Identifying whole grain foods: a comparison of different approaches for selecting more healthful whole grain products

Abstract

Objective Eating whole grains (WG) is recommended for health, but multiple conflicting definitions exist for identifying whole grain (WG) products, limiting the ability of consumers and organizations to select such products. We investigated how five recommended WG criteria relate to healthfulness and price of grain products. Design We categorized grain products by different WG criteria including: the industry-sponsored Whole Grain stamp (WG-Stamp); WG as the first ingredient (WG-first); WG as the first ingredient without added sugars (WG-first-no-added-sugars); the word ‘whole’ before any grain in the ingredients (‘whole’-anywhere); and a content of total carbohydrate to fibre of ≤10:1 (10:1-ratio). We investigated associations of each criterion with health-related characteristics including fibre, sugars, sodium, energy, trans-fats and price. Setting Two major grocery store chains. Subjects Five hundred and forty-five grain products. Results Each WG criterion identified products with higher fibre than products considered non-WG; the 10:1-ratio exhibited the largest differences (+3.15 g/serving, P<0.0001). Products achieving the 10:1-ratio also contained lower sugar (−1.28 g/serving, P=0.01), sodium (−15.4 mg/serving, P=0.04) and likelihood of trans-fats (OR=0.14, P<0.0001), without energy differences. WG-first-no-added-sugars performed similarly, but identified many fewer products as WG and also not a lower likelihood of containing trans-fats. The WG-Stamp, WG-first and ‘whole’-anywhere criteria identified products with a lower likelihood of trans-fats, but also significantly more sugars and energy (P<0.05 each). Products meeting the WG-Stamp or 10:1-ratio criterion were more expensive than products that did not (+$US 0.04/serving, P=0.009 and +$US 0.05/serving, P=0.003, respectively). Conclusions Among proposed WG criteria, the 10:1-ratio identified the most healthful WG products. Other criteria performed less well, including the industry-supported WG-Stamp which identified products with higher fibre and lower trans-fats, but also higher sugars and energy. These findings inform efforts by consumers, organizations and policy makers to identify healthful WG products.

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

“…Among several recommended metrics, a ratio of total carbohydrate to dietary fiber (g/serving) of <10:1 is a helpful practical guide to identify more healthful grain choices. 168, 169 …”

“…168 , 169 Foods with ratios <10:1 are preferable; i.e., food containing at least 1 g of fiber for every 10 g of total carbohydrate. In addition, minimally processed whole grains (e.g., steel-cut oats, stone ground bread) are generally preferable to finely milled whole grains (e.g., many commercial whole grain breads and breakfast cereals) due to larger glycemic responses of the latter.…”

Does dietary intake change during an intervention to reduce sedentary behavior and cardiovascular disease risk? A randomized comparative effectiveness trial

“…Additional file 2 shows locations of AHEI-2010 components derived using Nutritionist Pro. Additional information regarding AHEI-2010 scoring can be found in Additional file 3 [23][24][25].…”

Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

“…Whole grains-including dark bread, whole-grain breakfast cereal, popcorn, cooked oatmeal, wheat germ, brown rice, and bran-contain endosperm, germ, and bran, in contrast to refined grains, which contain only the endosperm and lose the germ and bran during the milling process (2). Compared with refined grains, whole grains contain higher amounts of dietary fiber, magnesium, phytochemicals, and other functional compounds (2,3). In both developed and developing countries, cardiovascular events and cancer are the main causes of mortality (4).…”