NEW WHOLE GRAIN DATABASE AND FINDINGS RELATED TO OBESITY
Laura Sampson Mary Franz Pauline Koh-Banerjee Simin Lui Donna Spiegelman Walter Willett Eric Rimm Department of Nutrition, Harvard School of Public Health
ROLE OF WHOLE GRAINS IN HEALTH
DIABETES HEART DISEASE GI HEALTH MAY DECREASE CANCER
WHOLENESS CODES
r=refined, no whole grain
wL = low whole grain, 1-24% whole by weight wM = moderate whole grain, 25-49% whole by weight wH= high whole grain
b=contains bran (separately from the bran in the whole wheat
What is a whole grain???
A CEREAL GRASS OR SEED
Go with the grain: Dietary Guidelines Tell the Whole Grain Story www.generalmills.com/nutrition
AMARANTH BARLEY BROWN RICE BUCKWHEAT BULGUR CORN FLAXSEED KAMUT MILLET
OATS PSYLLIUM QUINOA RYE SORGHUM SPELT TRITICALE WHEAT BERRIES WILD RICE
Whole grains
Rich cultural history Nutritionally rich
– Phytochemicals – Antioxidants – Fiber – Vitamins – Minerals
COOKED AS A CEREAL GROUND INTO FLOUR POPPED LIKE POPCORN SPROUTED TOASTED
WHOLE GRAIN
Bran
“Outer shell” protects seed
• Fiber • B Vitamins • Trace Minerals
Endosperm
Provides energy
• Carbohydrate • Protein
Germ
Nourishment for the seed
• B Vitamins • Vitamin E • Antioxidants
Go with the grain www.generalmills.com/nutrition
Milling of Grains
Whole Grain
All parts milled
Refined Grain
Endosperm is milled
Germ & Bran
Go with the Grain Dietary Guidelines tell the Whole Story www.generalmills.com/nutrition
DEFINITION
ANY FOOD IN ITS RAW, UNREFINED FORM FOODS THAT CONTAIN INTACT GRAIN FOODS THAT CONTAIN THE APPROPRIATE PROPORTIONS OF ALL MILLED GRAIN CONSTITUENTS FOODS THAT CONTAINS ALL OF THE INTACT GRAIN IN EITHER A NATURAL OR RECONSTITUTED FORM
JACOB’S DEFINITION
≥25% WHOLE GRAIN or BRAN BY WEIGHT
APPROVED FDA HEALTH CLAIM
Diets rich in whole grain foods and other plant foods that are low in total fat, saturated fat, and cholesterol may reduce the risks of heart disease and certain cancers.
FDA WHOLE GRAIN DEFINITION
– Contains ≥51% WHOL GRAIN BY WEIGHT PER REFERENCE AMOUNT CUSTOMARILY CONSUMED (RACC) – MUST CONTAIN ALL OF THE COMPONENTS OF THE INTACT GRAIN AND MINIMUM OF 16 GRAMS OF WHOLE GRAIN PER RACC
DATABASE OBJECTIVES
QUANTIFY WHOLE GRAIN, BRAN, GERM ESTIMATE WHOLE GRAIN WITH AND WITHOUT BRAN AND GERM CATEGORIZE FOODS AS LOW, MEDIUM, OR HIGH WHOLE GRAIN WITH AND WITHOUT ADDED BRAN AND GERM
8 DATABASE VARIABLES
whgrn = total whole grain bran = total bran brana = added bran from wheat, oats, corn, and rice brann = natural bran = bran minus added brana germ = total germ germa = added germ from wheat germn = natural germ = germ minus added germa whsub = whole grain minus added bran and germ
CLASSIFICATION VARIABLES
whper = percentage of whole grain = whgrn/amount x 100.0 wsper = percentage of whole grain without added bran and germ = whsub/amount x 100.0
CLASSIFICATION FILES
WITH ADDED BRAN AND GERM
LOW < OR = 25% MEDIUM > 25% AND < 50% HIGH = OR > 50%
WITHOUT ADDED BRAN AND GERM
LOW 25% AND < 50% HIGH = OR > 50%
DATABASE WHOLE GRAIN FOODS
WHOLE WHEAT FLOUR WHOLE CORNMEAL WHOLE CORN FLOUR BROWN RICE FLOUR WHOLE RYE FLOUR WHOLE BARLEY WHOLE OAT FLOUR RYE BROWN RICE BULGUR POPCORN
MILLET PSYLLIUM WHEAT GERM WHEAT BRAN RICE BRAN OAT FIBER OAT BRAN OATS CORN BRAN BUCKWHEAT
GRAIN (100 G)
DRY WEIGHT (G) 89.7
WHGRN (G)
WHPER (whgrn/ amount x 100.0) 89.7
whole wheat flour
89.7
whole corn 89.1 flour oats (dry) 91.2
89.1 91.2
89.1 91.2
brown rice 89.6 (dry)
barley (dry) 90.6
89.6
90.6
89.6
90.6
rye (dry)
89.1
89.1
89.1
Dry weight = Amount (g) – H20 (g)
MAJOR WHOLE GRAIN CONTRIBUTORS
BROWN RICE COOKED OATMEAL POPCORN COLD BREAKFAST CEREALS
DATABASE REFINED FOODS
INGREDIENTS
FOODS
REFINED WHEAT FLOUR WHITE RICE WHITE RICE FLOUR DEGERMED CORNMEAL CORN FLOUR PARTIALLY DEBRANNED OAT FLOUR
WHITE BREAD ENGLISH MUFFIN BAGELS ROLLS PANCAKES WHITE RICE PASTA COOKIES DOUGHNUTS BROWNIES SWEET ROLLS PIZZA
BRAN AND GERM CALCULATIONS
REVIEW OF THE LITERATURE
AMOUNT OF WHOLE GRAIN MULTIPLIED BY PERCENTAGES OF BRAN AND GERM
INGREDIENT WHOLE %BRAN GRAIN
BARLEY 90.8 30.0
BRAN
%GERM
GERM
27.2
3.0
2.7
BROWN RICE BUCKWHEAT
BULGER CORNMEAL MILLET OATS RYE WHOLE WHEAT
89.6 91.6
91.0 88.4 91.3 91.2 89.1 89.7
7.0 8.0
9.0 5.5 8.0 30.0 12.5 14.0
6.3 7.3
8.2 4.9 7.3 27.4 11.1 12.6
2.5 4.0
2.5 11.0 17.0 5.0 3.0 2.5
2.2 3.7
2.3 9.7 15.5 4.6 2.7 2.2
100% BRAN
TYPE OF BRAN CORN OATS RICE WHEAT
DRY WEIGHT 95.3 93.4 93.9 90.1
BRAN 95.3 93.4 93.9 90.1
GERM 0 0 0 0
GRAMS PER 100 GRAMS
100% GERM
DRY WEIGHT GERM WHEAT GERM 94.4 94.4
BRAN 0
WHOLE GRAIN RECIPES
WHEAT CRACKERS 100 GRAMS Label Ingredients: whole wheat flour, enriched wheat flour, shortening, sugar, salt, corn syrup
The recipe produces 26.9 grams of whole grain, 3.8 grams of bran, and 0.7 grams of germ.
PERCENT WHOLE GRAIN = 26.9% = whper (whgrn/amount) x 100.0 = (26.9/100.0) x 100.0
Commercial bran muffin – 100 grams
Recipe: h2o 20% all purpose flour 18% bran 13.5% eggs 13% barley malt flour 10% sugar 10% soybean oil 7.2% molasses 5% honey 4% salt 1.2% YIELD 12.5 grams bran 0 grams germ 12.2 grams added bran from 13.5% bran in recipe
ADDED BRAN AND GERM CALCULATION
High added bran and germ foods
ADDED BRAN FOODS
ADDED GERM FOODS
bran muffin oat bran bread meal replacement bar breakfast cereals
cream of wheat
NATURAL BRAN AND GERM
BRANN GRAMS OF TOTAL BRAN MINUS BRANA
GERMN GRAMS OF TOTAL GERM MINUS GERMA
AMT BRAN BRANA BRAN MUFFIN Honey Oat Cereal 100.0 30.0 12.5 3.7 12.2 0.0
BRANN 0.3 3.7
GERM 0.0 3.5
GERMA GERMN 0.0 2.8 0.0 0.7
High natural bran and germ foods
NATURALLY OCCURING BRAN
NATURALLY OCCURING GERM
granola bar whole wheat oatmeal bread toasted oats shredded wheat
popcorn corn tortillas
Food
whgrn bran
brana brann germ
germa germn
fig bars
cream wheat granola bar
0.92
2.1 43.8
0.0
0.0 13.2
0.0
0.0 0.0
0.0
0.0 13.2
0.1
2.1 2.2
0.0
2.1 0.0
0.1
0.0 2.2
tortillas
bran muffin rye bread graham crackers
34.6
15.9 26.5 10.8
1.9
12.5 2.6 1.5
0.0
12.2 0.0 0.0
1.9
0.3 2.6 1.5
3.8
0.0 0.8 0.3
0.0
0.0 0.0 0.0
3.8
0.0 0.8 0.3
bran flakes
shredded wheat
19.5
43.0
8.4
6.1
6.5
0.0
1.9
6.1
0.3
1.1
0.0
0.0
0.3
1.1
Whole grain without added bran and germ
FOOD
Bran Muffin Honey Oat Cereal
whgrn
15.9 15.1
bran
12.5 3.7
germ
0.0 3.5
whper
15.9 50.3
brana
12.2 0.0
germa
0.0 2.8
whsub
3.7 12.3
wsper
3.7 41.0
Muffin = 100 grams Cereal = 30 grams
EXAMPLES CLASSIFICATION FILES
<25% WHOLE GRAIN 25-50% WHOLE GRAIN >50% WHOLE GRAIN CORN FLAKES BRAN MUFFIN APPLE CINN CHEERIOS GRANOLA BAR ALL BRAN WHEAT BREAD ALL BRAN BRAN MUFFIN APPLE CINN CHEERIOS GRANOLA BAR CHEERIOS WHEAT BREAD
NO ADDED BRAN OR GERM <25% WHOLE GRAIN
25-50% WHOLE GRAIN
>50% WHOLE GRAIN
PERCENTAGES OF WHOLE GRAIN
Foods ranged from less than 1% for fig bars to 97% for popcorn. Cold breakfast cereals varied from 0% for puffed rice to 85% for toasted oats.
PERCENTAGES OF WHOLE GRAIN WITHOUT ADDED BRAN AND GERM
Foods range from 0% whole grain without added bran and germ to 51.1% wheat bread. Cereals range from 0% for corn bran to 84.7% for cheerios.
“Changes in whole grain and bran consumption in relation to 8-year weight gain among US men”
– Characterize relation between whole grains (grams/day) and weight gain – Examine if effect of whole grain depends on >51% whole grain concentration of food sources
METHODS
Analysis
– Restricted to 27,113 men with complete predictor and outcome information (1986-1994) – Men who died or developed cardiovascular disease, cancer or diabetes excluded – Completed food frequency questionnaires in 1986 and 1994
Multivariate Linear Regression
– Examined relation between changes in whole grains (grams/day) and weight change (1986-1994)
Quantitative Whole Grain Intakes (grams/day) in Men, 1986 and 1994, Assessed for FFQ Variables (grams/day) 1986 1994 ________________________________________________ Intakes From All Foods (No exclusions for whole grain content) Mean + SD Whole Grain Added Bran 19.9 +18.4 27.2+19.2 2.2 + 6.0 5.3 +7.9
Added Germ 0.4 +1.7 0.3 +1.3 ________________________________________________ Intakes from whole grain foods per Jacobs2 Whole grain 18.4 + 18.5 24.9 + 19.0 ________________________________________________ Intakes from whole grain foods per FDA1 Whole grain 16.0 + 17.4 14.5 + 15.0
Multivariate-adjusted Mean 8-year Weight Change (kg) According to Quintiles of Changes in Whole Grain Intakes Quintiles of change in whole grain intakes (g/d) 1 3 5 P for trend*
_________________________________________________________________________
Weight Change (kg)
FDA definition2 (> 51% whole grain content) 0.96 0.96 0.69 0.002 Jacobs definition2 (> 25% whole grain or bran) 1.25 1.28 0.73 <0.0001 From all Foods 1.03 0.75 <0.0001
Weight Change (kg)1
1
Weight Change (kg)
1.24
P value, test for trend. Tests of linear trend were conducted across increasing categories of change by treating the medians of intake in categories as a continuous variable
Multivariate-adjusted Mean 8-year Weight Change (kg) According to Tertiles of Changes in Added Bran and Germ Intakes _______________________________________________ Tertiles of change in bran or germ (g/d) 1 2 3 P for trend* _______________________________________________ Added bran from all foods Multivariate-adjusted weight change (kg)a
1.16
1.09
1.00
0.01
Added germ from all foods Multivariate-adjusted weight change (kg) b 1.01 1.05 0.75 0.9 _______________________________________________
a Multivariate model simultaneously controlled for baseline and changes in added bran and natural bran b Multivariate model simultaneously controlled for baseline and changes in added germ and natural germ
CONCLUSION
FIRST STUDY TO REPORT ASSOCIATIONS FOR QUANTITATIVE ESTIMATES OF WHOLE GRAINS AND WEIGHT GAIN INCREASED WHOLE GRAIN INTAKE – LESS WEIGHT GAIN SUPPLEMENTAL BRAN ALSO REDUCES WEIGHT GAIN ADDED GERM – NO ASSOCIATION
DIETARY FIBER ENSURES DEFINITION
(11 grams X 51% X RACC)/100 = grams fiber RACC 55 grams 50 grams 45 grams FIBER 3.0 grams 2.8 grams 2.5 grams