi) used linear mixed models to analyse the predictability of BMI and WHR by nutrient intake.ResultsIn overweight adults (n = 61 (21 female), mean age 28.2 ± 6.5 years, BMI 27.4 ± 1.6 kg/m2) nutrient intakes were mostly within recommended reference nutrient ranges for both last 7 days and last 24 h. Recommended fiber intake was not reached and sugar intake was surpassed. Calculated energy intake was significantly higher from last 24 h than from last 7 days but energy-adjusted nutrient intakes did not differ between those timeframes. Reliability of nutrient values between last 7 days and 24 h per visit was moderate (Pearson's rhoall ≥ 0.33, rhomax = 0.62) and absolute agreement across two timepoints was low to high for 7 days (Pearson's rhomin = 0.12, rhomax = 0.64,) and low to moderate for 24 h (Pearson's rhomin = 0.11, rhomax = 0.45). Associations of dietary components to anthropometric markers showed distinct sex differences, with overall higher intake by males compared to females and only females presenting a negative association of BMI with fiber intake. Lastly, in the overweight sample (but not when extending the analysis to a wider BMI range of 18.6-36.4 kg/m2), we could confirm that higher BMI was predicted by lower energy-adjusted fiber intake and higher energy-adjusted fat intake (when adjusting for age, sex and physical activity) while higher WHR was predicted by higher energy intake.ConclusionWe provide an openly available tool to systematically assess nutrient intake, including fiber, based on self-report by a common German FFQ. The computed nutrient scores resembled overall plausible and reliable measures of nutrient intake given the known limitations of FFQs regarding over- or underreporting and suggest valid comparability when adjusting for energy intake. Our open code nutrient scoring can help to examine dietary intake in experimental studies, including dietary fiber, and can be readily adapted to other FFQs. Further validation of computed nutrients with biomarkers and nutrient-specific metabolites in serum, urine or feces will help to interpret self-reported dietary intake.

Project description:BackgroundThere are limited data from randomized control trials to support or refute the contention that whole-grains can enhance protein metabolism in humans.ObjectivesTo examine: 1) the clinical effects of a whole-grain diet on whole-body protein turnover; 2) the cellular effects of whole-grains on protein synthesis in skeletal muscle cells; and 3) the population effects of whole-grain intake on age-related muscle loss.MethodsAdults with overweight/obesity (n = 14; age = 40 ± 7 y; BMI = 33 ± 5 kg/m2) were recruited into a crossover, randomized controlled trial (NCT01411540) in which isocaloric, macronutrient-matched whole-grain and refined-grain diets were fully provisioned for two 8-wk periods. Diets differed only in the presence of whole-grains (50 g/1000 kcal). Whole-body protein kinetics were assessed at baseline and after each diet in the fasted-state (13C-leucine) and integrated over 24 h (15N-glycine). In vitro studies using C2C12 cells assessed global protein synthesis by surface sensing of translation and anabolic signaling by Western blot. Complementary epidemiological assessments using the NHANES database assessed the effect of whole-grain intake on muscle function assessed by gait speed in older adults (n = 2783).ResultsIntegrated 24-h net protein balance was 3-fold higher on a whole-grain diet compared with a refined-grain diet (P = 0.04). A whole-grain wheat extract increased submaximal rates of global protein synthesis (27%, P < 0.05) in vitro. In a large sample of older adults, whole-grain intake was associated with greater muscle function (OR = 0.92; 95% CI: 0.86, 0.98).ConclusionsConsuming 50 g/1000 kcal whole-grains per day promotes greater protein turnover and enhances net protein balance in adults. Whole-grains impact skeletal muscle at the cellular level, and are associated with greater muscle function in older adults. Collectively, these data point to a new mechanism whereby whole-grain consumption favorably enhances protein turnover and improves health outcomes.This clinical trial is registered on clinicaltrials.gov (identifier: NCT01411540).

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Association between whole grain food intake in Canada and nutrient intake, food group intake and diet quality: Findings from the 2015 Canadian Community Health Survey.

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