Whole-grain food consumption in Singaporean children aged 6–12 years

Abstract

Public health bodies in many countries are attempting to increase population-wide habitual consumption of whole grains. Limited data on dietary habits exist in Singaporean children. The present study therefore aimed to assess whole grain consumption patterns in Singaporean children and compare these with dietary intake, physical activity and health parameters. Dietary intake (assessed by duplicate, multipass, 24-h food recalls), physical activity (by questionnaire) and anthropometric measurements were collected from a cross-section of 561 Singaporean children aged 6–12 years. Intake of whole grains was evaluated using estimates of portion size and international food composition data. Only 38·3 % of participants reported consuming whole grains during the dietary data collection days. Median intake of whole grains in consumers was 15·3 (interquartile range 5·4–34·8) g/d. The most commonly consumed whole-grain food groups were rice (29·5 %), wholemeal bread (28·9 %) and ready-to-eat breakfast cereals (18·8 %). A significantly lower proportion of Malay children (seven out of fifty-eight; P < 0·0001) consumed whole grains than children of other ethnicities. Only 6 % of all children consumed the amount of whole grains most commonly associated with improved health outcomes (48 g/d). There was no relationship between whole grain consumption patterns and BMI, waist circumference or physical activity but higher whole grain intake was associated with increased fruit, vegetable and dairy product consumption (P < 0·001). These findings demonstrate that consumption of whole grain foods is low at a population level and infrequent in Singaporean children. Future drives to increase whole-grain food consumption in this population are likely to require input from multiple stakeholders.

An Overview of Whole Grain Regulations, Recommendations and Research across Southeast Asia

“…A number of observational studies had collected valuable data on wholegrain intake but whose target population (e.g., patient groups or other sub-groups) may not be entirely representative of the country’s population. Similar to the available national intake data [ 31 , 32 , 73 ], these findings tend to support that consumption of wholegrain foods is infrequent across population groups in Southeast Asia [ 23 , 24 , 25 , 27 , 28 , 29 ]. As in other parts of the world, there are limited consumer-centred studies in Southeast Asia aimed at understanding people’s beliefs and attitudes towards whole grains.…”

“…One study evaluated the broad dietary patterns of Thai adults but did not present specific data on wholegrain food consumption [ 30 ]. The remaining two observational studies [ 31 , 32 ] were representative of dietary intake at a national level (in children) [ 31 , 32 ] and were also highlighted within the information collection whole grain recommendations, regulations and consumption from member states (see below).…”

“…To date, most longitudinal data and randomized, controlled trials that suggest whole grain intake might benefit health outcomes have been collected in Europe and North America [ 15 ]. This situation appears to be improving in Southeast Asia, particularly in relation to cross-sectional and/or longitudinal data [ 31 , 32 , 73 , 74 ]. Such findings should help develop rational food-based recommendations for wholegrain consumption and help in the development of strategies to move population level intake towards this.…”

“… a Previous studies in children ([ 31 ] for Malaysia and [ 30 ] for Singapore) have drawn comparisons with the 48 g of whole grains per day guidelines for whole grain intake recommended by the USDA [ 75 ]. b Only in children aged 6–12 years.…”

Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

“…This suggests that mothers in Singapore may interpret promoting variety in the diet as specifically being important for only vegetable intake, but not fruits or wholegrains. Evidence surrounding nutrition education in children, however, is still mixed, studies have reported associations with higher fruit [ 15 , 17 ], but not vegetable intake[ 16 ], and lower intake of grains[ 15 ].Children of Singaporean mothers who were educated about nutrition had higher wholegrain intakes, possibly because their mothers were focusing on nutritional education at home to promote increased intake of foods that are generally less appealing to them such as wholegrains[ 42 ].…”