Optimized nutrition during the first 1000 days (from conception through the 2nd birthday) is critical for healthy development and a healthy life for the newborn. Pregnancy and the postpartum period are accompanied by physiological changes, increased energy needs, and changing requirements in the nutrients critical for optimal growth and development. Infants and toddlers also experience physiological changes and have specific nutritional needs. Food and nutrition experts can provide women of childbearing age with adequate dietary advice to optimize nutrition, as well as guidance on selecting appropriate dietary supplements. Considering the approaching 2020–2025 Dietary Guidelines for Americans (DGA) will be making specific recommendations for children, it is important to provide accurate scientific information to support health influencers in the field of nutrition. The purpose of this review is to summarize the nutrition and supplementation literature for the first 1000 days; to highlight nutritional and knowledge gaps; and to educate nutrition influencers to provide thoughtful guidance to mothers and families. Optimal nutrition during pregnancy through early childhood is critical for supporting a healthy life. Nutrition influencers, such as dietitians, obstetricians/gynecologists, and other relevant health professionals, should continue guiding supplement and food intake and work closely with expectant families and nutrition gatekeepers.
The aim of this article is to review the definitions and regulations for dietary fiber and whole grains worldwide and to discuss barriers to meeting recommended intake levels. Plant foods, such as whole grains, that are rich in dietary fiber are universally recommended in dietary guidance. Foods rich in dietary fiber are recommended for all, but dietary recommendations for whole grains and dietary fiber depend on definitions and regulations. Official recommendations for dietary fiber in the United States and Canada are denoted by dietary reference intakes (DRIs), which are developed by the Institute of Medicine. An adequate intake (AI) for dietary fiber was based on prospective cohort studies of dietary fiber intake and cardiovascular disease risk that found 14 grams of dietary fiber per 1000 kilocalories protected against cardiovascular disease (CVD). This value was used to set AIs for dietary fiber across the life cycle based on recommended calorie intakes. Actual intakes of dietary fiber are generally about half of the recommended levels. Recommendations for whole grain intake are equally challenging, as definitions for whole grain foods are needed to set recommendations. The 2005 Dietary Guidelines for Americans recommended that half of all grain servings be whole grains, but usual intakes are generally less than 1 serving per day, rather than the recommended 3 servings per day. Scientific support for whole grain recommendations is based on the same prospective cohort studies and links to CVD protection used to inform dietary fiber guidance. Thus, dietary fiber is a recommended nutrient and whole grains are a recommended dietary pattern in dietary guidance in North America and around the world. Challenges for attaining recommended intakes of dietary fiber and whole grains include low-carbohydrate diets, low-gluten diets, and public health recommendations to avoid processed foods.
Definitions for whole grain (WG) have been published by governments, the food industry, and grain organizations and generally fall into 2 categories: WG and WG food. WG definitions focus on the principal components of the WGs and their proportions, whereas WG-food definitions describe the quantity of WGs present in food. In the United States, widespread agreement exists on the main parts of a definition for a WG, with a definition for a WG food still in its early stages; a standard definition that has been universally accepted does not exist. Furthermore, nutrition policy advises consumers to eat WGs for at least one-half of their total grain intake (2010 and 2015 Dietary Guidelines for Americans), but confusion exists over which foods are considered WGs and how much is needed to achieve health benefits. In December 2014, a workshop sponsored by the subcommittee on collaborative process of the US Government's Interagency Committee on Human Nutrition Research convened in Washington, DC, and recognized WG definitions as a key nutrition and public health-related issue that could benefit from further collaboration. As a follow-up to that meeting, an interdisciplinary roundtable meeting was organized at the Whole Grains Summit on 25 June 2015 in Portland, Oregon, to help resolve the issue. This article summarizes the main opportunities and challenges that were identified during the meeting for defining WGs and WG foods internationally. Definitions of WGs and WG foods that are uniformly adopted by research, food industry, consumer, and public health communities are needed to enable comparison of research results across populations.Am J Clin Nutr 2016;104:1508-14.
Oats are uniquely nutritious, owing to their composition of bioactive compounds, lipids, and β-glucan. Scientific research has established that oats can improve diet quality, reduce cholesterol, regulate satiety, and protect against carcinogenesis in the colon; however, determining the effects of oats on gastrointestinal health and the gut microbiome is a newer, evolving area of research. To better understand the effects of oats on gastrointestinal health in humans, a literature review with predefined search criteria was conducted using the PubMed database and keywords for common gastrointestinal health outcomes. Moreover, to examine the gastrointestinal effects of oats across the scientific spectrum, a similar search strategy was executed to identify animal studies. In vitro studies were identified from the reference lists of human and animal studies. A total of 8 human studies, 19 animal studies, and 5 in vitro studies met the inclusion criteria for this review. The evidence in humans shows beneficial effects of oats on gastrointestinal health, with supportive evidence provided by in vitro and animal studies. The effective dose of oats varies by type, although an amount providing 2.5 to 2.9 g of β-glucan per day was shown to decrease fecal pH and alter fecal bacteria. For oat bran, 40 to 100 g/d was shown to increase fecal bacterial mass and short-chain fatty acids in humans. Differences in study design, methodology, and type of oats tested make valid comparisons difficult. The identification of best practices for the design of oat studies should be a priority in future research, as the findings will be useful for determining how oats influence specific indices of gastrointestinal health, including the composition of the human gut microbiome.
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